Premiership rugby players are elite athletes. They train extensively, with passion and determination in order to perform at their absolute best. It is fully understood that the nature of the game they play is tough. They will take hits, hard hits, repeatedly. Sometimes those tackles will lead to injury and those injuries, especially head injuries, can result in long term negative effects on the players’ welfare.
Since the 2019–2020 season onwards, at all Gallagher Premiership Rugby, Premiership Rugby Cup and European home matches, as well as a team doctor, am immediate care doctor, and a pitch side video reviewer, there has also been an independent doctor present with the final say on whether a HIA (Head Injury Assessment) takes place and whether a player can return to the field of play. Before they can play again, they have to undergo strict return to play protocols.
Why is this the case? Surely the team’s doctor can assess this? Surely the managers, coaches and players are all aware of the symptoms of concussion and can step in if need be? Surely the player knows how bad they feel?
Players don’t want to leave the pitch though. They want to tough it out, and win. They want their team to succeed, as does their team. It’s who they are. Strong, tough, unstoppable. It can be hard to speak up and tell your star player that they need to sit this one out, that they aren’t well enough to keep going, especially when you are part of their team.
Rugby isn’t the only field these independent decision makers operate on. In a call discussing lawyer mental health and suicide, held by Law.com, it was pointed out that NFL has independent doctors who carry out this same function to protect American football players, and maybe we need to look at that model in the legal sector.
We can expect managers to pick up on things in one to ones, we can train our colleagues in mental health awareness, and we can expect and encourage people to speak up and ask for help when they are struggling.
But that isn’t enough. High performers don’t want to leave their work. They want to push through and succeed, and so does their firm. It’s who they are. Smart, dedicated, capable. It can be hard to speak up and tell your biggest assets that they need to step down, that they aren’t well enough to keep going, especially when you are part of their team.
I am a psychotherapist, and part of the requirements I must fulfil to be registered, insured, and ethical is to attend monthly sessions with a clinical supervisor. These sessions allow me to reflect on my practice and the effect it is having on me and my wellbeing. If ever I had a case that was reducing my ability to perform or affecting my mental wellbeing negatively, I would be coached, supported, but ultimately, if need be, told to refer it on to someone else. This wouldn’t mean I wouldn’t be able to practice at all, but it provides a detached, independent opinion that can determine what is in my and my clients’ best interests without being clouded by sentiment, ambition, or dogged determination.
While there have been some efforts to introduce this kind of supervision in some areas of the law, perhaps we need to look at whether or not this needs to be a mandatory requirement for all lawyers, or at the very least, for those who are hitting over a certain number of hours of overtime in a month. Hitting that benchmark could be seen as the equivalent of the trigger for the independent doctors to carry out a HIA on the rugby pitch. The majority of lawyers will be certified as able to carry on, but where necessary, the supervisor could call for additional resource on a case, for the individual to be moved to other work, or to take a break completely. There would also be the opportunity to have “return to work protocols” to ensure the decision isn’t being fed by the individual’s ambition or determination to complete a project, and instead is based on what is truly best for the wellbeing of the individual.
As we said in our letter to the profession “The project is never going to be more important than the lives of the people involved.” Perhaps through mandatory independent supervision we can remain mindful of that fact.
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