Kearnan Myall’s interview with Robert Kitson of The Guardian, detailing his struggles with mental health as a professional player, was just one contribution to an increasingly widespread debate about mental health in rugby.

Another such individual, forcing the issue onto the agenda, is Zac France. Left severely injured in a match four years ago, paralysed and with worries he would never walk again, France recovered physically, only to face years of mental health struggles. He has since established a rugby side called ‘Salad Dodgers Sevens’ for men with mental health issues.

The potentially jarring impact physical debilitation can have on all aspects of a person’s life is little discussed and catered for.

“I just didn’t see any way out other than putting an end to it really,” France told the BBC.

He and his team are consciously trying to eradicate the sport’s “macho culture,” challenging the mentality of ‘fix up and get on with it’ when it comes to injury. Such a hyper masculine denial culture is not conducive to creating an environment in which people feel free to express how they are truly feeling.

One of the players, Iestyln, said, “I can open up to a lot of people, especially people I trust and care about like a lot of the coaches here.” That is the difference between a positive environment and one which places player’s mental health under strain.

It is not about removing the competitive, confrontational, aggressive streak in rugby from the game (as becomes instantly apparent if you actually watch clips of Zac France’s team playing) but ensuring that it is allied to trust, support and genuine openness.

One individual who has spoken extensively on this issue is Ben Ryan, the Olympic Sevens winning coach, who now operates in a performance consultancy role. He has stressed the need for a “profound cultural change.” Citing various anecdotes from unnamed academy players, Ryan has emphasised the gulf in effort placed on maintaining physical health compared to mental.

“They [coaches] will get every ounce of energy from a player to maximise those returns but what about their psychological safety?”

He also came out challenging those who pay lip service to mental health, but are unwilling to deal with its manifest consequences, saying clubs must offer more than, “a sense of false safety, that your door is always open as head coach but if I don’t like what I’m hearing then there will be another door leading you to your exit.”

Fortunately for those who support his cause, Ryan is an individual who demonstrates that creating a positive, open and inclusive environment is not mutually exclusive from success. His Fiji Sevens side that triumphed in Rio 2016 were not only comfortably the best side, but visibly exuded a genuine love for the game.

A culture of denial may have existed, but that is now changing. Whether it is changing with the requisite speed and enthusiasm from those inside clubs is difficult to tell.

There are always those who are unwilling to change, so the message must be drummed home time and time again: ensuring that structures are in place to deal with mental health issues when they arise is not the same as consciously creating an environment designed to minimise unnecessary mental strain.

Kearnan Myall’s testimony bears this out; the availability of mental health support inside his club environment did not stop him from attempting to take his own life. That must change, from the grassroots to the upper echelons of professional rugby.

Written by Joe Ronan