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Mental health and well-being: nurse’s initiative helps rugby players tackle their issues

State of Mind charity has potentially saved dozens of lives

Combining a love of sport with his work, mental health nurse consultant Phil Coopers State of Mind charity hosts presentations at rugby club training sessions to talk about depression, anxiety, suicide and alcohol and drug misuse

The tragic death of a professional rugby league player inspired mental health nurse consultant Phil Cooper to set up an innovative charity that has potentially saved dozens of mens lives.

I love sport, especially rugby league, says Dr Cooper, who works part-time in Warrington at North West Boroughs Healthcare NHS Foundation Trust in dual diagnosis of mental health

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Combining a love of sport with his work, mental health nurse consultant Phil Cooper’s State of Mind charity hosts presentations at rugby club training sessions to talk about depression, anxiety, suicide and alcohol and drug misuse

Mental health nurse consultant and 2012 RCNi Nurse Award-winner Phil Cooper
Mental health nurse consultant and 2012 RCNi Nurse Award-winner Phil Cooper

The tragic death of a professional rugby league player inspired mental health nurse consultant Phil Cooper to set up an innovative charity that has potentially saved dozens of men’s lives.

‘I love sport, especially rugby league,’ says Dr Cooper, who works part-time in Warrington at North West Boroughs Healthcare NHS Foundation Trust in dual diagnosis of mental health and substance misuse and clinical transformation.

Following the untimely death of English professional rugby league player Terry Newton, who took his own life in 2010, Dr Cooper spotted an article in a sports newspaper suggesting that the NHS and rugby league should get together to prevent such tragedies ever happening again. There was also a letter on the same issue from another mental health nurse, Malcolm Rae.

After gaining approval from his trust – which is based in an area with five professional rugby league clubs – Dr Cooper and Mr Rae met, eventually co-founding State of Mind in 2011, which aims to improve the mental health, well-being and working lives of rugby league players and their communities.

‘It’s my passion,’ says Dr Cooper, who won the mental health nursing category at the 2012 RCNi Nurse Awards for his work with State of Mind.

Mental health sessions use sport to get across key messages

Although the initial idea was to host a conference, they decided instead to go directly to clubs, offering each a mental health session, devised with the players themselves.

‘At the time, players didn’t have any mental health support,’ Dr Cooper recalls. ‘Everyone bought into it quickly and now we’ve delivered sessions all over the country, reaching around 70,000 people.’

Hosted by former players who have been specially trained, the 50-minute or so presentations use sport to get across key messages about mental health. This includes addressing mood; depression; anxiety and suicide; describing symptoms; and listing the signs of potential drug and alcohol misuse.

‘Language is crucial, making it activity based and also having a bit of a laugh if you can. Men aren’t hard to reach – there just hasn’t been a focus on how best to do it’

Participants are given information to help improve their mental health, with goals and measures for overcoming adversity. They are also encouraged to look out for collegues who might be having problems.

‘Playing professional sport at the highest level brings its own pressures,’ says Dr Cooper, who was awarded an MBE in 2017 for services to nursing.

Negative thinking can overwhelm sports professionals unless addressed early

‘You’re in a goldfish bowl, performing in front of others regularly. Most professional sportspeople are self-critics too, so negative thinking can become predominant unless addressed early. Our aim was to get to them first, always with the view of reaching the fans and their communities too.’

Traditional mental health services have sometimes failed to engage men, he admits. ‘Although it’s changing, services aren’t always directed at enticing men into them,’ says Dr Cooper. His charity takes a different approach, taking the message directly to men, hosting sessions before or after training, for example.

‘Language is crucial, making it activity based and also having a bit of a laugh if you can,’ he says. ‘Men aren’t hard to reach – there just hasn’t been a focus on how best to do it.’

State of Mind visits rugby clubs to
talk about depression, anxiety,
suicide and alcohol and drug
misuse Picture: iStock

The charity is exploring ways of supporting match referees, umpires and officials. ‘The abuse they receive is leading a lot of them to leave,’ says Dr Cooper. ‘I’d love to get mental health nurses to spearhead a campaign to support their local referees’ society. They could deliver resilience training.’

After qualifying in 1993, Dr Cooper struggled to get a job in mental health and worked in a nursing home for a few months. He then began working for a substance misuse service, initially on a detoxification unit for alcohol and drugs, and then as part of a community drugs team in Warrington.

‘It opened my eyes and gave me a fantastic background in drug and alcohol misuse, inspiring my passion for that area of nursing,’ says Dr Cooper. ‘Attitudes can sometimes be a little bit negative, because there’s a perception that people won’t change, so some staff feel it’s frustrating to work in that scenario.

Recognising specific changes in people’s behaviour is key

‘But people alter their drug and alcohol use all the time. For example, if someone hasn’t got enough money for heroin, they will use something else. It’s about recognising that change in behaviour – that’s what facilitates natural change happening for the future.’

After becoming a community mental health nurse in 1995, he was appointed as a specialist practitioner in 2001 before becoming the programme lead for dual diagnosis training across north west England two years later. His programmes included one, five and 12-day training courses covering three NHS trusts in the region.

‘Every time I delivered training, I always felt I had one chance to influence someone to do something positive for those who may be using substances’

Inspiring his ideas was his dissertation for his master’s degree on how people are assessed on mental health inpatient wards. ‘In terms of substance misuse and the interactions between mental health, staff didn’t have a great deal of information and felt a bit out of their depth,’ says Dr Cooper, who gained his PhD in 2013.

He approached his employers with the idea of training. ‘There was little around at the time that bridged the two,’ he recalls.

Originally due to run for two years, the programme proved so popular it continued for a further 18 months. ‘I like training that entertains and inspires,’ says Dr Cooper. ‘Every time I delivered this training, I always felt I had one chance to influence someone to do something positive for those who may be using substances.’

In his current role, which began in 2005, he initiated a pilot scheme designed to address substance misuse on psychiatric inpatient wards. ‘Substance misuse remains a big issue for mental health wards, with people being admitted under the influence or using substances beforehand,’ says Dr Cooper.

State of Mind’s ultimate goal is suicide prevention

‘I wanted to be more responsive to those coming through the service, making more appropriate interventions based on what they want to do and are positive, rather than punitive.’

State of Mind’s ultimate goal is suicide prevention, with more than 100 people telling the charity that being at one of their sessions or a ground where they have had a marquee has made them think again.

One particularly poignant story happened in the charity’s earlier days. ‘A woman came up to us and said her friend’s son had taken his own life and that her friend had been talking about wanting to join him,’ says Dr Cooper, who then spoke to the man for about 30 minutes before the game began.

‘After the match ended, he came back to the marquee and said: “This was going to be my last game of rugby league. I was going to take my own life tonight, but I’m not going to do that now,”’ says Dr Cooper.

‘Two years later, I saw him again. He told us he would probably have never met his grandson if he hadn’t spoken to us that day. That’s about as powerful as it gets for me. It spurs you on every day to keep on doing what you do.’

Three tips for setting up your own mental healthcare initiative

  1. Choose something you feel passionate about, advises mental health nurse consultant Phil Cooper. ‘I managed to combine my love of mental health, sport and work on drug and alcohol misuse,’ he says. ‘In the first year, I was delivering sessions to all my heroes’
  2. Seek support from key leaders and decision-makers, presenting your ideas to them and asking for their support
  3. Finance is always an issue, says Dr Cooper. State of Mind’s commercial model is based on selling some services to businesses – such as mental health first aid training – and using the profits to deliver sessions to community sports clubs and other organisations for free

Find out more

State of Mind


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