The Autopsy That Crashed the NFL's Mental Health Party

Within 24 hours after the NFL launched a mental health initiative for its players with special emphasis on the Life Line (its version of a suicide hotline), Ray Easterling's autopsy results crashed the party.
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Within 24 hours after the NFL launched a mental health initiative for its players with special emphasis on the Life Line (its version of a suicide hotline), Ray Easterling's autopsy results crashed the party. Easterling, who played for the Atlanta Falcons for eight years in the 1970s, died of a self-inflicted gunshot wound. The results of the autopsy showed that he suffered from moderate to severe Chronic Traumatic Encephalopathy (CTE) caused by the multiple concussions he sustained while playing professional football.

It was a tragic irony that Mary Ann Easterling, Ray's wife, found out about the NFL's new suicide prevention program only hours after receiving the medical examiner's report about her husband.

The suicides of former players coupled with the class-action lawsuit brought against the NFL by retired players or their family members claiming negligence with respect to lasting head trauma, has the NFL scrambling to look responsible. It would be cynical to assume that the league's primary motivation for the mental health initiative was to improve its image. It would be naive, however, to assume that the league didn't factor it into the equation.

Everyone agrees that the NFL's Life Line to help current and former players and their family members cope with stressful events is beneficial. Dr. Timothy Lineberry, Medical Director of the Mayo Clinic psychiatric hospital in Rochester, Minn. said, "Some crises are time-limited. If you can give a service to get somebody through that, it can be very effective."

The operative words in Dr. Lineberry's comments are time limited. If someone is suicidal due to some major life stressor -- a significant loss, financial pressure, family crisis, etc. -- then a hotline really can be a lifeline. Talking to a competent professional can ground someone suffering and set into motion appropriate coping mechanisms. If you're suicidal because your brain is broken, well, that's something very different.

In other words, a hotline is extremely useful when the problems are psychologically triggered, not neurologically based. And that's the rub. Virtually the entire conversation surrounding the NFL and mental health is the neurological side of the continuum. It's about concussions, CTE and the long-term damage caused by playing football.

What is a Life Line professional going to say to the wife of a retired player who calls and says her husband is exhibiting symptoms of CTE -- memory problems, major depression, severe mood swings, etc.? Or worse, my husband has a shotgun in the closet and he's talking about using it. There are only two choices: call 911 or take your husband to the emergency room immediately.

CTE is not time limited. Moreover, like Alzheimer's, it only gets worse over time, and there's no way to slow it down.

The next step in the NFL's mental health initiative should be focused on early detection and prevention. This means following through on their long overdue impact study to quantify the full magnitude of blows to the head. How is it that the first impact study was done at the Pop Warner level and the continuing research is everywhere but the NFL?

In addition, it's time to monitor the cognitive health of its players over time. In earlier posts I noted that imaging technologies are available that can detect subtle brain changes suggesting damage has occurred. Dr. Charles Berdick, who did the pioneering research on CTE in fighters, noted a time lag between brain trauma and the appearance of CTE symptoms. The NFL should be doing everything it can to protect the players before they reach the point of no return.

While the NFL has taken the first steps in addressing concussions and mental health, most of the really difficult changes have yet to occur. It's time for the league to begin the heavy lifting.

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