First Results – Mental Health

First Results – Mental Health

Mental Health in football – how can we fight the taboo?

In November 2009, the devastating news about the suicide of a former national team goalkeeper, Robert Enke, shocked the world. Enke had been suffering from depression for years, but he kept it a secret from the public and his team. Following this tragedy, the topic of mental health in elite sport received increased attention in the media, and it was speculated that the distinct features of a professional sports career may constitute a risk factor. But are these speculations warranted? Which factors actually affect the well-being of active and retired football players? Does the permanent performance pressure and public attention impact the players’ mental toughness positively or negatively? What facilitates or prevents successful coping with stressful situations?

In phase 1 of the HITG study in Germany, we surveyed former elite female football players on their mental health as well as on risk factors and coping strategies to boost their mood. Almost two thirds of all contacted players filled in the survey; here are some of the most interesting results:

Mental Health

  • 32% of all female Bundesliga players had symptoms of a major depression at least once during their active career. Additionally, 25% have suffered from symptoms of a mild or moderate depression.
  • Almost 40% stated that they wanted or needed psychotherapeutic support during their career, whereas only 10% actually received professional counselling.
  • After their football career, 9% of the surveyed players suffered from depression. A further 11% experienced anxiety.
  • Players with a concrete plan for their future after the football career, showed significant lower depression scores than players with vague or no plans.

Risk factors

  • The most commonly listed reasons for negative mood were conflicts with the coach/management (50%), lows in performance/injuries (48%) and too little support/acknowledgment by the coach (40%).
  • Furthermore, there seems to be a relationship between playing position and depression. On average, strikers reported the highest depression scores while defenders had the lowest depression scores.
  • The most commonly listed reasons for lows in performance were injuries (57%), psychological stress (47%) and lack of inner drive (28%).

The Taboo

According to football star Birgit Prinz, “mental fitness is just as important for professional footballers’ well-being and performance as physical fitness and technique.” Based on several studies, researchers assume that there is no significant difference in the prevalence of depression between football players and the general population. However, the results of our study support that the existing stigma seems to prevent affected players from seeking professional help. The only way we can overcome this problem is working against the stigma together. A new approach to this topic is the smartphone App “EnkeApp”, which was released yesterday. The App educates about depression in general and includes features such as a self-test, an online community and an emergency button. Currently, the App is only available in Germany.

We have to overcome the myth that professional football players are invulnerable and care for the health of tomorrows elite players. Mental stress can be prevented, treated and cured.
Birgit Prinz

Further information regarding our study is summarized in a scientific paper you can find here:


In phase 2 of the Head in the Game study, we will carry out a detailed clinical evaluation of the neurocognitive and musculoskeletal health of retired players, and analyse potential associations with previous injuries.

Participate now and help us solve some of the many unanswered questions regarding long-term health in elite athletes!

Do you have questions of your own that we should address in our research? Thoughts? Ideas? Feedback? Comment below or send us an email:


The goal of the Head in the Game project is to evaluate and improve long-term health in elite men's and women's football. The main question we seek to answer is: does a professional football career have any consequences for the musculoskeletal or neurocognitive health of former players?

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