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David Wheeler
Wheeler in action in last season's EFL Cup - Wycombe lost 6-1 to Man City in round three

It is obvious that David Wheeler is frustrated.

A player who has played for seven clubs and at every professional level below the premier league has seen many team-mates suffer from depression, eating disorders and gambling addictions.

A culture of "hypermasculinity" and "outdated perceptions of what it is to be a man" has been witnessed by a player.

It's a situation that Wheeler, now at League One Wycombe, feels the game needs to address quickly. With 2020 figures revealing a 50% rise in the number of players seeking counselling support from the Professional Footballers' Association (PFA) between 2018 and 2019, his concerns seem well-founded.

He says that we are leaving open the possibility of a fire raging in someone's head.

Wheeler's personal journey informs his uneasiness.

He went from seeking psychological support for panic attacks to leading a research project that he hopes will change the way football views mental health.

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Many will be familiar with a feeling of butterflies during the warm-up but less will have to deal with bouts of vomiting. For a long time, Wheeler lived in a routine.

He had extreme levels of competitive anxiety when he was a child.

There were times when I couldn't eat or go to the toilet and that affected my performance.

It entered my personal life because I didn't address it well. I would start having panic attacks when I was shopping or eating out. I started looking for help when that happened.

Thanks to a concerted effort to understand and manage the anxiety that affected the early parts of his career, those days are behind him. Wheeler says that he's able to feel those feelings of anxiety, but they don't overwhelm him anymore.

His recent post-graduate research was overseen by a former England women's football team psychologist. Wheeler's status as a current player offers a true reflection of how psychology is seen within the game, according to her.

Wheeler and Gervis worked together at Queens Park Rangers.

She was the first sport psychologist hired by the English Football Association to support any of its national teams. She thinks a hypermasculine culture discourages players from asking for help.

She remembers a time when a manager prevented her from working with a vulnerable player.

She says it is easier to show butch manliness because you create a barrier.

There is no safe space for vulnerability to be expressed and that is problematic.

Liverpool and Everton players pose together in support of the FA's Heads Up mental health campaign
From January 2020: Liverpool and Everton players supporting the FA's Heads Up mental health campaign. Psychology training is now included as part of youth and senior coaching programmes run by the FA

Wheeler's study contains testimony from managers who have worked with national teams. He talked to them about football's reluctance to embrace psychological support.

A manager described a lack of honesty in football that sees players struggling because they don't want to be seen as struggling.

It's something Wheeler encountered during his career, which began at Lewes in 2007, and has included spells at Staines Town, Exeter City, Pompey, MK Dons and Queens Park Rangers. He shows how a macho dressing room atmosphere affects mentality.

He says that he's experienced something close to the best in the Football League and that the difference is stark.

It was so bad that I didn't want to go in every day. I didn't want to be there and it wasn't a good place to live.

When players are not fit to play a match, they end up playing because they don't want to give up their spot in the team.

It is like a cauldron of pressure when the manager is under it. There is a lack of a sports psychologist presence.

If you had a psychologist as a permanent fixture, the manager would almost say, "We've got someone on our team, so if you're having any issues go to them and be open about it." If you don't want it to, it won't affect my selection of you.

It's almost saying either we don't value the players' mental health highly, or you're saying: "I'd rather not know about it, so if you need it, go and find it somewhere else." I don't think both are good.

A full-time psychologist should be mandated by Wheeler's research for the premier league and championship clubs. The cost of doing so should not be a problem for teams in either division.

He believes that clubs can encourage players to leave the football bubble.

He believes that change comes from celebrating individuality and promoting people to explore their personality and develop their character over and above just being a footballer.

Having a narrow idea of who you are can lead to a spiral of anxiety, depression, gambling or eating disorders.

First and foremost, that narrow idea is a footballer. That is everything if that is not going well.

Sam Vokes and David Wheeler of Wycombe
A 2019 study showed that only 37% of English clubs reported having staff with relevant training in supporting players psychologically as they recover from injury

Across last season, PFA members at clubs in the Premier League, EFL and the Women's Super League were invited to complete a confidential survey on mental health. Some 22% reported experiencing severe anxiety over the previous month.

The scale of the mental health challenge facing the game is obvious, but the responsibility on clubs to provide psychological support is not.

The Health and Care Professions Council is the body that regulates health and care professions in the UK.

The rules of the Elite Player Performance Plan only apply to academies and there is no requirement for teams to hire an accredited performance psychologist.

Many elite clubs use psychologists to work with first-team players, but some believe more can be done.

In an interview with The Football Psychology Show in 2021, Wycombe assistant manager Richard Dobson, who established at the club a psychology programme described as the "biggest in Europe" by the FA's former psychology lead, said that the system allows clubs to "play at psychology".

The Elite Player Performance Plan states that you have to have a psychologist in order to get a job at a club academy.

"So, they went to the clubs and said, 'Well, we've brought one in, but we've got one, so we're doing psychology now.' They aren't. That isn't as simple as it sounds. You can't understand psychology at a superficial level.

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A growing number of current and former players are drawing attention to football's provision of psychological support Real Madrid assistant coach Davide Ancelotti said in an interview that elite players would soon be using their own psychologists.

Wheeler is aware of the potential for abuse of the system and agrees with the need for more mental health support.

Even players who can afford top psychologists can be sucked in by someone who is very good at marketing themselves on the internet.

"They get in people who have a good social media following but don't have the qualifications or expertise to do what they say they can do in a safe way."

Wheeler believes a quicker pace of change is needed as there has been progress in highlighting the positive impact psychological support can have.

He says the tide is turning, but it's not fast.

One of the managers questioned how many young men would fail before they got their act together.

I am impatient about changing things because I know how many people will suffer in the meantime.