R M Cullen MD MSc MFM BA DipStats DipProfEthics

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november 2016

preventing suicide in young elite sportsmen II

Eighteen months ago I wrote about suicide prevention in young elite sportsmen. That piece followed the deaths of two young rugby league players, Mosese Fotuaika and Alex Elisala, and then, over the long weekend celebrating Australia day, another two young players, Hayden Butler and Regan Grieve killed themselves.

In that earlier piece I suggested that there are three parts to a professional rugby league club's suicide prevention programme. The first is the club systems which make suicide risk negligible. Second is the identification of at-risk club members. Third is the internal review to ensure that those at-risk are not falling between cracks in the systems.

Since that time I have had a number of conversations with young men, aged 16-24 and I now realize that I missed something - suicide is often an expression of anger in young elite rugby league players. I have now heard this, or something very close to it, a number of times "It made me so angry I could kill myself."

Frustration is something these young men do not have to deal with on a day to day basis. Academic expectations of them are low, so low that most do not have that normal teenage stressor of external exams. They never experience the necessity of overcoming the frustration of coming to terms with new learning. Instead they are allowed to walk away from the books. For obvious reasons, given their physical attributes and elite player status they are popular and don't have the ordinary teenage frustrations of having to attract girls.

This is a group of young men who have never moved beyond the early childhood methods of dealing with frustration - get angry and then either hit or walk away.

It is my view that in many cases of completed suicide in young elite rugby league players the directing emotion is anger. Anger dissolves personality.

This suggests two more things club welfare and education officers can do to prevent suicide in young players. They can ensure that these young men (all the players in the development group) are exposed to frustration, and learn to overcome it, by insisting that their school work does make demands of them and providing adequate tutoring support. They can also devise a frustration/anger management course for the group as a whole. There are many such courses around. The key elements are learning to recognise developing frustration, learning to step back from the situation, reflection, and adjustment.