Time flies. It’s been 15 years since Marcus Trescothick last played for England, in a warmup match against New South Wales in November 2006. He broke down in the dressing room on the last day of the game – “All the same feelings of irrational fear, despair and panic came back in wave after bloody great wave” – and flew back to England that same evening. The team management described it as a “recurrence of a stress-related illness”. There were a lot of accusations, jokes and innuendoes, which were only put straight when Trescothick published his autobiography in 2008, and people at last began to understand how badly he was suffering. It was a turning point for the sport. Right now Ben Stokes is on an indefinite break while he treats his mental health, and an entire Ashes tour has been in the balance – it is all set to go ahead, according to the latest reports – while his teammates have been trying to decide whether their employers could guarantee proper care and protection for their mental health. After Trescothick, after Mike Yardy, after Jonathan Trott, after Sarah Taylor, and so many others, you would think we’d all understand their argument by now. But the game has changed so much, so fast, not everyone does. You can hear it in the remarks made by some players and pundits, and read it online, in the comment sections and on social media. It’s a privilege. They’re being paid to play. They should be proud. Fans who can only dream of what a player’s life must be like expect them to be happy with their lot. I’ve suffered with depression myself, have interviewed, and written about, many of those same players and, if I’m honest, there are times when even I can’t quite wrap my head around this radical shift in the way we think about sport, which belies the old idea that the admirable thing is persisting through the suffering, that strength is always in the overcoming. Researchers are only just beginning to flesh out all the anecdotal evidence about the mental health problems in cricket. The British Medical Journal recently published a review of the existing literature in the field. The authors concluded that elite cricketers are “at high risk for distress, anxiety, depression and adverse alcohol use” and are “more likely to experience anxiety and depressive symptoms” than members of the general population. The most interesting of the studies included was published in South Africa in 2017, on a group of 116 current and former professional cricketers, all under the age of 45. Among that group, 38% were suffering with distress, 38% with sleep disturbance, 37% with anxiety/depression and 26% with adverse alcohol use. These figures weren’t just higher than you would expect to find in the general population, they were higher than have been found in similar studies of elite athletes in other sports such as rugby union and football. The authors of the BMJ study talk specifically about the effects of long tours. The authors of the South African study mentioned in particular “the constant feeling of guilt from balancing a professional career as sportsmen and their family commitments”. And that was before the pandemic. The British Association of Sport and Exercise Medicine started the job of unpicking the effects of the past two years in its latest magazine, which was devoted to mental health in cricket. In it Ian Thomas from the Professional Cricketers’ Association reported a dramatic rise in the number of members accessing mental health support, from 34 cases in 2015 to 94 in 2020. He suggests the spike is because of a rise in awareness, and more recently by the stress caused by pay cuts, employment uncertainty and biosecure bubbles. Until you’ve been in one, Thomas says, it’s hard to imagine how hard life in a bubble can be. It’s not just the isolation, Thomas explains, it’s the boredom. It makes people more vulnerable. They drink more, gamble more and exercise less. The magazine also includes an article by two members of Cricket Australia’s medical staff, Matt Burgin and Dr John Orchard, who say that, while the symptoms caused by bubbles may be subclinical (so, easy to dismiss) they are also cumulative “and it is possible that the negative effects were experienced weeks and months after the event”. Orchard and Burgin write about “the widespread acceptance of players making personal decisions to prioritise their mental health” as “a cultural shift for Australian sport”. And beyond. Like so much else that has happened in the past 18 months, this may be a permanent change. There’s a sense that priorities have shifted irrevocably during the pandemic. The stand over the Ashes may be another sea change in the sport, brought about by players who have more options, so more power, than they did in Trescothick’s day. The PCA, which recently ran an independent review of its mental health provision, has already cottoned on to this shift in the way players think about their health. So have the administrators. The England and Wales Cricket Board has been trying its best, in its way, to manage the problem by running a rotation policy on tour. And soon as England lost, the ECB was nailed for it. The ECB may have made mistakes along the way (using mental health as justification for pulling out of the tour to Pakistan was one) but reading some of the coverage, and comments, it feels like it’s the rest of us who are still catching up to the fact that things are different now. At the start of the last decade, progress was in understanding that some people were struggling; at the start of this decade, it’s in understanding that almost everyone is.