First ever brain health service for rugby players launched in Ireland

World Rugby and Rugby Players Ireland (RPI) have launched a new Brain Health Service to support retired former international and provincial players from Sevens and 15s, men and women, who have concerns about their brain and mental health issues. Ireland is the first country in the world to launch the new initiative which is available free of charge.

The service includes an awareness and education component, an online questionnaire and cognitive assessment with a trained brain health practitioner to look for brain health warning signs while providing advice on managing risk factors and signposting anyone in need of specialist care.

World Rugby is funding the service. Ex-players seeking to participate are sent a link to a questionnaire which takes about 25-30 minutes to complete, before undertaking an online assessment across a variety of cognitive functions with a brain health practitioner.

World Rugby chief medical officer and former Ireland team doctor Professor Eanna Falvey explained: “If you go and see a psychologist on their own that is what they would do with you,” in relation to aspects of the testing process.

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He continued: “Those look in broad terms at cognition, executive function, like your ability to list.”

Other aspects include delayed recall testing, which is part of the concussion protocol, but this is a much broader approach. There is a huge mental health focus, one that involves a collaborative consultation between former players and their General Practitioners (GPs).

Falvey explained: “What you want to be picking up is the modifiable factors; health and lifestyle. A player who does the report gets the information and then gets a one-time access code. His GP gets the letter with the information, [the ex-player] gives them the access code and they get [to study] the report with you in the room.”

He pointed out that while cognitive function may look great, there may be other underlying issues relating to sleep, exercise, alcohol intake, smoking or bloods that require further scrutiny. “When you do the testing, the software will grade you green, amber, and red based on your scoring profile.

“What we have is a practitioner who is a clinical psychologist looking at each one of the tests and scoring it side by side [with the software]. The Brain Health Practitioner delivers the test, but they don’t do the analysis.

“One of the beauties with this being all online is that the guy who does this for us is in Australia. He can just pick it up and check it for us. That will expand as the numbers expand. We are piloting it here and the next stop is Australia next week.

“Our plan in rugby is to introduce this at the Under-20 World Championships, you get this at the start of your rugby career, we follow this on a five-year basis as you go through your career and then we do it afterwards as well.”

Former Munster and Ireland international Marcus Horan, a player development manager with RPI, pointed out that ex-players availing of the service must provide contact details for a GP and a partner “so that someone can be contacted, and support can be there.

“And we can then have a staff member tracking that and being able to see these players are engaging. If there are red flags from the initial questionnaire they can be flagged with the GP and our professionals here.

“We have contact details for all our group, it’s a little bit difficult for those before professionalism. We don’t know whether we will have a tsunami of requests, but this initiative will get [the message] out there.”

Recently retired Leinster and Ireland secondrow Devin Toner went through the consultation a fortnight ago. “It’s [the second part after the questionnaire] a video call that lasts about 30 minutes and is all about brain function, memory, and fluency. They sound easy but are pretty hard.

“I found myself tired at the end of it. It’s good. It’s all about baselines and then you can do it in two or five-year’s time. My wife got an email asking her to do it as well to corroborate your answers.”

Ireland’s most capped women’s international Lynne Cantwell, now high performance manager for women’s rugby in South Africa, welcomed the initiative. “The women’s game hasn’t always felt included, not for bad reasons, but they are now included in this community which is great,” she said.

“This call goes out to former female players who have an interest in this because education is key. Being diligent with health is vitally important. The hope is that education can help settle anxieties, but any abnormalities can allow them to seek help from the appropriate professionals.

“Women have had a lack of access to diagnostic and medical support. With this, there are good tools, screening, and support and that is a really positive thing.”

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