State of Mind Sport

State of Mind Sport working alongside the 5 Boroughs Partnership NHS Foundation Trust and the Rugby Football League promote an increased awareness of mental fitness, wellbeing and resilience in rugby league players, fans and communities. Together we tackle the stigma around mental health by focusing a round of top division fixtures themed around State of Mind, signpost people to support, encourage early access to help and ultimately prevent suicide


  • From start: Yes
  • During process: Yes
  • In evaluation: Yes


  • Peer: Yes
  • Academic: No
  • PP Collaborative: Yes

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What We Did

State of Mind Sport working alongside the 5 Boroughs Partnership NHS Foundation Trust and the Rugby Football League promote an increased awareness of mental fitness, wellbeing and resilience in rugby league players, fans and communities. Together we tackle the stigma around mental health by focusing a round of top division fixtures themed around State of Mind (7th to 10th July 2016), signpost people to support, encourage early access to help and ultimately prevent suicide. This is a first in British Sport, commended by both MIND and the Department of Health.

Together we keep our information simple using mental fitness cards with tips to stay mentally fit, provide website information that has local and national, 24-hour help and support. Together we have delivered education sessions to over 13,000 people since 2011 primarily in places where traditional NHS services don’t usually access, (as men do not frequently access services) including sports clubs (rugby league, rugby union, football, hurling, Gaelic football, cricket), construction companies, the police, fire service, schools, colleges and universities and prisons. Together we have developed and are developing innovative projects to access socially isolated older people using the power of showing classic sports fixtures in local communities with former players in attendance is a magnet for people to attend. Using marketing in barber’s shops and public houses, local food outlets and community shops alongside social media has been really useful in accessing supposedly ‘hard to reach’ groups of men (Men’s Health Forum, 2014). We are currently targeting men’s health in a joint bid to pilot a unique project using a sporting club as a template to deliver men’s mental fitness interventions.

The project saves lives and the former high profile players and referees with lived experience of mental health issues ranging from depression, anxiety, psychosis, substance misuse and gambling issues use their personal stories to educate and encourage people to talk about how they feel and access support if they need it. Players who present in the sessions report feeling part of a team again, giving back to communities and helping themselves as well as others. People have told us that accessing support via our website, Sky Television, information in the Wembley Challenge Cup Final Programme, mental fitness cards information or talking to volunteers at games during the round of fixtures has saved their lives.

Example: At one game during the State of Mind round of fixtures a man and woman approached the State of Mind marquee inside a rugby ground. The woman stated her friend’s son had taken his own life two weeks earlier and he had been posting messages on Facebook that he wanted to join his son. He spoke to a health professional at the game and was guided towards help locally, nationally and 24-hour support. He went away and after the game he approached the health worker again and said that this was going to be his last game of rugby league as he was going to take his own life that evening, he said he had decided to change his mind. He contacted State of Mind via Facebook four months later stating that he had accessed support and was going to be grandfather and thanked us profusely

Wider Active Support

The 5 Boroughs Partnership NHS Foundation Trust provide the support for a Nurse Consultant to lead and deliver education session across the geographic area of the Trust and across the country and have delivered sessions to 13,000 people since 2011 in a range of locations. The RFL and 5 Boroughs Partnership NHS Foundation Trust attend a regular operational group meeting hosted in a rugby stadium (Warrington Wolves) to foster the development of a range of activities. These include organising the round of fixtures (State of Mind Round) that will take place in July 2016 and the themes for the round and the practicalities of having a presence at each game. A two-year partnership agreement has been signed between the organisations to deliver a national round of fixtures.

State of Mind in 2016 have worked with Liverpool John Moores University fashion students to design the tee shirts for players to warm up in before the games this year allowing a State of Mind session to be delivered to the students. Liaising with clubs to ensure no clashes with club sponsors, arranging volunteers at games, delivering tee- shirts to the clubs, mental fitness cards being available to give to fans that are designed to be attractive and easy to digest for fans. Organising education sessions across the next year and arranging a promotional campaign to maximise the impact of the round of fixtures have been crucial as State of Mind has now been adopted in the National Rugby League in Australia ( and in Ireland via the University of Cork and across all of Ireland (http:// There is a growing section developing in rugby union in the UK and Ireland ( and former player involvement with our links with the Rugby Football League’s charity Rugby League Cares.


A number of former players with lived experience of mental health are part of the Trustee Board for State of Mind Sport as are NHS Staff Nurse Consultant, Senior Nursing Manager and a psychiatrist are crucial with other trustees and partners who have experienced their own mental health issues or care for people with mental health issues. It enables the perspective of players and people with lived experience to be at the heart of the project and development for the future. Former players have accessed ASSIST Suicide training and are now taking part in a teaching course to further their skills.

Looking Back/Challenges Faced

Agreeing a partnership agreement with the governing body would have been helpful earlier to allow us to have a longer lead time to the round of fixtures to make arrangements to allow a greater impact to be made. This has now been formalised and has helped planning massively. State of Mind initially had no formal constitution and was a group of committed individuals, pursuing charitable status has allowed an ability to raise funds and expand our operations and education over the past 18 months as State of Mind Sport and has opened the option of accessing arrange of sports and increasingly we are supporting other sports in their quest to achieve similar goals.

Accessing a themed State of Mind round of fixtures. Our approach aimed at offering the sport a free education session to support players and the governing body agreed subject to presenting the education session to the Chief Executives of all the Top Division Rugby League clubs at one of their meetings and once they had viewed the content they agreed. The Rugby Football League have been immensely proactive in supporting the agenda to improve the mental fitness of their players at all levels with Emma Rosewarne being a fantastic supporter in her role in player welfare at the RFL engaging Sporting Chance Clinic for player and former player support and encouraging all clubs to have a player welfare manager and encouraging the player welfare officers to attend mental health first aid training. Mental fitness to improve performance was the hook for players to want to improve their mental fitness. When players saw the education session (devised with players) and knew why they were wearing the tee shirts at the round of fixtures they have been immensely supportive with over 200 players in the sport accessing help and support via the numerous support mechanisms put in place jointly to improve their mental fitness. Using former players with lived experience has now made the session extremely attractive for community clubs as is draws a crowd in the community clubs (people buy drinks or players attend before or after training) to get players to improve their mental fitness from a young age because they see this is what we have done in professional clubs to build player resilience.


Now that charitable status has been attained it has allowed the sustainability to be assured as fund raising has provided the opportunities to continue and the charity can now bid for funding alongside the governing body. Using the expertise and support of an NHS mental health trust has allowed the partners to make all projects relevant and appropriate to meet the latest agendas nationally and explore new avenues in terms of prevention, access, quality and integration with a range of partners. The links have allowed former players with lived experience to access educational support via the Trust’s recovery college to improve their presentation skills.


The numbers attending the education sessions are 13099 (11/04/16) and 83% of those attending have never accessed mental health awareness training previously. An article was published about a project showing classic rugby league games and its ability to attract a local audience in an area with high levels of mental health chosen by the local health and wellbeing board (Cooper et al. 2015) and the project was featured in BBC Panorama’s ‘A Suicide in the Family’ a notable example of how State of Mind can reach audiences using sport where the NHS cannot usually attract those that are supposedly hard to reach. State of Mind alongside the players association in rugby league completed a very first survey of players views (Cooper et al. 2014).

Our joint bid for funding a men’s health project pilot with the RFL and 5 Boroughs Partnership includes the partners currently tendering educational establishments to evaluate the pilot of a men’s health project. The project will use the sporting club as the attraction to see if men are willing to attend a project that shows them how a sporting club manages the physical and mental fitness of players located in the clubs stadium after initially asking fans at games whether they would attend. Measures of well-being, anxiety and depression and social isolation will be key to the project with the club’s different options to keep men involved in the club following the project’s completion including becoming fan ambassadors, mentors to the next cohort of people attending or becoming club volunteers on match days.


State of Mind Sport and our partner have presented at local and national conferences about our work ever since being established. In 2016 we have presented to a conference of all rugby league officials (referees and assistant referees) organised by the RFL in January, to Cheshire and Merseyside Suicide Prevention Network in February, the launch of State of Mind Ireland in Belfast as well as the rest of Ireland, Liverpool Institute of Directors to local businesses, Leeds Beckett University and at a national Men’s Health Conference in London and Yeovil in May and Bridgend in June. We have published some elements of our work already (Cooper et al., 2014 and 2015) and are awaiting a submission of a publication later this year about men’s appetite to access a mental fitness project. Our work has featured in the UK Government’s Preventing suicide in England: One year on. First annual report on the cross-government outcomes strategy to save lives in 2014 as an exemplar of good practice and featured in MIND’s Performance Matters Mental Health in Elite Sport report in 2014. State of Mind have featured on BBC Panorama ‘A Suicide in the Family’ in 2015 and Inside Out BBC North 2014 and won a MIND Media Award with Sky Sports for features leading to the State of Mind Round of Fixtures in 2014.

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Our partnership work has allowed mental fitness and ‘helping a mate’ to become the norm in a previously very macho environment that would never foster discussion of mental fitness problems. We have commissioned six films including players and fans. We have worked alongside Time to Change at venues across the country presented at the MIND AGM in 2014 about our work and have gained support from the All Party Parliamentary Group for Rugby League. We are in discussion with rugby union player associations in England and Scotland about how we may transfer our work in to rugby union. Our work has now been adopted in Australia and Ireland and there are discussions about a State of Mind for board sports (Snowboarding, surfing and skateboarding) following an approach from a former World Champion Snowboarder David Pitschi.



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