Sports Minister Tracey Crouch announced last week an action plan to stop professional athletes ‘reaching crisis point’ with their mental health. Footballer and author Ruth Fox has been outspoken about her personal experience with clinical depression, and on Good Friday is rewarded as Ethos Community Hero of the Day for her contribution to sport in the community at Cambridge United’s League Two match against Crawley. The Mixed Zone’s Katie Whyatt talks to her here
“I think football’s just beautiful,” begins Cambridge United midfielder Ruth Fox. “The way teams play, the creativity of players, how different players are so different to watch. You know when you’re a kid, and you just love a set of players in the team? It was Peter Crouch for me, and Southampton. My dad would take me to the field and we’d just kick a ball around, and I fell in love with the game. Everything sounds so stupid, because it’s just, like, kicking a ball from one end of a field to the other – but it’s so much more than that.”
Fox would know. Football was her lone shield against the depression that left her hours away from committing suicide, feeling as though she had lost everything and that professional help was no longer an option. There was the time she had paced a psychiatry ward at 2am, her head clouded with suicidal thoughts, to rise 12 hours later to take to the pitch. Playing football is where Ruth Fox forgets. Growing up, it was her way of communicating.
Football, too, gave Fox her voice back. She has written a book, The Unseen Battle: One young footballer’s struggle off the pitch, and her story has drawn goodwill messages from the likes of Chris Kirkland, Stan Collymore, Kelly Holmes – all open about their own demons – and Neville Southall. On Sunday she met Southall in person and on Monday she gave a mental health presentation at Stamford Bridge. She now works part-time for the mental health project at Cambridge United’s Community Trust, and there are further talks planned. She is 18.
She tells her audiences at those talks about the day, four months ago, she had planned to end her life. She was 17. The plan was meticulous. She would wake before anyone else, walk to the field next to the railway line and throw herself in front of a train. Her overriding emotion that morning was relief. Peace was imminent. She wrote a letter to her parents. No matter how strong someone is there is only so much they can take. The past few days I have felt very distant, and as though I am looking down on my life, not living it. I just don’t see a way out at all. There is nothing I look forward to and I have lost everything.
“I wanted to explain, at least to a point, to my family what was going on in my head,” Fox says. “There was no way I could talk to them about it in any other way. It’s just sad that it got to that point, to know that was the only time I could tell them.
“It just felt like the right thing. I don’t want to say it’s the right thing, because I know full well it’s the wrong thing, and I think I knew at the time. But it’s not that you want to die – it’s that you don’t want to live. They’re two very different things. I was pushed deeper and deeper into a corner, and it was either carry on living in pain and pain and pain, or just end it.”
Fox had never seen this coming. As a child, she had been academically able, popular. Her GCSE results read: nine A*s and two As. “I didn’t really have a worry in the world,” she says. “I got on with life – I loved life. I was energetic, sporty, just loved learning.”
She was 14 when the problems began. In October 2013, Fox’s older sister – the pair had been inseparable – moved to university. She had no reason to think she would be unable to cope, no prior history of mental illness. But her emotions began to overwhelm her. Fox then picked up an injury – a minor ligament tear in her upper back – that took football away from her.
“I was crying on end, for days and days,” she recalls. “I didn’t have the motivation to do anything. I couldn’t deal with people. I couldn’t deal with school. It just went against everything that I was before. I didn’t have anyone that really understood what I was going through – I didn’t really understand what I was going through. I didn’t understand anything to do with mental health, what depression even was, I didn’t know what would help and I didn’t understand why calling the doctor was the right thing to do, because I associated the doctor with anything physical.
“I felt like all my team-mates were improving around me, and I was just, left. I just didn’t have that release. I didn’t really know who I was anymore. It left me in a really bad headspace. Once the injury recovered, I felt like my head would recover, too, and I would feel good again, but I just didn’t. I found that really confusing. I didn’t know anything about mental health or mental illness – I thought I was only sad because I couldn’t play football. And then when I could play football again, I was still sad.
“I came back to football and I still wasn’t in a good place. I was really, really weak, both on and off the ball. I kept getting shoved off the ball. I’d lost a lot of weight – I found having control over food a satisfying thing, because I couldn’t control anything else. I didn’t enjoy it. I couldn’t deal with the social side.
“I truthfully thought that was it – the girl who was known for playing football decided to quit.”
A GP diagnosed Fox with clinical depression and prescribed Prozac, which “got me to a point where I could start seeing the positives in my life and then build from there”. She returned to football 18 months later for a local women’s side. She came off her medication earlier than anticipated. She felt stronger than she had before. “It was hard to come back because I associated the latter end of my football career with a really dark place. But it was the best decision. I just wanted to get back to playing the game. I didn’t want any pressure – I wanted it because I loved it.”
Three years later, the darkness returned. “I could feel my head going into the same place,” Fox remembers. She was 17, in the middle of her A Levels, and this time the demons would stalk her to university. She remembers staring numbly at her face in the mirror, tracing her hands over the shadows beneath her eyes. “It’s just the last thing I ever wanted to happen, to know I had to fight this all over again. I just genuinely thought I’d never have to go through it again. I didn’t know how ongoing it was, but I was aware of how long the process would be.”
Her dad dropped to his knees when he noticed the pink lines racing up her wrists. She was self-harming. “Because I was older, I was more aware of what I could do to myself,” Fox says. “It just reached a whole new level of darkness. It was hard. It’s just hard to know that’s the place that you’re at, and you’ve reached that point where whatever you’re thinking feels like the right thing. I was scared for my life.”
They travelled to Bedford Hospital for a psychiatric assessment. They waited six hours. Ruth was seen at 2am. Twelve hours later, she was on the football pitch. “I was exhausted and just down with everything, but I remember sitting on the sofa, and my dad said, ‘Are you going to play football today, or what?’ And every single part of my body said no, but one tiny part of my head said, ‘I will play’, and that’s the part that I listened to. It’s always worth it.”
Football was her only release, but there were times depression nearly stole that from her, too. “Sometimes, it’s not the actual playing football that’s the issue, but talking to people, dealing with pressure of performance. Everything around it except for the actual being there and playing.”
Fox recounts a day she should have been playing football, but instead broke down every time she tried to drive to the game. “I couldn’t deal with the pressure, the people, anything. My mental illness was taking my life away from me.” She drove to a Tesco car park and sobbed uncontrollably. Waiting in the cupboard at home were three packets of paracetamol and she couldn’t go back for fear of taking every one. A football coach advised her to call an ambulance. The operator said a clinician would call within two hours. It was 11pm. Fox got out of the car, walked to the road and thought about what would happen if she jumped in front of a car. It reached 1am and there was still no call. She went home. The call came at 5am.
She was referred to an Acute Day Treatment Unit at the local hospital, the days consisting of therapy sessions, creative sessions, cooking, socialising. She was discharged three weeks later – she reflects that this was probably too soon – and was hopeful of returning to university, where she had been studying a foundation degree having been unable to finish her A2 exams. She was told instead that the university “didn’t have the resources to support me”. “It’s horrific, because if I had a physical condition, they would make any change they needed to support me,” Fox explains. “The place is there in September if I want it, but the fact that they can’t deal with mental health issues is not great.”
She moved the 20 miles back home from university, into a county with different NHS funds – and lost the support of the Community Mental Health team. She had been receiving acute hospital care just days earlier, and now – nothing. Even the old crisis numbers were unavailable to her. “When people are discharged from hospital, they need to have ongoing support and they need to have continuity in their support,” Fox says. “All my care was dropped. It was literally the next county along. It’s not like I’d moved to a different country. There needs to be more crossover and communication between different organisations and different counties. It left me on my own again. A relapse or a breakdown was inevitable because I’d never had that continuous care.
“I’ve lost complete and utter trust in the professionals and the mental health services because of the experiences I’ve had. The immediate thing that a lot of people say is, ‘Talk to a professional and go to your GP’. I feel all those options are unavailable to me. Lack of support nearly cost me my life. I’ve got a brick wall up and it leaves me in a very strange place.
“It just goes against everything: how are you meant to open up to someone you don’t trust? And it’s not like I don’t trust anyone – I’ll trust the right person, and I’ll trust someone who gives me the reliability and the continuity that I need.”
A care coordinator should have visited her within a week of discharge. Fox waited ten days. The care coordinator fell ill. There was no correspondence from the Community Mental Health team, no appointment with an outpatient team. “People who have just been discharged are going to be some of the most vulnerable people out there,” Fox explains. “They’re the people who can end up taking their own lives – and that could have been me.”
Fox didn’t take her own life that day. Her parents were going for coffee and invited her. She declined – but the distraction saved her life. She sat in bed that morning drinking the takeaway coffee they had brought her and “appreciating the taste, thinking of all the little things that made life worth living.
“I’ve always been open with my experiences, [but] you feel kind of weak, and like you shouldn’t have to open to people because you shouldn’t be feeling this way,” Fox says. “If I’m going through a bad patch, it’s hard, because you’ve got the expectations of people who know how far I’ve come. People assume that because you’ve done something like writing a book, that means everything’s fine for the rest of your life. That’s not how it works.
“It’s a bit like an ongoing battle. I’ve got the knowledge that I’ve got through it before and therefore can get through it again. I feel like I’ve got a determination to get through whatever life throws at me in the future, and, somehow, it’s about clinging on to that. All we want to do is help other people, but you can’t do that if you’re not in a good place yourself.
“I’ve been let down so many times that [my recovery] had to be down to me and the people around me. It’s not just about mindset, but once you think of one thing positively, you start to move towards the other side, and you push past that. It’s not like I just took medication and that worked for me, because that’s not true. It’s not like I just spoke to some psychologists and had three weeks of therapy and that worked, because that’s not true, either. And it’s not like one particular person said one magic thing that really changed the way I think. But I think all bad things will come to an end at some point. Sometimes it’s just about being able to stick with it, and I feel like that’s what happened with me.
“My coaches have helped me through some of my darkest times, when talking to my parents or something wasn’t an option.” Fox concludes. Cambridge United compete in the first division of the South East strata of the FA Women’s Premier League. “They’ve helped me, they’ve accepted where I am at any particular point, and they respected when I was in hospital and things were incredibly challenging. There’s always been someone to talk to, an ear when I needed one. Team-mates have been on my side and respected what I’ve been through. I think what I like most is when you’re on the pitch no one really cares about anything else. Whatever you’ve just done that day – for me, a couple of months ago, I might have had a whole day of treatment, of therapy, because I was in hospital – it doesn’t matter. You’re just a team-mate at the end of the day, and I think that’s what’s nicest, because no one treats you in any other way.”
ABOUT THE AUTHOR
Katie Whyatt. Katie’s latest articles