Suffering in Silence: The Mental Health Challenges in Maltese Football

When we think of footballers, we picture strength, discipline, and confidence. But behind the image of control and success, many are struggling in silence.

A new study by Ayrton Attard and Dr Adele Muscat from the University of Malta reveals a reality few in Maltese football want to talk about — mental health challenges are widespread among Premier League players, yet support and understanding remain shockingly limited.

The study

Eight male players from Malta’s Premier League (2023–2024 season) opened up in in-depth interviews about the pressures, expectations, and emotional toll of playing professional football. Through reflexive thematic analysis, Attard and Muscat explored how mental health affects performance, the role of education and awareness, and the lack of structural support across Maltese clubs.

The main findings

1. Pressure and performance anxiety - Players spoke of constant pressure from fans, media, coaches, and committees — compounded by an unspoken rule that showing vulnerability is a sign of weakness. The “macho” culture of football still dominates, leaving little space for open discussion.
   

2. Mental health directly impacts performance- Burnout, fatigue, and anxiety were common. Players said that poor mental health affected concentration, decision-making, and confidence — key elements for peak performance. One admitted:
   

   “If I play a bad match, I have a whole week depressed… if I play well, I’m happy.”
   

3. Transitions take a heavy toll-Moving from youth to senior football was described as one of the hardest periods in a player’s life. For some, moving clubs or playing abroad caused isolation, homesickness, and self-doubt — especially given Malta’s close-knit culture.
   

4. Injuries can break more than bones- Long-term injuries triggered identity crises among players. One recalled:
   

   "I thought my only identity was football… until I was injured and realised I needed other parts of myself.”
   

5. Clubs lack mental health professionals - Despite awareness campaigns, no Premier League club in Malta currently employs a full-time psychologist. Only one player interviewed had attended a mental health talk organised by the Malta Football Players Association (MFPA).
   

6. Stigma and lack of education - The taboo remains strong. Players fear being labelled “weak” for seeking help. As one said:
   

   “If you tell someone you’re going to a psychologist, it’s unheard of. People are still shy talking about it.”
   

7. Education must start early - Players called for mental health awareness to begin at school and academy level — normalising emotional wellbeing from a young age. They suggested including mental health modules in PE and football curricula, delivered by professionals.

Why this matters for Malta

This study is a wake-up call. Footballers — the country’s most visible athletes — are showing that mental health is not a luxury topic, but a performance issue. Clubs and federations cannot keep treating wellbeing as an afterthought.

Players are asking for what every worker deserves: a safe, supportive environment where they can talk, recover, and perform without fear of judgement.

The big takeaway

Malta’s football system urgently needs a cultural and structural shift:

• Hire qualified sports psychologists within clubs.

• Integrate mental health education into schools and academies.

• Normalise conversations about stress, anxiety, and burnout.

• Move from “mental toughness” to mental literacy and care.
  

Because no player should have to suffer in silence.

Reference: Attard, A., & Muscat, A. (2025). Suffering in Silence: Mental Health in the Maltese Football Premier League. Studies in Social Wellbeing, 4(2), 128–160. University of Malta.