For anyone looking for their next read, Match Fit by Johnnie Lowery should be top of the list. In fact, even if you’re not looking for your next read, or don’t even like reading, if you’ve got a friend or a family member who needs a book recommendation, or you want to gift a book or suggest it to your book club, or for any other reason at all, this is the book people should be reading and talking about. We don’t say that lightly or without reason but because Match Fit is genuinely a book that can make a difference, tackling as it does mental health across football. Author Johnnie Lowery is well placed to lead the discussion and his research, dedication and intent are clear throughout. Kindly taking time to discuss his book in more detail with Pitch, he addresses everything from social media and gambling to managing his very own 7-a-side team, all with incredible empathy, insight and wisdom. 

You’ve written an extremely powerful and important book in Match Fit, exploring mental health throughout football. Can you tell us a bit about the background to the book, its conception and the motivation behind it?

Match Fit is really inspired by my own experiences as a teenager. I felt down a lot of time but had never even heard of the term ‘mental health’ and just thought it was a normal part of growing up and getting older. It wasn’t until I went to university and had a breakdown of sorts that I realised something was up and sought help. Since then, I’ve been able to live a much more fulfilling life, largely through knowing my triggers and how to stop myself spiralling into deep lows. I wouldn’t have read a book specifically about mental health when I was a teenager, but have always been obsessed with football, and so I think Match Fit can introduce mental health awareness to people by using football as a vehicle to do so. My hope is that people will buy and read the book to learn something about football, and in doing so, will be able to learn a bit about mental health and ultimately themselves as well.

It absolutely will! The book explores the myriad ways in which mental health manifests in the game, and you start with the players themselves and specifically the death of Gary Speed, which shook the football and wider world. Do you feel that was a particular wake-up call about both the insidiousness of mental health in football and the need to act?

There’s no doubt the death of Gary Speed was something of a watershed moment for football in the UK. Before that, I think there was a feeling of invincibility about the game. I was still young at that time, but you look back and realise that mental health wasn’t discussed at all. ‘Man up and get on with it’ was the mantra, particularly in football, which has always been more macho than the rest of society. Speed’s death was a wake-up call, and showed that even someone who appeared to be absolutely fine on the surface might be struggling underneath. It’s a shame it took a tragedy to deliver that wake-up call, particularly given German goalkeeper Robert Enke had taken his own life in 2009. That was a big story in the English press but never translated across to any lessons learnt over here – it was as if British football detached itself completely with what was happening abroad. Thankfully, there have been changes since then, the setting-up of the PFA Wellbeing department, for example.

It’s so easy to look from the outside at footballers and imagine life is pretty perfect, but there’s a really telling remark that it’s about ‘dealing with people who play football’ rather than footballers. Why do you think footballers tend to be treated differently in this regard and how important is it to move away from these somewhat unhelpful stereotypes and narratives about footballers?

So much of football is consumed on TV and social media these days that I think footballers, particularly at the top level, are viewed by many almost as characters in a show. They play a role as a Premier League footballer, but people forget they don’t go back to being a different actor when their day job is over. This view legitimises the shocking abuse aimed at top players that you regularly see on social media these days. Society plays a big role in how people see themselves, and so the whole country seeing people who play football as just ‘footballers’ reinforces this issue. I spoke to Marvin Sordell, who said that he felt guilty about feeling low during his time as a professional footballer. Shaped by society’s expectations of what it is to be a professional footballer, he struggled to see himself as a person, which contributed to the mental health issues he experienced. Anyone in any job should feel comfortable pursuing their interests outside of work, and football should be no different. 

Football is so omnipresent these days, whether that be games being played, news stories online, social media posts, or the like, do you feel the status, value and importance placed on the game is detrimental to the mental health of those involved? Would less be more?

I think the genie is already out of the bottle on that front. I think the rise in the popularity of football since the dark days of the 1980s is something to be celebrated and, living in London, I love the fact that I can pretty much always find a local game to go to on any given night, should I feel like it. However, football’s authorities and its clubs need to realise just how much pressure comes with playing the game these days. The level of scrutiny is beyond belief. Even at League Two level, if you make a mistake you can guarantee that it will be played millions of times on the internet by the time you’re even showered and changed after the game. The pressure itself isn’t going away, but clubs can make sure their players are sufficiently well supported to deal with this pressure as best they can.

And in terms of pressure, do you think there’s a sense in which this has perhaps been a factor in stymying arguably the most ‘under pressure’ team, England men? 

Oh, absolutely. I think this is the main reason why Gareth Southgate has done so well relative to his recent predecessors. At the World Cup in 2018, you could see the team went into it with relatively low expectations given the Iceland debacle and subsequent controversy with Sam Allardyce. Southgate played to this and was able to bring the players together, making them feel valued as people as well as for their talents on the pitch, as several of them attested to. This has been kept up since then, but sadly we haven’t quite been able to get over the line and win a major trophy. Now the importance of looking after your players has become apparent, I like to think whoever succeeds Southgate will carry this part of his style into their approach as well.

One of the great attractions of the modern game is the multiculturalism, with players moving between countries and leagues, but that also brings a little-considered challenge for players, who may move to an entirely new country, with a completely new language, which is a huge transition, yet in football terms there’s almost always a sense of immediate expectation, do you think there needs to be a greater understanding and empathy towards the challenges footballers face?

I spoke to Vincent Pericard, who moved from Juventus to Portsmouth in 2002. He was basically just left to fend for himself despite speaking no English and knowing nothing about how to live in the country before he was even out of his teens. This was the norm for foreign players until very recently, which is unbelievable when you think about it. Even if we forget the main issue, the welfare of the player himself, it’s a huge oversight on the part of the clubs, who were often spending millions of pounds on incredible talent, only to do nothing to help them reach their potential. You’re never going to be at your best if you’re feeling stressed and homesick, which is almost inevitable when you’re in the situation Pericard was in. Thankfully, clubs are starting to wake up to this and player care teams are the norm in the Premier League now. You do have to wonder why something you would think is just common sense has taken so long, though, and it shows just how lax the game has been when it comes to mental health in the past.

The book highlights some strides that have been made in terms of mental health provision at the top of the game, but presumably there’s a lot still to be done, what do you think is still lacking and needs to be prioritised?

With support from the likes of the PFA and LMA available for players and managers respectively, football has systems in place that weren’t there when Gary Speed passed away. We’re making progress, but there’s certainly no room for complacency. If I had to pinpoint one area, it would be issues around addiction, specifically gambling, but also with painkillers and medication which has seen rising awareness in recent years. The gambling industry is rotten to the core, with the majority of their profits coming from just 5 per cent of players. There are so many adverts for gambling companies, many of whom are based abroad and are completely unregulated, that you can’t get away from it. Is it any wonder that players such as Sandro Tonali or Ivan Toney develop addictions to gambling when they’re in a sport where they’re constantly being told by thousands of adverts to do it? And when they’re caught, instead of offering them support, we punish them. The media will often contribute to the cycle of shame by failing to empathise with these players, and the result is that anyone else going through the same thing will feel unable to access support. The sport needs to entirely rethink its relationship with gambling. 

Retirement too is a major factor in mental health in football, and for players, for whom football is often all that they know, it can be a real struggle. Do you think more should be done to help players transition, perhaps having more roles available at clubs after retirement?

I think the most important thing to help players successfully transition into life after the game is education whilst they are still playing. Right from when they first enter the academy system until the day they retire, every footballer should be encouraged to have passions that don’t involve football. This could double up as a backup plan in case they ever fall out of the game unexpectedly, through serious injury, for example, or just for when they reach their 30s and find that there aren’t a whole host of clubs chasing their signature anymore. Whilst some Premier League players may earn enough to live off for the rest of their lives, the majority of professional footballers take home more modest wages and have to go into another industry to pay the bills. There will only be so many jobs in coaching and punditry, and so players should look elsewhere for their next steps, just in case staying in the game after retirement is not for them.

One of the biggest changes in modern football, indeed modern life, has been the advent of social media. We’ve all seen the negative headlines around the issue, but what do you think have been the biggest impacts of social media on mental health concerns in football?

Social media, for better or for worse, has given everyone a platform to voice their opinion but also a place for anyone to easily find out what people’s opinions of themselves might be. I don’t care who you are; if you receive criticism or abuse often enough, it will start to affect you and you will start to believe it to an extent. I think it’s dangerous for young players to go seeking this external validation on social media, which is easily done. Then there are the faceless and nameless accounts spouting racial abuse, which sadly means black and other minority players are particularly vulnerable to the detrimental effects of social media. As the women’s game continues to grow more popular, we are sadly seeing more abuse from the bitter and insecure, and clubs and authorities should be aware of this when looking to support their players going forward. 

Given that social media could be such a vehicle for positivity in terms of uniting fans, clubs, players, etc., do you think it’s possible to get to a healthy place in the way football and social media intersect?

To an extent – although I don’t think it’s ever healthy for players themselves to be active on social media. There have been great examples of social media being used for good – Marcus Rashford coordinating a campaign to get food to those in need being one of them. But, where possible, I think it’s always in a player’s best interests to work with a team to run their social media accounts on their behalf, so long as all parties are agreed on a vision of what to do with it. Abuse on social media won’t ever go away unfortunately, and the social media companies have made little ground in combatting it.

Aside from players, you also look extensively at managers in the book and the pressures of the job and the loneliness of the role, and it does seem that it is a position that, perhaps even more than being a player, comes with inherent issues. The role of the manager feels like a bit of a Sisyphean task, do you think the very nature of management makes it particularly tough on mental health? 

Larger-than-life character Barry Fry said being a football manager should carry a health warning, and I can certainly see where he’s coming from. The job security is essentially non-existent and when things are going badly, all the pressure sits on your shoulders. Speaking to Paul Lambert for Match Fit was fascinating largely because he hasn’t suffered from any particular mental health problems during his career – his experiences reflect those of the average manager, you might say. Lambert admitted he had not once sat back, relaxed, and enjoyed the things he had achieved in his managerial career, despite taking Norwich from League One to the Premier League with back-to-back promotions. Then there was the pressure of fan anger when things weren’t going as well, such as towards the end of his spell at Aston Villa. To an extent, I think managers know the pitfalls of the job when applying for their first roles, but that doesn’t mean coping with those challenges is easy, and I don’t envy anyone doing the job. I feel enough pressure managing my Wednesday night 7-a-side team! 

As well as looking at players, managers, supporters, how important was it for you to also look at mental health amongst referees, especially in what seems to be an increasingly volatile environment at all levels of the game?

Match Fit is a long book and there’s a lot of stuff I could have written about and didn’t just to keep it down to a reasonable length. I wanted to include something about referees, though, because they’re often overlooked in mainstream mental health in football literature, and without them we wouldn’t have a game. The stats are as staggering as they are worrying – there are about 28,000 registered referees in England, but 6,700 quit the game in 2017/18. That’s nearly a quarter of referees. I’d hate to think anyone’s mental health would be compromised by them effectively doing football a service, and there are significant implications for the whole of football, as well as just the individuals on the receiving end. Hopefully, the chapter makes everyone think twice about how they speak to a referee on a Sunday morning, but also how they talk about referees at the top of the game as well. It’s all linked, and I think everyone has been guilty of condemnation at some point.

For fans, everyone knows those highs and lows of supporting a club, but football can really be a seminal part of a person’s life, can’t it?

My own experiences supporting Sutton United were a big part of my motivation for writing Match Fit. I’ve supported them since I was seven years old and have barely missed a game in the last few years. I feel like some of the best days of my life have been centred around Gander Green Lane, and so it was great to speak to some people who have had similar experiences with their teams for Match Fit. I’ve heard it said that if you’re a football fan no explanation is needed for your love, and if you’re not a football fan no explanation is possible. There’s no doubt my life is much richer for Sutton United Football Club (despite our struggles this season), and everyone who supports a team themselves should be proud of it. It’s such an incredible thing to be a part of and no doubt highly beneficial to your mental health, despite the jokes you might make when that team is on a bad run!

The book clearly stems from an incredible deal of research, did you experience any pushback from clubs or authorities when you discussed mental health? Were initiating discussions easier/harder than you expected and what did that tell you about attitudes towards mental health in the game?

I was slightly disappointed, although not surprised, with how hard it was to arrange interviews with current footballers in the men’s game. I think there is still a fear amongst players, agents and clubs that talking about mental health will make players ‘damaged goods’. As more top-level players do break this silence, as Richarlison has done recently, it will become easier for others to do so, which can only be a positive thing. I think for any average person struggling with their mental health it’s hugely valuable to have visible role models who are going through the same thing and being open and honest about it, showing that it’s nothing to be ashamed of. Generally speaking, football’s authorities (the PFA, LMA, Premier League) were quite happy to talk about their mental health provision, which is positive and indicates it is now regarded as more of a priority. 

How did the process of researching and writing about the status of mental health in football leave you feeling about where the game is at? Are you hopeful about the direction, speed in which things are moving?

I think we’re certainly in a much better place than we were, say, ten years ago. It’s a minimum requirement really, but the football world has finally accepted that mental health is real and nobody is exempt from it because of their circumstances. There are some good services out there, the likes of Life After Professional Sport (LAPS) and the Chris Mitchell Foundation, which are looked at in Match Fit. We’ve been promised an independent football regulator – perhaps its remit could involve funding services like these to take the pressure off core services such as the PFA. This will contribute towards a culture change in which mental health and physical health are seen as equally important. I remember Michael Bennett, head of the PFA Wellbeing department, describing how the inaugural PFA Wellbeing conference was named ‘Injured’, after the idea that mental injury is as important and is the same as physical injury. We’re on the right path, but we certainly aren’t at that point yet. There’s always more the game can be doing.

I think it’s important to end on the positives, so what would you say are the biggest positives that football has given you and why football can be such a force for good when it comes to mental health?

At my lowest points, football has given me a sense of purpose and a feeling of hope that things will get better. The most popular sport in the world, it has an incredible power to bring people together in joy and pain and to give people an outlet for the frustrations they accumulate throughout their lives. There’s some particularly interesting research in Soccernomics on just how much football can unite people and prevent isolation. Simon Kuper and Stefan Szymanski discuss how suicide rates in countries participating in a major tournament fell when the nation was playing – perhaps in part because of the common currency for conversation that football provides. Going forward, I hope football can go one step further and provide the rest of the country with a series of mental health role models. I truly believe that if the general population see footballers – who work in an industry typically considered to be macho and relying on showing strength and never weakness – talking about their mental health then they will believe it is okay for them to do so as well. I hope this is a message that Match Fit helps to propagate.