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VOL. 37 | NO. 7 | Friday, February 15, 2013

Will NFL players actually use Life Line?

By Linda Bryant

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Andrew Gregory

The Nashville Ledger asked four nationally-recognized health care professionals to discuss mental and physical health issues in the National Football League.

All four experts praised the league’s new crisis line, NFL Life Line, a service for current and former NFL players, coaches, team and league staff and their family members. Nashville-based Centerstone, and one other mental health provider, the Mental Health Organization of New York City, were chosen to run the 24/7 hotline.

The roundtable of experts, all of whom have worked with professional athletes are:

  • Andrew Gregory, MD, a sports medicine specialist at Vanderbilt University
  • Jack Singer, PhD, a California-based clinical, sport and industrial psychologist
  • Jack Singer

  • Loren Fogelman, M.Ed, a peak-performance expert based in Oregon
  • Simon Rego, PsyD, director of the Cognitive Behavioral Therapy Training Program at Montefiore Medical Center in New York.

Rego has been a loyal fan of the Tennessee Titans since the team was known as the Houston Oilers. He travels to Nashville several times a year to attend games with his father.

What do you think of the NFL’s decision to launch the NFL Life Line, a 24-hour-a-day crisis line for current and former players, coaches, staff and family?

Gregory: “I think the crisis line is a good idea only because of the atmosphere that has been created by sensationalizing (mental health issues and the class action lawsuit about brain injuries) in the media.

Loren Fogelman

“It is hard to know what the NFL is doing because they think it is the right thing to do or because they are trying to protect themselves against a large settlement from the class action suit. More education and research are what is needed so if they are supporting that then regardless of motivation, I think it is a good thing.’’

Rego: “The question is whether league officials and coaches will create an atmosphere in which the players can feel comfortable coming forward and asking for help when they need it.

“Will the NFL improve their ability to detect players who need help and get it for them before it is too late?’’

Singer: “Life Line is a terrific idea. The problem is that only a small percentage of people needing such help actually seek it out.

Simon Rego

“Secondly, the staff must be carefully trained. Also, I think having some ex-NFL players manning the lines would be helpful from a trust standpoint.’’

Fogelman: “I think it will help, but I don’t think the stigma will be removed right away.

“There has been such a strong code of silence, and there will still be some who see mental illness as a weakness. The coaches are going to have to support it.’’

What do you think of the elevated conversation surrounding the NFL about mental health, stress and trauma? Are some being too catastrophic or is the issue critical? Maybe somewhere in-between?

Gregory: “There is no doubt they may have chronic issues related to playing football –degenerative arthritis or disc disease and, for linemen, issues related to obesity – but the real question is how do they compare with other men matched for age and activity level.

“Because of increased awareness of concussion, and the concern for chronic traumatic encephalopathy, I do think the pendulum has swung too far in the direction of drawing conclusions about cause and effect prior to science proving it.

“It does cause a scare factor for players and families of those who played the game that may be unwarranted.’’

Do you have any opinions about how the NFL can address safety and mental health-related issues?

Rego: “We still have a long way to go in spotting people at risk. We need greater awareness campaigns and better screenings.

“That said, we do know that certain approaches are effective, so giving NFL players wider access to them would be great.

“One of my specialties is cognitive behavior therapy, which teaches patients how their thoughts can impact their mood and behaviors. CBT has been increasingly used in sport psychology to enhance performance.

“After engaging in CBT, athletes can learn how to catch, challenge and change these negative thought patterns and turn them into more adaptive/rational/balanced thoughts.’’

Singer: “I believe this starts with the helmet manufacturing companies, and safeguards need to be built into those helmets beginning with the young Pee Wee players.

“No one knows about the cumulative effect of head injuries.

“It could be that the NFL experience simply represents the point at which the brain succumbs to that one more hit, but the deterioration process began many years before.

“The culture of the typical team in the NFL preaches playing through pain, so teaching athletes about warning signs often falls on deaf ears. Players are hesitant to report symptoms to the medical staff.

“I suggest that the medical staff train the coaches to look for symptoms and insist on player evaluations by qualified physicians when any head injury or concussion takes place.’’

Fogelman: “My hope is they [the NFL] really know how to start a movement to destigmatize mental health issues.

“We have to reach out to as many athletes are possible. I think it will mean coaching in a different way and intervening earlier.

“For example, the first time a player gets arrested for a DUI, drugs or fighting is the time to get help.

“That’s a critical time for intervention. Coaches should deal with it, not look the other way.’’

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