Victorian crown calls for more research into the long-term impact of headaches in sport, in a report outlining the extent of mental health decline of former AFL player Danny Frawley in the years and days before the great St Kilda took its own life.
Giving up her findings into Frawley’s death Tuesday, Crown Paresa Spanos confirmed a post-mortem examination of former Richmond coach’s brain was a low-grade, chronic traumatic encephalopathy, a brain disease linked to constant blows to the head.
It comes a week after the Australian Guardian revealed that the AFL is considering a proposal to set up a multi-million dollar trust to support players in the past, future and future. who suffers from the long-term effects of concussion which, if adopted, could be a turning point in the way sports-based concussions around the world deal with head trauma.
Spanos said research into the impact of contact sports on the brains of AFL players could save lives as there is currently insufficient knowledge about the extent to which CTE causes brain disorders, in part due to a lack of research in Australia and internationally.
“Mr. Frawley retired in professional football prior to the discovery of CTE and to implement standard AFL policies and procedures aimed at minimizing the impact of sub-concussive decisions and injuries,” wrote Spanos.
“There is strong agreement that more research on CTE is needed to understand the condition, diagnose and prevent or at least prevent the impact of CTE on AFL players. ”
CTE, which can only be diagnosed after death, is associated with changes in mood and behavior along with brain and memory impairment.
Frawley died in a car crash in September 2019, at the age of 56. The coroner said her mental state began to decline in the months before he died and he appeared to be stopping at the drug- treatment and a number of “psychosocial pressures”.
Spanos found that “at most, CTE contributes significantly to Frawley’s decline in the years before his death.
“Like many players, Mr Frawley began his football career in his heyday, and may have suffered head trauma while his brain was still developing,” she said. “Therefore, it is difficult to assess the contribution of CTE to personality, behavior, any mental deficits, or feelings over a lifetime.
“Since CTE can only be confirmed post-mortem, it is impossible to determine at what point CTE started and whether this coincided with changes in mood or behavior. ”
The report states that Frawley had been experiencing depression since 2014 and reported a history of “depression,” noted with work with the AFL Coaches Association in earnest.
“He had a large concordance of depressive symptoms including severe insomnia, depressive episodes, relative anhedonia, self-criticism, motivation, difficulty working and episodic intolerance,” he says .
“He had also been involved in bad decisions and conflicting behaviors in his marriage.”
Psychologist Frawley described him as a “particularly needy” patient because of his “weak emotional state” and required frequent sessions and reviews. Frawley’s wife, Anita, felt it had taken her husband at least a year to recover “but it was never the same”.
“To his family, Mr Frawley would lie in bed all week and desperately needed him, but he would be able to put on a heroic ‘public face’ and give the appearance of a normal job,” the report says.
Anita said he never showed a degree of private harassment to friends or the public, even while he was a public candidate for men’s mental health. In late 2018, psychiatrist noted that Frawley had reduced his dose of antidepressants without consultation and wanted to stop them altogether.
In January 2019, the report says Frawley’s sex improved significantly, but he stopped taking his medication, telling his wife he did so with his doctor’s permission. Since then, his presence in the media has greatly diminished as his wife seemed to be “brushing the ego”.
One month before his death Frawley returned to psychiatry, which said Frawley had undergone treatment because he felt “bulletproof”.
His medication was restarted. He finally saw his mental illness on September 6, 2019 – three days before he died.
The crown said the weight of the available evidence supported a conclusion that Frawley deliberately took his own life, but could not determine the extent, if any. there, which CTE contributed to his mental health problems and / or death.
“In the run-up to his death, Mr Frawley was suffering from a number of personal and professional pressures, and a severe decline in his mental state, with a reduction in the anxiety and depression he had been suffering from. about five years, ”Spanos found out.
“At the very least, CTE is adding to Mr Frawley’s decline for many years before his death. The available evidence does not enable me to determine the specific suicidal stress that caused or contributed to Mr. Frawley’s death. ”
She found nothing to support any failures in Frawley’s clinical governance.
“Like many professional footballers, Mr. Frawley began his football career in his heyday and may have suffered head trauma before his personality was established,” Spanos wrote. “Coupled with this, the inability to diagnose CTE before death, confirms an assessment of the contribution of CTE to personality, behavior, any mental deficits or mental capacity.”
The coroner recommended the AFL and Australian Football League Players Association actively encourage players and, their posthumous legal representatives, donate their brains to the Australian Sports Brain Bank to contribute significantly to research on CTE.
Changes to coronation processes and practices to better identify CTE have also been proposed.