A Victorian coroner has called for more research into the the long-term consequences of head blows in contact sports while confirming the devastating final few months of Danny Frawley's life.
Frawley, a legend of the AFL, had CTE (chronic traumatic encephalopathy), which is associated with repeated blows to the head and can only be diagnosed after death.
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The 56-year-old took his own life in the single-car crash the day after his birthday in September 2019.
In her findings into the St Kilda legend's death, Victorian Coroner Paresa Spanos said AFL players should be encouraged to donate their brains to science to shed more light on CTE.
Frawley sustained about 20 concussions throughout his 240-game career with St Kilda between 1984 and 1995 and retired before the discovery of CTE.
His mental health started going downhill around the time he finished up a coaching role with Richmond in 2004, according to his wife Anita.
A decade later, he began seeing a psychiatrist for his depression but "was never the same", Mrs Frawley said.
Frawley became an advocate for men's mental health, but kept the extent of his own struggles private.
From late 2018 and during the following year, he stopped taking his antidepressants and seeing his psychiatrist, started drinking in excess, withdrew from his family and his marriage suffered.
Frawley started treatment five weeks before his death, and the day beforehand appeared happy celebrating his birthday with friends and family.
“He had a significant constellation of depressive symptoms including significant insomnia, depressive ruminations, relative anhedonia, self-reproachment, amotivation, difficulty functioning and episodic passive suicidality,’’ the coroner's report said on Tuesday.
“He had also engaged in poor decision making and conduct that caused conflict in his marriage.
“To his family, Mr Frawley would lie in bed all week and be extremely needy, but he would be able to put on a brave ‘public face’ and give the appearance of normal functioning.
“From about April 2019, she observed that he became increasingly erratic and began to eat and drink in excess.
“Mr Frawley stopped turning up to planned bike rides with his friends and was consumed by his own needs with little apparent regard for his family.
“In late June 2019 Mr Frawley’s decision-making was still erratic and his personality had changed.
“He became even more self-absorbed and had gained about 25kg.
“He avoided his family’s Christmas in July celebrations, preferring to spend the time with a country AFL team that he had been coaching.”
Coroner calls more research into concussions
Ms Spanos concluded it was impossible to establish when Frawley developed CTE and unclear how much this affected his mental health.
At its highest, it potentially contributed to the depression.
"Mr Frawley began his football career in his formative years and likely experienced head trauma before his personality was well established," the coroner said.
"This coupled with the inability to diagnose CTE before death, confounds evaluation of the contribution of CTE to personality, behaviours, any cognitive deficits, or lability of mood."
The prevalence of CTE in Australia is unknown. But the coroner pointed to studies suggesting at least 17 per cent of people who experienced repetitive concussions or mild traumatic brain injury developed it.
Among her recommendations were calls for the AFL and its players' association to encourage footballers to agree to donate their brains to the Australian Sports Brain Bank following their deaths.
This would help further research, and improve safety for future AFL players and others involved in contact sports across the board, Ms Spanos said.
The AFL earlier this year doubled the time concussed players were barred from returning to the field from six to 12 days.
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