The prevalence of mental health difficulties in the UK has become a major concern for public health, with approximately a quarter of the adult population currently experiencing mental health difficulties in some form. Mental health difficulties, such as anxiety and depression, are most commonly treated using pharmacological or psychological interventions, but exercise-based interventions have long been established as an effective alternative.
Several trials and large-scale systematic reviews have demonstrated that exercise is an effective ‘tool’ in the prevention and management of depressive symptoms. Most studies report beneficial effects of physical activity upon multiple mental health difficulties including anxiety, depression and schizophrenia, with a small to moderate effect size for improvements in aspects of physical well-being, such as improved cardiorespiratory fitness and reduced risk of development of cardiovascular disease.
Given the evidence to suggest that exercise is an effective intervention for mental health difficulties and other aspects of physical health, which have a higher prevalence rate in individuals with mental health difficulties, it is intuitive to think that sport-based / team-based exercise, like football, may promote positive mental health. While a number of studies document sports-based exercise as a pathway to improve mental health, there has been a gap in the evidence-base as to the potential positive aspect of sports-based interventions embedded within the community.
Given the often long wait to access psychotherapeutic interventions, exacerbated under COVID-19, identifying more easily accessible effective interventions such as sports-based therapy is of great importance. Accordingly, we set out to explore the impact of a team-based football programme within the community for individuals with challenges to their mental health. Participants attended weekly 90-120 minute football sessions, held in local community venues across Wales, with no requirement on the number of sessions that participants had to attend. A qualitative method was employed to explore the experiences of those who took part.
Individuals who participated in the programme reported psychosocial and physical benefits, such as improved physical and mental health, improved social confidence and having a sense of purpose added to their day-to-day living.
Many players attributed improvements in stress levels and anxiety to participating in sessions:
“I think when you have the adrenalin pumping it kind of flushes out any kind of negative emotions and stuff you have, almost like you kind of sweat it out. Go home in the evening and feel much more relaxed. It would be great to do it every day.”
Being part of the programme enabled people to make social contacts that previously they had struggled with. Football was instrumental in providing a common interest for players and coaches, with a sense of making a connection through sport:
“You talk about what has happened on the field. That is what the ice-breaker is. I think that is where people gain their confidence then to talk to new people.”
One of the key issues that contributed to the success of the programme was the enthusiasm and commitment of the coaches, especially those who were volunteers. The participants recognised that the dedication of their coaches acted as a motivating factor for many of them to commit to the programme.
This experience and knowledge also contributed to creating a positive, inclusive environment for the players. For example, the programme was initially designed to be ‘non-competitive’ but the coaches recognised that this might not attract players: “It is competitive but in a good way.”
The findings provide both support and contextual extension to previous research in this area, demonstrating the positive effects of sport-based therapy upon mental health. Implications and conclusions could be used to inform future research into developing community sport-based programmes to improve mental health. The results add strength to the evidence that sports-based community programmes could be established as a low cost, easily accessible and relatively effective mechanisms for improving people’s self-reported mental health status.
Most powerfully, perhaps, was the way in which becoming part of a team, sharing a pitch and a spirit helped to normalise their feelings and allowed them to build connections to each other as footballers and to their own team. The success of the programme was dependent on a number of factors including the facilities, the coaches and their knowledge of mental health, and the way in which a supportive environment was curated. Future initiatives should strive to develop a more structured communication with mental health service providers and initial contact with players, to overcome the barriers of lacking confidence and facilities. 🔳
Professor Mark Llewellyn is Professor of Health and Care Policy and Director of the Welsh Institute for Health and Social Care (WIHSC) at the University of South Wales. His work is focused on providing an evidence base upon which decisions around policy and practice across health, social care and the third sector can be taken.
Dr Philip Tyson is a Senior Lecturer in Psychology at the University of South Wales and a member of the Promoting Lifelong Health Research Group. He is currently researching the role of professional football clubs in enhancing the mental health and psychological well-being of children and young people.
Dr Alecia Cousins is a Tutor in Psychology at Swansea University. Alecia's Psychology Masters at USW focused upon the psychology of health behaviours and health behaviour interventions.