title: Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project.
abstract: BACKGROUND
  Mental ill health, especially depression, is recognised as an important health concern, potentially with greater impact in rural communities. This paper reports on a project, Coach the Coach, in which Australian rural football clubs were the setting and football coaches the leaders in providing greater mental health awareness and capacity to support early help seeking behaviour among young males experiencing mental health difficulties, especially depression. Coaches and other football club leaders were provided with Mental Health First Aid (MHFA) training.
  
  
  METHODS
  Pre-post measures of the ability of those club leaders undertaking mental health training to recognise depression and schizophrenia and of their knowledge of evidence supported treatment options, and confidence in responding to mental health difficulties were obtained using a questionnaire. This was supplemented by focus group interviews. Pre-post questionnaire data from players in participating football clubs was used to investigate attitudes to depression, treatment options and ability to recognise depression from a clinical scenario. Key project stakeholders were also interviewed.
  
  
  RESULTS
  Club leaders (n = 36) who were trained in MHFA and club players (n = 275) who were not trained, participated in this evaluation. More than 50% of club leaders who undertook the training showed increased capacity to recognise mental illness and 66% reported increased confidence to respond to mental health difficulties in others. They reported that this training built upon their existing skills, fulfilled their perceived social responsibilities and empowered them. Indirect benefit to club players from this approach seemed limited as minimal changes in attitudes were reported by players. Key stakeholders regarded the project as valuable.
  
  
  CONCLUSIONS
  Rural football clubs appear to be appropriate social structures to promote rural mental health awareness. Club leaders, including many coaches, benefit from MHFA training, reporting increased skills and confidence. Benefit to club players from this approach was less obvious. However, the generally positive findings of this study suggest further research in this area is desirable.
authors.affiliation: Rural Health Academic Centre, Melbourne Medical School, The University of Melbourne, 806 Mair Street, Ballarat, Victoria 3350, Australia. d.pierce@unimelb.edu.au.
authors.forename: David
authors.initials: D
authors.lastname: Pierce
authors.forename: Siaw-Teng
authors.initials: ST
authors.lastname: Liaw
authors.forename: Jennifer
authors.initials: J
authors.lastname: Dobell
authors.forename: Rosemary
authors.initials: R
authors.lastname: Anderson