Title:

Professional sport and initial mental health public disclosure narratives

Authors and affiliations

*Dr Christopher Elsey, Faculty of Health and Life Sciences, De Montfort University, UK

ORCiD ID: 0000-0003-2997-9120

Co-authors:

Dr. Peter Winter, Faculty of Medicine, Dentistry and Health, University of Sheffield, UK

ORCiD ID: 0000-0003-0766-6297

Susan Jayne Litchfield, Faculty of Life Sciences, De Montfort University, UK

Sharon Ogweno, Faculty of Life Sciences, De Montfort University, UK

James Southwood, Faculty of Business and Law, De Montfort University, UK

*Corresponding author:

Dr Christopher Elsey, Faculty of Life Sciences, EM 6.09, Edith Murphy Building, De

Montfort University, The Gateway, Leicester, LE1 9BH; Telephone: +44 (0)116 2078812;

Email: christopher.elsey@dmu.ac.uk; Fax: n/a.

Word count:7678

Acknowledgements:

The paper is indebted to Derek Edwards who helped identify some of the media sources for

the cases and discussed some of the ideas contained in the final paper. The contributions of

Leanne Billington and Cait Mansfield to the project also require appreciation.

1
Funding:

Small internal grant paid for additional data collection and analysis by the research assistants.

De Montfort University (DMU) Frontrunner internship scheme funded contributions of James

Southwood and Susan Jayne Litchfield.

2
Professional sport and initial mental health public disclosure narratives

Abstract

The disclosure of absences from professional sporting activities to the media is a routine and

generally unproblematic part of a sporting career. However, when the reason for the absence

relates to mental health concerns, players can encounter difficulties in trying to define,

describe and conceptualise their own issues while attempting to maintain privacy as they

undergo assessment and treatment. Drawing on ethnomethodology and conversation analysis

principles and methods, this paper explores first/initial public mental health disclosure

narratives produced by players and sporting organisations across several professional sports

via media interviews, press statements, and social media posts. The analysis focuses on

(in)voluntary accounts produced by teams or players themselves during their careers and

examines the different communication strategies they employ to categorise and explain their

predicament. The analysis reveals how some players provide partial or proxy public

disclosure announcements (due to a desire to mask issues or delayed help-seeking and

assessment), whereas others prefer fuller disclosure of the problems experienced, including

diagnoses and on-going treatment and therapy regimes. The paper outlines the consequences

of these disclosure strategies and considers the implications they can have for a player’s

wellbeing in these stressful circumstances.

Keywords (=5)

Professional Sport; Mental Health Disclosure; Stigma; Sports Media; Ethnomethodology

3
Professional sport and initial mental health disclosure narratives

The disclosure of mental health issues by professional sports players and organisations have

been previously explored, and reveal how such absences are ordinarily communicated to fans

via various media channels (e.g. press statements, media interviews, team websites, social

media posts) (Elsey, 2019; Lavelle, 2020; Parrott, Billings, Buzzelli & Towery, 2019). These

studies show several barriers to disclosure that adversely impact help-seeking. For example,

timely help-seeking for mental health issues by sports players can be impacted by the fear of

revealing symptoms to other people, the negative perception of counselling as being for

'weak' people, the continued use of the dominant 'no pain, no gain' injury maxim, and the

lack of healthy coping mechanisms in response to failures (Curry, 1993; Gulliver, Griffiths,

& Christensen, 2012; Putukian, 2016). In short, the stigma of mental health in sport retains a

strong influence, especially when it comes to disclosure in male-dominated environments

(Messner, 1992; Young, White & McTeer, 1994).

In terms of mental health disclosure in the general population, previous research highlights a

range of factors that can encourage or inhibit these conversations. The process captured in the

literature outlines the possibility of 'selective', partial or gradually evolving disclosures in

which an individual can devise a plan based on their own disclosure preferences which sets

out 'what can and should be disclosed and to whom, and of what and when it is advisable to

conceal' (Bril-Barniv, Moran, Naaman, Roe & Karnieli-Miller, 2017, p. 9; Pahwa, Fulginiti,

Brekke & Rice, 2017). These decisions to disclose (as well as involuntary or 'forced

exposures') apply to encounters with family members, friends, and within workplaces and

healthcare settings (Bril-Barniv et al., 2017; Pahwa et al., 2017).

In the media-oriented context of professional sport another layer of disclosure recipients is

added: the public as an ‘over-hearing audience’, via journalists (Heritage & Clayman, 2010).

4
The reporting of a player's health status is a structured and organised feature of sports ‘media

strategies’ from press conference announcements to teams publicly available 'injury reports'

(Armstrong, Delia & Giardina, 2016; Smith & Keeven, 2019). In terms of welfare issues, for

players and teams, the difficulty stems from managing these competing interests.

The disclosure of mental health issues within professional sport has received a noticeable

increase in media coverage. In part, this trend has been interpreted by players and the media

as an eroding of the stigma associated with mental health issues within sporting circles

(Elsey, 2019; In Submission; Lavelle, 2020; Parrott et al., 2019), as well as reflecting wider

societal trends towards promoting the 'parity of esteem' between physical and mental health

(The King's Fund, 2017).

The process of diagnosis and treatment of any injury revolves around the medical and sports

science staff employed by clubs and associations. Common and typical physical injuries can

be diagnosed and treated, with clear and relatively unambiguous details released to the public

via the media (e.g. nature/cause of injury, treatment details, approximate timeframe for

return) (Sanderson, Weathers, Grevious, Tehan & Warren, 2016). However, in comparison,

the diagnosis of mental health conditions can be complicated and protracted. As a result,

differential or provisional diagnoses can be put in place and be subject to change with further

assessment and information. This points to delayed diagnosis, from the initial onset of

symptoms to the commencement of appropriate treatment and management of the presenting

issues (Wang et al., 2005). This extended process can include delays in help-seeking (Souter,

Lewis & Serrant, 2018), problems accessing services (Royal College of Psychiatrists, 2018)

and misdiagnosis (Wang et al., 2005).

The focus of this paper is to examine a player’s absence in relation to mental health

disclosure: how does their disclosure become a matter of public/media interest? And how are

5
diagnoses attributed as the 'official' reason for a specific public disclosure? In this study, we

present an original contribution to research on professional sport and communication which

showcases how players (whether personally or via their sporting agent, club or association)

provide the first or initial public disclosure of mental health issues to account for their

absence from competition in the form of 'coming out' announcements (Corrigan & Matthews,

2003; Lavelle, 2020; Parrott et al., 2019). One critical aspect of these disclosure narratives is

their social and interactional organisation e.g. Who is told what, when and how? (Sacks,

1995).

A recurrent feature of these first announcements is the issue of timing of the public

disclosure. These can be accelerated (compared to non-sporting contexts) and delivered at the

time of the absence or withheld until retirement (Elsey, 2019; Elsey, In Submission; Lavelle,

2020; Parrott et al., 2019). This, in part, relates to whether the player/team were aware of the

(eventual) mental health diagnosis at the time of the various communications (e.g. routine

press conferences with injury updates). The timing aspect also relates to the degree of

openness or transparency that a sportsperson feels comfortable with when dealing with the

media (Reng, 2011). One potential issue in the professional sporting context is that accurate

mental health diagnosis and competitive schedules are not necessarily aligned in that a

'reason' for an absence is always pursued by the media and the public. This can result in

partial, delayed, and gradual public disclosure, and can ultimately lead to complications and

unwanted knock-on effects (e.g. invasive fan and media interest). Another background factor

that may impact a player's willingness to speak openly relates to how information about their

mental health could negatively affect future employability i.e. will teams be less likely to give

them a contract (Bauman, 2016; Merz et al., 2019).

While there is a growing body of sociological literature on the wider debates and

consequences of disclosure, little is known about players' disclosure practices across the

6
diverse range of (sports) media texts. This article aims to address this gap by exploring the

actual statements of disclosure by professional sports people and organisational

representatives (e.g. coaches, teams, law enforcement) allowing for a more fine grained

analysis of the evolving processes of announcing disclosures.

Methods

This research employs the principles and methods of ethnomethodology and conversation

analysis (CA) in order to examine official public statements produced by players, players'

agents and their clubs or organisations (Garfinkel, 1967; Lynch, 2007; Sacks, 1995). These

modes of analysis focus on the accounting practices used in these contexts that provide a

public and ‘inferentially-rich’ official reason for absence on the record (Sacks, 1995).

As part of our analysis, 7 case studies of professional sports players were selected from

prominent sporting figures (Denison, 1996). These include British football/soccer (Lenny

Pidgeley), American Football (Everson Griffen; Brandon Brooks; Brandon Marshall), cricket

(Marcus Trescothick; Sarah Taylor), and Basketball (Imani Boyette). Cases reflected

different diagnoses (i.e. stress, depression, anxiety and borderline personality disorder). In

this study, mental health was defined as any common psychological or psychiatric conditions

which received formal diagnoses (e.g. anxiety, stress, depression, bi-polar disorder,

schizophrenia, borderline personality disorder, etc). We selected these cases on the basis of

whether the mental health issues had an impact on the player's on-going career were disclosed

during their career, thereby excluding cases disclosed post-retirement (Schwenk, Gorenflo,

Dopp & Hipple, 2007). Comparison was made between team-led disclosure (where a team

employee speaks on behalf of a player) and player-led disclosure (where a player voluntary

discloses in their own words) to explore the variety of media disclosure practices and the

implications of the strategies.

7
We then constructed a retrospective 'mental injury' timeline for each case. 1 The timelines

capture the prospective-retrospective nature of the accounts as provisional, changeable, and

evolving (Elsey, 2019; Lavelle, 2020; Stokoe & Attenborough, 2015). The timelines utilise

official or authorised public announcements about a player's mental health using a range of

public-facing media sources (e.g. media interviews, press statements and conferences, social

media, (auto)biographies, sports media websites). Analysis then retrospectively/prospectively

tracks when and how mental health is referred to in relation to player's participation in

competitive fixtures (i.e. past, present and future appearances). In particular, this study

focuses on the first known disclosure of a player’s mental health situation which occur during

their career. For audio-visual sources, transcripts were produced using the CA transcription

conventions to represent the interactional features of the original recordings (Jefferson,

2004). In doing so, we analyse and compare the following features of the 'mental injury'

timelines and ask the following questions:

 What was the context of the first known disclosure? Why was the disclosure made

now?

 Who performs the disclosure?

 What platform was used to release the information and what form did the disclosure

take? (e.g. personal/team social media posts, press statement, press conference, media

interviews etc)

 What was the impact and consequences of the disclosure for the player?

We encourage readers to view available videos alongside the analysis.

Results

Team-Led Disclosures

8
Analysis begins with two contrasting cases in which the sporting organisation or team

discloses a player’s mental health issues to the media on behalf of the player with or without

their permission.

"Outed" by the team. The first case is based on Farnborough Football Club’s (FC)

statement regarding Lenny Pidgeley (Case 1 in the supplementary timelines). Pidgeley was a

goalkeeper who started his career in 2002 with Chelsea FC in the English Premier League

before finishing his career in the semi-professional leagues with Farnborough FC. Pidgeley

retired in September 2018 due to ongoing difficulties related to depression. Pidgeley had

suffered from bouts of depression throughout his career (notably while at Millwall between

2006-9, Newport County 2012-2015 and Margate FC in 2017) but he felt it was a 'private

matter' and therefore he 'was never, ever going to speak in public about it' (Pearlman, 2018).

Here we present how the player’s disclosure preferences (i.e. to withhold his medical history

from fans) are framed using public/private or front-stage/back-stage distinctions, and as

revealed involuntarily against his wishes (Goffman, 1990a, 1990b).

On 12 September 2018 Farnborough FC, via their official team website, announced

Pidgeley's retirement from football with immediate effect due to, what they defined as, a

'significant long term personal medical condition' in the lead up to an FA Cup match against

Lewes. Pidgeley reacted angrily to this disclosure on Twitter:

I've never talked about my depression in the last 10 years ... but after that club

statement [the issue] seems to be out the bag.

To try to clear up the argument between club and player, Farnborough released a second

statement (14 September) to 'clarify' the original announcement:

9
 With no goalkeeper available that night we owed the fans an explanation [why

midfielder CJ Fearn played as goalkeeper] before kick-off ... [The] Club fully backs

the support and care required in dealing with all mental health issues and meant no

harm to Lenny and sincerely apologise for any hurt.

This second official club statement was also subsequently deleted from the club website.

What is noticeable from this ‘forced exposure’ is how player welfare and confidentiality are

depicted as being at odds with the public interest (i.e. the team ‘owed the fans an explanation’

for the goalkeeping problems) to account for team selection and player absences before a

match. In a BBC interview two days later Pidgeley expressed his anger and distress that the

club had effectively 'outed him' without his permission and consent, a clear breach of trust:

Pidgeley said he is upset he did not get to decide if he went public with his illness,

even revealing that close family members, including his own mother, were unaware of

his plans to retire. ‘When the statement came out, it put me in a dark place. The way

the club have conducted themselves is not right...They mentioned my illness, which I

have never been comfortable talking about. For 10 years I've tried to keep it

undercover...I have never wanted this to come out, never ever’. (Pearlman, 2018)

While not specifically mentioning his 'depression' Farnborough's actions broke Pidgeley's

confidentiality and essentially 'outed' him by forcing him to address the club's revelations

about his health. Although the club is semi-professional this example provides many lessons

about public relations and the negative impact it can have on mental health. What is clear is

that, where possible, teams must consult players about their disclosure/concealment

preferences before releasing public statements.

10
The second team led disclosure case reveals a very different set of circumstances in which

mental health issues are made public by sporting organisations where the team is responding

to specific events or incidents.

Law enforcement: Police enforced psychiatric/psychological evaluation. The

disclosure of mental health difficulties can also relate to circumstances in which players are

detained by law enforcement officers. Under police protection, players (like any citizen) may

be admitted for psychiatric evaluation due to safety concerns for the individual and/or the

public. In contrast with Pidgeley’s case (private/backstage issues), the visible/public

manifestation of a player’s problems forces their organisation to make press statements (with

the agreement of a player and/or player’s family) in order to respond to the unfolding

situation. These very public help-seeking behaviour can point to a currently undiagnosed and

untreated psychological issue.

The mental injury timeline of American Footballer Everson Griffen (Case 2) began with

unusual and 'erratic' behaviour around 16 September 2018 according to his wife. On 20

September 2018 the Minnesota Viking's reportedly sent Griffen a letter stating that he would

not be welcome at training until he underwent a mental health evaluation following recent

verbal outbursts at training. Two days later Griffen was detained by the local Minnetrista

Police Department (in Minnesota) under a 'health and welfare hold' and escorted to a mental

health facility for evaluation. The Department's incident report documented Griffen's

behavior during his detention as not 'acting normal', ‘sleep deprived’, 'delusional', 'paranoia',

'rapid speech', 'irrational', 'rambling' and 'repeating himself' (Graff, 2018).

On the day of his detainment (22 September 2018) Griffen was sent away from training,

before causing a 'disturbance' at the hotel where he was temporarily staying. Griffen then

allegedly broke into the house of a teammate and accosted a man at a petrol station (who

11
drove him home). Neighbours contacted the police after observing Griffen outside his house

yelling (‘777’ and how ‘God made me do it’). One officer reported that Griffen had

mentioned being afraid of people trying to kill him. While Griffen eventually agreed to attend

hospital the officer in charge still produced a 'hold form' and paramedics were called. On

route to hospital Griffen escaped from the ambulance and more police officers were called to

assist. Eventually persuaded to return to the ambulance, the vehicle was followed by a police

officer (with Griffen's permission) to make sure Griffen arrived at his destination. The police

dashboard camera which recorded this event was leaked to the media a few weeks later

(TMZ, 2018). The official outcome of the situation was that 'no criminal charges [were]

forthcoming'.

Two days later the team would issue a statement on behalf of the player (technically the first

official disclosure). This announcement represented a ‘forced exposure’ given the recent very

public and visible conduct of the player and was announced as part of the team’s weekly

injury report (Bril-Barniv et al., 2017). In this case it is the timing of the announcement that is

involuntary in nature. The Viking's General Manager Rick Spielman stated that:

"We are aware of the situation involving Everson Griffen and certainly concerned by

what we have heard. We are currently focused on Everson's well-being and providing

the appropriate support for him and his family." (Graff, 2018)

Notably, beyond reference to ‘the situation’ in the team’s announcement there was no

mention of any specific details of the incident. While Griffen was assessed his absence was

officially recorded as a 'personal matter'/'not injury related' and he would miss the next five

games. On the 27 September Griffen posted on Instagram revealing that he was 'resolving

personal issues'. However, no formal diagnosis was made public. In April 2020 his agent,

Brian Murphy, revealed that:

12
 After five weeks of work and evaluation [in September 2018], the doctors concluded

Everson's erratic behavior resulted from significant unresolved emotional distress,

emotional incongruence and a lack of healthy coping skills (Pelissero, 2020).

The interview also stated that other significant psychological and psychiatric diagnoses had

been ruled-out.

Player-Led Disclosures

Compared with team-led announcements, player-led mental health disclosure narratives are

informed by a different set of considerations. While disclosure preferences and match

schedules remain relevant, a major factor impacting what is revealed at a specific moment in

time is diagnostic certainty.

Mental health issues pre-dating sporting career. The first player-led case

represents a unique context in which a player's own volition results in a public disclosure.

Imani Boyette, nee McGee-Stafford, was the latest of a long line of successful female

basketball players in her family (Case 3). Boyette joined the Texas Longhorns (University of

Texas) on a college scholarship in November 2011 where she enjoyed four successful

seasons between 2012-2016 (Berkman, 2016). During this time Boyette was reported to have

had only one significant time away from basketball to recover from ankle surgery (Texas

Longhorns Online, 2014).

On 27 February 2015 the team announced that Boyette would be appearing on an ESPN show

in a feature entitled ‘Her Voice’ (Broadcast 1 March 2015). The 7-minute video features both

snippets of Slam Poetry read by Boyette and interviews with Boyette and her father Kevin

Stafford about her career trajectory, suicide attempts, molestation (‘I’m a suicide survivor,

I’m a molestation survivor’), and how she was able to manage these traumatic experiences

13
through Slam Poetry (‘found solace in words’). Below is an excerpt from the video which

represents the first time Boyette’s history of suicide attempts and molestation was disclosed

to the public via the words of its narrator, including her own account of the third suicide

attempt before University:

Imani was a ten-year-old struggling with her parents' divorce when she first attempted

suicide. In high school she would try twice more. Her third attempt came upon the

realisation that as a child she had been molested by a family member -- ‘I started

having really bad nightmares and just remembering things that I had probably

repressed or had not really been aware of […] I lashed out, I was like a walking cry

for help. I got suspended from high school- there was a lot happening at that time. I

overdosed and went to the Hospital and I was committed for [Pause] about, almost

two weeks? And that was a lot- I basically took a really long look at myself because I

had everything at high school it was really easy to me and I almost threw it all away’.

The video covered various traumatic experiences, including her parents' divorce, the history

of sexual molestation [which occurred between the ages of 8 and 12] and three suicide

attempts. There was no explicit mention of mental illness or depression to account for the

suicide aspect of the narrative. The inferences and upshots of the video are that her traumatic

experiences were tied to mental illness. In its aftermath, the video prompted an engagement

with the media and interviews with Boyette soon followed allowing her to explicitly disclose

her battle with mental health issues (see Berkman, 2016; Foster-Brasby, 2017; Martinez,

2018). Her clinical depression and suicide attempts followed the period of abuse. In a

newspaper interview Boyette disclosed her mental health experiences more explicitly:

"In terms of just mental illness and depression, you don't think there's an end (to the

suffering). To be here now and see the other side and remember what it felt like when

14
 I was in it, I just want to grab people and say, 'Please just hold on!'" (Thompson,

2016)

Analysis of interviews with Boyette by Vertuno (2015), Martinez (2018) and Berkman

(2016) of the Associated Press, Daily Texan and New York Times respectively reveals that

there were six key moments of ‘backstage’ disclosure prior to the initial public disclosure,

which require separate consideration in future analysis. What is clear from this case is that

Boyette’s diagnostic certainty (along with the long-term treatment and therapeutic support)

meant that she was able to ‘choose’ the timing of her disclosure and felt comfortable enough

to share concrete and unambiguous details of her experiences.

Delayed help-seeking and diagnosis. A frequently reported problem associated with

professional sport and mental health is significant and consequential delays in seeking

medical help, which can impact the clarity and certainty of information made public (Gulliver

et al., 2012; Sacks, 1995; Souter et al., 2018). The contrasting experiences of NFL players

Brandon Brooks and Brandon Marshall illustrate some of the important factors involved.

For Brandon Brooks (Case 4), ritualistic pre-game routines had been misinterpreted and

misdiagnosed throughout his college and professional career, whereby his sickness was seen

as a purely physical problem (and treated as such), rather than it being understood to be

symptomatic of his anxiety. Prior to his public disclosure (via a locker room interview

following training) in the 2016 season Offensive Guard Brooks had missed two out of three

Philadelphia Eagles games (against the Green Bay Packers and the Washington Redskins)

because of his anxiety and four NFL games across his career (including 2 years at the

Houston Texans). At the time the official reasons provided to the media for these missed

games was that he had suffered from 'stomach ulcers' or 'pains', uncontrollable vomiting and

15
severe dehydration, which had led to him being hospitalised (Kapadia, 2017). This unusual

and recurrent behaviour (throwing up right before his games to ‘feel better’) eventually drew

the attention of the Eagles’ doctors who sought to identify the cause of the problem.

After missing the game against the Washington Redskins in December 2016 Brooks opened

up about his battle with anxiety in a short interview:

INSERT TABLE 1 HERE

Brooks' candid interview outlines when the diagnosis was made (‘recently’ - line 1), as well

as the nature of his ‘anxiety condition’. His description of his issues reveals how this type of

‘unhealthy obsession’ goes beyond the expected level of pre-game ‘nervousness or fear’ and

therefore required medical support (lines 2-8). This key message is then reiterated (lines 8-

10), before Brooks thanks his team, organisation, and coaches for their support. Furthermore,

he states that this type of issue is ‘nothin' I’m ashamed of...I own it’ (lines 14-15). Brooks

would repeat this message to educate, tackle and support other people in future interviews

(Erby, 2019). This desire to speak out comes from a 'dark place' (recall Pidgeley's language

about the impact of his 'outing' on his health) in which Brooks admitted that the anxiety made

him miserable to the extent that he considered retirement (Friedman, 2018).

In contrast, NFL wide-receiver Brandon Marshall's (Case 5) delayed mental health diagnosis

of Borderline Personality Disorder (BPD) was dramatically different as his behaviour directly

impacted others and crossed criminal boundaries. Clearly Marshall's case shares some

similarities with the domestic violence case of Ray Rice (Smith & Keeven, 2019) who also

had a history of misdemeanours throughout his football career. However, Marshall would

later attribute these actions to his BPD. Marshall's chaotic off-field life included (alleged)

theft, damage to property, being drunk and disorderly, assaulting police officers, resisting

arrest, and domestic violence (Jones & Klis, 2011). Marshall's problems came to a head in

16
2011 when he was reportedly stabbed by his fiancée in self-defence. Around this time

teammate Ricky Williams recommended that Marshall seek professional help at the Mclean

Psychiatric Hospital (Jaslow, 2011).

At a press conference on 31 July 2011 Marshall announced that he had been diagnosed with

BPD and was undergoing treatment. Marshall revealed his entire professional career and

adult life had been marred with symptoms that left him unhappy, despite his (successful) life.

he pleaded with the media to ‘tell my story in an accurate way’ (line 1). During his treatment

Marshall reported that he had learned to deal with the consequences of his actions that were

influenced by his BPD. Before his diagnosis he was known as ‘The Beast’ and seen as a

deviant, but the diagnosis of BPD offered an alternative explanation for his behaviour and

altered the perception of his past actions. This chimes with Smith's (1978) analysis of how

single instances of potentially mental disordered actions are perceived as being connected,

and therefore each new instance interpreted as indicative of an underlying problem. Marshall

spoke out about his diagnosis in the hope that it would end the stigma attached to the

condition and to raise awareness and understanding, to encourage others in a similar situation

to seek the appropriate support (lines 2-3).

INSERT TABLE 2 HERE

"Cover-up" - proxy/surrogate terms. The next case looks at England international

cricketer Marcus Trescothick (Case 6). Unlike the cases of Brooks and Marshall, where

alternative explanations (e.g. physical sickness or deviant behaviour) were originally

employed as their mental health diagnoses had yet to be determined, Trescothick’s diagnosis

had already been established. However, in Trescothick’s case he was reluctant to disclose

details of his mental health to the media and the public. When he did eventually disclose,

Trescothick opted to employ a surrogate term ('virus') in place of a mental health diagnosis.

17
At the time his mental health issues were deteriorating, Trescothick was vice-captain of

England and an experienced opening batsman. However, Trescothick’s international career

was prematurely ended by depression and anxiety (undiagnosed at the time) that took hold

during England's tour of India in February 2006 (see Elsey (in submission) for full timeline

and analysis). During the tour the England and Wales Cricket Board (ECB) provided various

reasons to account for his absence from tour games ('migraine') and his early return to the UK

for 'family, personal reasons' on 25 February 2006. The unintended consequences of using

surrogate terms to gloss Trescothick's situation produced rumours in the UK media (e.g. his

wife's post-natal depression, extra-marital affairs) and caused a great deal of distress for him

and his family.

Around 6 weeks after his return to the UK (and subsequent medical consultations)

Trescothick decided that he needed to set the record straight about his exit from the tour. The

ECB and his agent arranged a choreographed interview with Sky Sports journalist (and

friend) Ian Ward. All questions were pre-screened and Trescothick's answers rehearsed. In

his autobiography, Trescothick reveals that, when he was prompted to account for his

departure by the journalist, he had agreed to state that he left the tour as a result of having

picked up a virus and also some personal issues to resolve to which he then ‘decided to return

home...’ (Trescothick, 2008, p. 227). This was meant to be the first step in his evolving

disclosure that was in line with his on-going therapy and treatment for depression (Lavelle,

2020). An excerpt from the interview transcript is below:

INSERT TABLE 3 HERE

Trescothick’s (2008) autobiography revealed how the pressure of discussing his 'personal'

situation in public (let alone disclosing the under-lying psychological issues that he was

addressing in private) led to him panicking and retreating to offering a purely physical

18
explanation for his return (‘I picked up a bug’) (lines 2-3). This answer would further deepen

the media suspicion with former cricketers critical of the baffling logic behind the ECB's

reluctant non-disclosure of a 'virus'. It would not be until September 2006 that the ECB

would release a statement drafted by Trescothick (2008, p. 299-300) and his psychologist

stating that:

In addition to the deleterious effects of the acquired gastrointestinal infection on his

health, it later became evident that he was also suffering from an underlying stress-

related illness.

This case raises many important questions. What should the ECB, the England management,

Trescothick and his agent have done differently to protect the player's welfare and well-being

when formulating and going public with the disclosure? The example of England cricketer

Sarah Taylor (Case 7) a decade later points to a model of good practice. On 16 May 2016 the

ECB announced that

“Sarah is taking a break from cricket at the moment having decided to take some

personal time away from the game. We will support her, keep in touch and talk with

her prior to selection for the Pakistan series and the start of the Kia Super League."

(BBC, 2016)

The BBC and Guardian paraphrased this statement as the wicketkeeper/batsman taking an

‘indefinite break [for] personal reasons’. What happened next was a remarkable and

significant next step. Weeks later on 8 June 2016 the ECB would release a one-to-one media

interview of Taylor openly discussing her back story, diagnoses (‘best part of four years I've

been suffering with anxiety’), how it was impacting her batting (‘There have been times

when I've had to run off into the changing rooms and be sick sometimes, just through like

sheer panic’), and details of her treatment (‘Cognitive Behavioural Therapy... talking through

19
the struggles that I have on a regular basis and...my thought processes’). Like Brandon

Brooks, Taylor also articulated her desire to tackle the 'stigma' surrounding the issues, saying

‘I don't want any stigma attached with any kind of anxiety, depression, mental um health, or I

call it mental injury...other people are going through the same thing, it's okay, and it's normal’

(Elsey, 2019). Interestingly the interviewer mentions how in recent years prominent England

cricketers have disclosed their own mental health issues and Taylor responded by applauding

those 'coming out' and how it undermines the perceived stigma.

Discussion

This paper captures seven mental health disclosure discourses drawn from different

professional sport contexts. The public nature of this workplace means that the disclosure of

players' mental health issues takes place in the public eye and any personal concealment

preferences cannot always be factored into the decision-making process (Bril-Barniv et al.,

2017; Pahwa et al., 2017). The mental injury timelines that we analyse show how these

reasons vary quite profoundly. Therefore, it is important to recognise the circumstances in

which the disclosure occurs as this informs the reasoning and language used in any

announcement. Cumulatively the cases display how these barriers to help-seeking and delays

in diagnosis are not perfectly suited to 24/7 worldwide media coverage that increasingly

dominates professional sport and makes players’ careers and health visible and publicly

accountable (Boyle, 2006; Steen, 2015).

One common factor across all the cases is the need to account for any absence from

competition, which can accelerate the process of disclosure of mental health issues and force

players and organisations to make public statements in line with routine media appearances

scheduled during the playing season. For players and team staff the content, timing and

platform of any statement or announcement requires close consideration and agreement as

20
part of a reflexive ‘media strategy’ (Armstrong et al., 2016; Smith & Keeven, 2019). This

analysis raises questions about best practice in this context. While there is no single model of

best practice that can be employed under all circumstances, based on the case studies

presented here it is possible to outline some recommended disclosure practices.

In terms of the ‘timing’ of any announcement a player’s personal preferences cannot always

be adhered to. For example, Imani Boyette was not known to be under any external pressure

to reveal her depression and was able to decide when and how to disclose. In contrast, for

Lenny Pidgeley (whose personal preference to conceal his depression was complied with by

all his football clubs) his mental health issues were inadvertently and involuntarily revealed

by his final club without his permission. These matters are critically important as they can

‘impact outcomes in the context of mental illness' and Pidgeley’s case should therefore serve

as a stark lesson for sporting organisations (Pahwa et al., 2017, p. 583). However, sometimes

players and teams cannot manage the timing of an announcement, particularly where law

enforcement is involved. The very visible and public conduct of Everson Griffin in which he

was considered a threat to himself and others was caught on video camera and therefore

accelerated the team’s disclosure announcements.

Another major consideration is the ‘content’ of the disclosure. The cases of Sarah Taylor and

Imani Boyette suggests that (when possible) players should speak plainly and frankly in these

circumstances. To minimise unwanted scrutiny and speculation from the media and fans,

players and/or teams should seek to provide factual and accurate explanations for absences

due to mental health, including, where appropriate, symptoms, diagnoses, and treatment. In

part, this speaks to players' responsibility as public role models who educate, advocate and

promote mental health literacy and awareness (Corrigan & Matthews, 2003; Pahwa et al.,

2017; Parrott et al., 2019). The goal is for culture change in sport and wider society so that

21
talking openly and honestly about mental health is ‘normalised’ (Charlesworth & Young,

2006; Curry, 1993; Young et al., 1994).

However, this study also reveals that barriers to the normalisation of mental health disclosure

continues to remain. For example, the complexity of accomplishing a mental health diagnosis

and its diagnostic uncertainty can make it difficult for players to feel able to speak coherently

and knowingly of their situation. The case of Marcus Trescothick (2008) provides a

cautionary example of how ambiguous language, such as surrogate terms like

‘personal/family issues’, to refer to mental health matters can be misleading for the media

and public and result in further unwanted scrutiny that has negative psychological effects.

This study also raises vital questions about patient confidentiality and media ethics.

Marrying the needs and welfare concerns of players and the 'public interest' is not always

satisfactorily achieved in which the competing interests of coaches, team-mates, team

medical staff, media and fans can place pressure on players to ‘hide’ their mental health

issues and play through them (Charlesworth & Young, 2006; Greenslade, 2019; Reardon et

al., 2019).

Players and teams should consider where to draw lines or mark boundaries between public

and private matters in which players rights under disability legalisation might be systemically

undermined. One consideration linked to this is that due to the persistence of stigma, mental

health issues can (hypothetically) impact a players chances of being offered a contract and the

monetary value of these agreements (Merz et al., 2019). This speaks to a critical question of

how organisations speak and act on behalf of players in the digital age (Armstrong et al.,

2016).

Limitations

22
 By almost exclusively relying on publicly available data this study is limited to the

inferences that can be drawn from such announcements. It is therefore critical that the views

of players, coaches, media workers and the like are sought in order to assess their personal

motivations, intentions and rationale for these key decisions. Furthermore, the case study

approach adopted has relied upon a small number of examples to illustrate key features of

disclosure narratives. More comparative work along these lines is needed, as is a close

examination of the gendering of disclosures.

Notes
1
The complete mental injury timelines for each case study, containing key dates, events and

media sources can be downloaded here:

https://dmu.figshare.com/articles/dataset/Elsey_et_al_-_Communication_Sport_article_-

_Supplementary_Materials_-_Mental_Injury_Timelines/13121969

23
 References

Armstrong, C. G., Delia, E. B., & Giardina, M. D. (2016). Embracing the social in social
media: An analysis of the social media marketing strategies of the Los Angeles Kings.
Communication & Sport, 4(2), 145-165. https://doi.org/10.1177/2167479514532914
Bauman, N. J. (2016). The stigma of mental health in athletes: Are mental toughness and
mental health seen as contradictory in elite sport? British Journal of Sports Medicine,
50(3), 135-136. https://doi.org/10.1136/bjsports-2015-095570
BBC. (2016, May 16). Sarah Taylor: England keeper-batter takes indefinite break for
personal reasons. Retrieved from http://www.bbc.co.uk/sport/cricket/36301437
Berkman, S. (2016, April 13). Stronger bond with mother helps Texas star follow in her
footsteps. The New York Times. Retrieved from
https://www.nytimes.com/2016/04/14/sports/basketball/imani-boyette-may-soon-
follow-mother-into-wnba.html
Boyle, R. (2006). Sports journalism: Context and issues. London: Sage.
Bril-Barniv, S., Moran, G. S., Naaman, A., Roe, D., & Karnieli-Miller, O. (2017). A
qualitative study examining experiences and dilemmas in concealment and disclosure
of people living with serious mental illness. Qualitative Health Research, 27(4), 573-
583. https://doi.org/10.1177/1049732316673581
Charlesworth, H., & Young, K. (2006). Injured female athletes: Experiential accounts from
England and Canada. In S. Loland, B. Skirstad, & I. Waddington (Eds.), Pain and
injury in sport: Social and ethical analysis (pp. 89-106). London: Routledge.
Corrigan, P., & Matthews, A. (2003). Stigma and disclosure: Implications for coming out of
the closet. Journal of Mental Health, 12(3), 235-248.
https://doi.org/10.1080/0963823031000118221
Curry, T. J. (1993). A little pain never hurt anyone: Athletic career socialization and the
normalization of sports injury. Symbolic Interaction, 16(3), 273-290.
https://doi.org/10.1525/si.1993.16.3.273
Denison, J. (1996). Sport narratives. Qualitative Inquiry, 2(3), 351-362.
https://doi.org/10.1177/107780049600200307
Elsey, C. (2019). Mental health disclosure in the public eye: Accounting for and managing
absences from professional sporting competition. Qualitative Research in Sport,
Exercise and Health, 11(4), 435-459.
https://doi.org/10.1080/2159676X.2018.1564691
Elsey, C. (In Submission). "Cover-up"? The avoidance of mental health disclosure in
professional sport media interviews. Journal of Sport and Social Issues.
Erby, G. (2019, April 11). Eagles Brandon Brooks opens up about his struggles with anxiety;
recovery from injury. Eagleswire. Retrieved from
https://theeagleswire.usatoday.com/2019/04/11/eagles-brandon-brooks-anxiety-battle/
Foster-Brasby, T. (2017, May 31). Atlanta Dream center Imani McGee-Stafford is helping
break taboo on mental illness. Retrieved from
https://theundefeated.com/features/atlanta-dream-center-imani-mcgee-stafford-
mental-illness-taboo/
Friedman, J. (2018, December 11). Eagles: Anxiety not stopping Pro Bowl guard Brandon
Brooks anymore. Courier Post. Retrieved from
https://eu.courierpostonline.com/story/sports/nfl/eagles/2018/12/20/eagles-brandon-
brooks-overcomes-anxiety-make-consecutive-pro-bowls/2367884002/
Garfinkel, H. (1967). Studies in Ethnomethodology. Cambridge: Polity.
Goffman, E. (1990a). The presentation of self in everyday life. London: Penguin.

24
Goffman, E. (1990b). Stigma: Notes on the management of spoiled identity. London:
Penguin.
Graff, C. (2018, September 25). Police report: Everson Griffen went to hospital voluntarily
after incidents raised concerns for his mental health. The Athletic. Retrieved from
https://theathletic.co.uk/547740/2018/09/25/everson-griffen-hospital-mental-health-
evaluation-vikings/
Greenslade, R. (2019). Murdoch gazes at a setting Sun. British Journalism Review, 30(2), 21-
31. https://doi.org/10.1177/0956474819855544
Gulliver, A., Griffiths, K. M., & Christensen, H. (2012). Barriers and facilitators to mental
health help-seeking for young elite athletes: A qualitative study. BMC Psychiatry,
12(1), 157. https://doi.org/10.1186/1471-244x-12-157
Heritage, J., & Clayman, S. (2010). Talk in action: Interactions, identities, and institutions.
Oxford: Wiley-Blackwell.
Jaslow, R. (2011, August 1). Borderline personality disorder blamed for Brandon Marshall’s
troubles. CBSNews.com. Retrieved from https://www.cbsnews.com/news/borderline-
personality-disorder-blamed-for-brandon-marshalls-troubles/
Jefferson, G. (2004). Glossary of transcript symbols with an introduction. In G. Lerner (Ed.),
Conversation Analysis: Studies from the First Generation (pp. 13-31). Amsterdam:
John Benjamins.
Jones, L. H., & Klis, M. (2011, April 23). Brandon Marshall’s troubled timeline. Retrieved
from https://www.denverpost.com/2011/04/23/brandon-marshalls-troubled-timeline/
Kapadia, S. (2017, October 6). How Eagles guard Brandon Brooks blocked anxiety from
consuming him. The Athletic. Retrieved from
https://theathletic.com/119662/2017/10/06/how-eagles-guard-brandon-brooks-
blocked-anxiety-from-consuming-him/
Lavelle, K. L. (2020). The face of mental health: Kevin Love and hegemonic masculinity in
the NBA. Communication & Sport. Advance online publication.
https://doi.org/10.1177/2167479520922182
Lynch, M. (2007). The Origins of Ethnomethodology. In S. Turner & M. Risjord (Eds.),
Philosophy of Anthropology and Sociology (pp. 485-515). Amsterdam: Elsevier.
Martinez, J. (2018, April 19). A brighter day: How Imani McGee Stafford found light in
darkest of times. The Daily Texan. Retrieved from
https://thedailytexan.com/2018/04/18/a-brighter-day-how-imani-mcgee-stafford-
found-light-in-darkest-of-times
Merz, Z., Perry, J., Hansen, A., Montgomery, T., Shulze, J., & Ross, M. (2020). The cost of
mental illness: The public’s derogation of athletes with psychological distress. Stigma
and Health. Advance online publication. https://doi.org/10.1037/sah0000213
Messner, M. A. (1992). Power play: Sports and the problem of masculinity. Boston, MA.:
Beacon Press.
Pahwa, R., Fulginiti, A., Brekke, J. S., & Rice, E. (2017). Mental illness disclosure decision
making. American Journal of Orthopsychiatry, 87(5), 575-584.
https://doi.org/10.1037/ort0000250
Parrott, S., Billings, A. C., Buzzelli, N., & Towery, N. (2019). “We all go through it”: Media
depictions of mental illness disclosures from star athletes DeMar DeRozan and Kevin
Love. Communication & Sport. Advance online publication.
https://doi.org/10.1177/2167479519852605
Pearlman, M. (2018, September 14). Lenny Pidgeley: Goalkeeper angry after illness is
revealed by former club. BBC Sport Wales. Retrieved from
https://www.bbc.co.uk/sport/football/45527016

25
Pelissero, T. (2020, April 10). Free agent Everson Griffen says 2018 incident changed his
life. NFL.com. Retrieved from https://www.nfl.com/news/free-agent-everson-griffen-
says-2018-incident-changed-his-life-0ap3000001109048
Putukian, M. (2016). The psychological response to injury in student athletes: A narrative
review with a focus on mental health. British Journal of Sports Medicine, 50(3), 145-
148. https://doi.org/10.1136/bjsports-2015-095586
Reardon, C. L., Hainline, B., Aron, C. M., Baron, D., Baum, A. L., Bindra, A., Budgett, R.,
Campriani, N., Castaldelli-Maia, J. M., Currie, A., Derevensky, J. L., Glick, I. D.,
Gorczynski, P., Gouttebarge, V., Grandner, M. A., Han, D. H., McDuff, D.,
Mountjoy, M., Polat, A., Purcell, R., Putukian, M., Rice, S., Sills, A., Stull, T.,
Swartz, L., Zhu, L. J., & Engebretsen, L. (2019). Mental health in elite athletes:
International Olympic Committee consensus statement (2019). British Journal of
Sports Medicine, 53(11), 667-699. https://doi.org/10.1136/bjsports-2019-100715
Reng, R. (2011). A life too short: The tragedy of Robert Enke. London: Yellow Jersey Press.
Royal College of Psychiatrists. (2018, November 14). Long waits for mental health treatment
lead to divorce, job loss and money problems, RCPsych finds. Retrieved from
https://www.rcpsych.ac.uk/news-and-features/latest-news/detail/2018/10/08/long-
waits-for-mental-health-treatment-lead-to-divorce-job-loss-and-money-problems-
rcpsych-finds
Sacks, H. (1995). Lectures on Conversation. Oxford: Blackwell.
Sanderson, J., Weathers, M., Grevious, A., Tehan, M., & Warren, S. (2016). A hero or sissy?
Exploring media framing of NFL quarterbacks injury decisions. Communication &
Sport, 4(1), 3-22. https://doi.org/10.1177/2167479514536982
Schwenk, T., Gorenflo, D., Dopp, R., & Hipple, E. (2007). Depression and pain in retired
professional football players. Medicine & Science in Sports & Exercise, 39(4), 599-
605. https://doi.org/10.1249/mss.0b013e31802fa679
Smith, D. E. (1978). `K is mentally ill': The anatomy of a factual account. Sociology, 12(1),
23-53. https://doi.org/10.1177/003803857801200103
Smith, J. S., & Keeven, D. (2019). Creating separation from the on-field product: Roger
Goodell’s image repair discourse during the Ray Rice domestic violence case.
Communication & Sport, 7(3), 292-309. https://doi.org/10.1177/2167479518769896
Souter, G., Lewis, R., & Serrant, L. (2018). Men, mental health and elite sport: A narrative
Review. Sports medicine - Open, 4(1), 57. https://doi.org/10.1186/s40798-018-0175-7
Steen, R. (2015). Sports journalism: A multimedia primer (2nd ed.). London: Routledge.
Stokoe, E., & Attenborough, F. (2015). Prospective and retrospective categorisation category
proffers and inferences in social interaction and rolling news media. In R. Fitzgerald
& W. Housley (Eds.), Advances in membership categorisation analysis (pp. 51-70).
London: SAGE.
Texas Longhorns Online. (2014, December 17). McGee-Stafford returns from injury.
Retrieved from https://www.youtube.com/watch?v=Whd2Rne5uQI
The King's Fund. (2017, May 19. Is there ‘parity of esteem’ between mental and physical
health? Retrieved from https://www.kingsfund.org.uk/publications/articles/big-
election-questions-parity-mental-physical-health
Thompson, P. (2016, May 12). Sky's top pick Imani Boyette proves 'there's light at end of
tunnel'. Chicago Tribune. Retrieved from https://www.chicagotribune.com/sports/ct-
sky-imani-boyette-spt-0514-20160512-story.html
TMZ. (2018, October 5). NFL'S Everson Griffen police video shows ambulance
escape...Cops Trying To Help. Retrieved from
https://www.tmz.com/2018/10/05/everson-griffen-police-video-ambulance-escape/
Trescothick, M. (2008). Coming back to me: The autobiography. London: HarperSport.

26
Vertuno, J. (2015, March 27). Poetry pulled Texas center McGee-Stafford from depression.
Retrieved from https://federalnewsnetwork.com/entertainment-news/2015/03/poetry-
pulled-texas-center-mcgee-stafford-from-depression/
Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C. (2005).
Failure and delay in initial treatment contact after first onset of mental disorders in the
national comorbidity survey replication. JAMA Psychiatry, 62(6), 603-613.
https://doi.org/10.1001/archpsyc.62.6.603
Young, K., White, P., & McTeer, W. (1994). Body talk: Male athletes reflect on sport, injury,
and pain. Sociology of Sport Journal, 11(2), 175-194.
https://doi.org/10.1123/ssj.11.2.175

27
Tables

Table 1 - Brandon Brooks 'anxiety' disclosure interview (14 December 2016)

Video source:

https://www.nbcsports.com/philadelphia/philadelphia-eagles/anxiety-condition-caused-
football-obsessed-brandon-brooks-miss-games

Speaker:

BB = Brandon Brooks (Philadelphia Eagles player)

Line Speake Utterances

# r
1 BB Basically (.) ah found out (.) that recently .hhh that I have an anxiety (.) ah
2 condition (0.6) Uhm: ((tsk)) (1.6) when I mean by anxiety condition (.) you
3 know not nervousness or fear of the game. What it is is .hhh I’m
4 consciously=ah (0.7) >I like have an obsession with the game< .hhh (1.5)
5 ah:: it’s an ah unhealthy ah: (0.4) obsession right now an' (.) an y'know
6 working with .hh (0.6) team doctors and things to ah (0.5) get everything er
7 straightened out and the help that I needed (.) um un (0.8) .hhh and things
8 like that (.) Ah: (0.5) once again (.) y'know it’s an- it’s an obsession (0.4)
9 y'know I can’t emphasise that enough (.) Ah: it’s not (.) no nervousness or
10 fear (.) I love the Organisation [Philadelphia Eagles]. Organisations been
11 great (0.4) Uhm they’re supporting me with this (0.3) ah: (0.4) know the
12 head coach ((Douglas Pederson)), my position coach ((Jeff Stoutland,
13 Offensive Line Coach)) (0.5) Howie ((Roseman, Executive Vice
14 President/General Manager)) (.) Er everybody supported me (.) and ah: (1.0)
15 you know I’ll- I'm make it through (.) I’ll be okay (0.2) uhm (1.3), no
16 nothin' to ah > nothin' I’m ashamed of< (0.6) Um (1.1) y'know (.) I- I own it
17 (0.3) Uhm (1.2) an' (0.3) that’s it.

28
Table 2 - Brandon Marshall 'BPD' disclosure press conference (31 July 2011)

Video source:

https://www.youtube.com/watch?

v=JvgamHqUHeQ&list=PLmutsg__wVhPg_bVjy0HXpuXaza-yxwEp&index=36&t=5s

Speaker:

BM = Brandon Marshall (then Miami Dolphin player)

Line Speake Utterances

# r
1 BM With that being said, I want you guys to tell my story in a accurate way, (.)
2 uh in a way that people, what, that people who read it, that may suffer with
3 what I suffer from (0.2) can get the proper help, the proper treatment. This
4 is, uh (.) this is the most stigmatised disorder out there, but yet it’s very
5 treatable and (0.3) with <the right help, the right treatment, programme the
6 right treaters, (0.5) one diagnosed with BPD can live a healthy, effective,
7 peaceful life.>

29
Table 3 - Sky Sports News 'Tresco Interview' (10 April 2006)

Video from Sky Sports News interview with Ian Ward (archive footage)

Broadcast: 10 April 2006, 5pm

Adaptation of ESPN transcript:

http://www.espncricinfo.com/england/content/story/244106.html

Speakers:

JT = Sky Sports Journalist Ian Ward

MT = Marcus Trescothick (then England Cricketer)

Line Speaker Utterances

#
1 JT >So, why did you leave India< was it to spend more time with your family?
2 MT (0.2) ((tsk)) (0.5) .hh Um the main reason was I picked up a bug while I
3 was out there (0.2) Um: (0.3) the sort of the first erm:- the second part of
4 Bombay when we were there at the end of that trip (0.6) .hh um (0.3) and it
5 just- really hit me hard, and just sort of- I wasn't sleeping er (0.6) .hh yeah I
6 just couldn't get t'- I couldn't shake it off really (0.5) .hh um (0.2) and sort a
7 get- we moved on to Baroda, didn't really get any better, I couldn't eat too
8 much, I wasn't really drinking and (0.8) .hh y'know it just- it really took its
9 toll on me and it got to the point when I said l'k((look)) (.) y'know I'm
10 pretty fatigued here, I'm (0.5) .hh struggling to concentrate on my cricket (.)
11 as much as I can do obviously leading up to a big Test match (.) Um
12 preparing myself in the right way (.) Y' an' so I spoke to obviously the
13 people that needs to be (0.7) .hh and decided it was the right thing to do
14 was to come home.
15 ((interview continues))

30