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Racehorse Trainer Mental Health: Prevalence and Risk Factors
L. King , S.J. Cullen , S. O’Connor , A. McGoldrick , J. Pugh ,
G. Warrington , C. Losty
PII: S0737-0806(21)00053-8
DOI: https://doi.org/10.1016/j.jevs.2021.103423
Reference: YJEVS 103423
To appear in: Journal of Equine Veterinary Science
Received date: 20 January 2021
Revised date: 15 February 2021
Accepted date: 15 February 2021
Please cite this article as: L. King , S.J. Cullen , S. O’Connor , A. McGoldrick , J. Pugh ,
G. Warrington , C. Losty , Racehorse Trainer Mental Health: Prevalence and Risk Factors, Journal
of Equine Veterinary Science (2021), doi: https://doi.org/10.1016/j.jevs.2021.103423
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©2021 The Author(s). Published by Elsevier Inc.
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
1
Highlights
Much of the research examining racehorse trainer mental health has used non-
validated screening measures to assess prevalence of symptoms of common mental
disorders. This paper is the first to use validated screening measures in Europe
A prevalence of symptoms associated with common mental disorders was identified.
Specifically, depression (41%), adverse alcohol use (38%), psychological distress
(26%), and generalised anxiety (18%)
Career dissatisfaction, financial difficulties, and lower levels of social support
increased the likelihood of meeting the criteria for depression, psychological distress
and generalised anxiety
Findings indicate screening measures exploring career dissatisfaction, financial
difficulties, and social support may aid early identification of common mental
disorders among racehorse trainers.
2
Title Page
Title: Racehorse Trainer Mental Health: Prevalence and Risk Factors.
Author names and affiliations: King, L1; Cullen, SJ1, O‟Connor, S2; McGoldrick, A3; Pugh,
J3; Warrington, G4,5; Losty, C1.
1. Department of Sport and Exercise Science, Waterford Institute of Technology, Ireland.
2. Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of
Health and Human Performance, Dublin City University, Ireland.
3. Irish Horseracing Regulatory Board, Kildare, Ireland.
4. Health Research Institute, University of Limerick, Ireland.
5. Physical Education and Sport Sciences, University of Limerick, Ireland.
Corresponding author: Lewis King.
Email: lewis.king@postgrad.wit.ie
Word Count: 3771
3
Abstract
Racehorse trainers play an important role within the horseracing industry. Despite this, scarce
empirical information exists regarding the mental health of this population. Thus, the purpose
of the present study was to explore the prevalence of symptoms related to common mental
disorders (CMDs) and their associations with specific risk factors for CMD. Participants
completed an anonymous online questionnaire. CMDs were assessed including distress,
depression, generalised anxiety and adverse alcohol use. The risk factors examined included
career dissatisfaction, social support and financial difficulties. 124 participants (28% response
rate) completed the questionnaire. In total, 45% met the threshold indicative of at least one
CMD. Specifically, prevalence of symptoms associated with depression (41%), adverse
alcohol use (38%), psychological distress (26%), and generalised anxiety (18%) was
observed. Career dissatisfaction (28%) and financial difficulties (64%) were identified.
Career dissatisfaction, lower levels of social support and financial difficulties all increased
the likelihood of trainers meeting the criteria for at least one of distress, depression or
generalised anxiety. The study was the first to highlight prevalence rates of symptoms
associated with CMDs among racehorse trainers in Ireland and identify certain risk factors
which may increase the likelihood of racehorse trainers meeting the criteria for a CMD.
Assessment of risk factors can aid early identification of CMDs among racehorse trainers.
Such benefits may include early diagnosis or signposting to professional support. Further
research is required in examining other occupational stressors experienced by trainers and the
impact these may have on symptoms of CMDs.
Keywords: racehorse trainer; mental health; prevalence; depression; anxiety
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1. Introduction
Racehorse trainers play an important role within the horseracing industry. Their role
primarily involves training racehorses to earn the maximum prize money in a competitive
season as well as managing members of staff, facilitating or maintaining relationships with
owners, and ensuring the health and safety of the racehorse. However, the occupation is not
without its difficulties. Speed and Andersen [1] highlighted the unpredictable nature of a
career as a racehorse trainer. Trainers work exhaustive schedules, on average nearly 65 hours
per week. Associations between lengthy working hours and adverse health outcomes have
been identified [2], and racehorse trainer lengthy working hours appear comparable to other
animal related occupations such as farmers [3] and veterinary services [4]. Two-thirds of
trainers never or rarely had one day off per week. Trainers also face increased pressure from
owners (e.g. pressure to win competitive races), shoulder the burden of responsibility for
keeping horses healthy and sound, as well as financial difficulties. Racehorse trainers costs
primarily relate to staff, feed for the horses, fixed overheads (rent, mortgage payments) and
maintenance costs for the yard such as machinery or gallop repairs [5]. Financial aspects
associated with this highly demanding role were reported as the most prevalent work-place
challenge to the point that trainers often explored other avenues of employment, with the
main reason cited as a lack of income earned from training racehorses. Indeed, with prize
money reduced due to the COVID-19 pandemic, these challenges may be greater than
previously reported.
Despite these stressors and difficulties, research exploring the mental health of racehorse
trainers is sparse. In one of the few reports to examine the mental health of this population, it
was found that 29% of trainers (n = 303) in Australia reported feeling anxious often or very
5
often, whilst 32% stated they felt down/depressed often or very often [1]. More recently,
another study in Australia explored the psychological wellbeing of racehorse trainers in
comparison to other racing personnel (not specified) and the general population [2]. The
authors suggested that racehorse trainers reported significantly greater scores on depressive
and anxiety measures in comparison to other racing staff and the general population. Lastly,
Racing Welfare, a UK based charity designed to support the horseracing industry, found that
75% of trainers (n = 75) reported experiencing stress, anxiety, or depression over the previous
12 months [3]. Moreover, 51% of trainers reported take home earnings after taxes at less than
£19,000 per year, and 69% earning less than £29,000 per year. Therefore, it appears that
racehorse trainers predominantly earn substantially less than other similar industries such as
farming where in 2017 an average salary was reported at €31,000 [8]. In total, 39% of all
trainers found financial uncertainty a very stressful component of their occupation. As such,
financial difficulties may have contributed to the steady decline in the number of racehorse
trainers, with the climate for racehorse trainers to run and maintain a sustainable business a
challenge [9]. As with most sports, the concentration of the most successful athletes usually
arises in a small number of teams. In horseracing, similar concepts apply wherein the most
successful horses reside with a small number of trainers, which means for a vast amount of
trainers, success is difficult. The abovementioned stressors may influence the mental health
of trainers, but there is also a possibility that common stressors play a role in the development
of mental health issues as has been highlighted amongst other populations in sport (e.g.
athletes, coaches) and other rural occupations (e.g. farmers). Specifically, determinants such
as career dissatisfaction, a lack of social support, and financial difficulties, have been
reported to be associated with an increase in the occurrence of symptoms for common mental
disorders (CMDs) [6,10–12]
6
To date, no study has examined the mental health of racehorse trainers in Ireland using
validated screening questionnaires. Thus, the purpose of this study was to investigate the
prevalence of symptoms associated with CMDs, defined as depression, generalised anxiety,
psychological distress and adverse alcohol use, and their associations with specific risk
factors (career dissatisfaction, lower levels of social support, financial difficulties) among
racehorse trainers. It was hypothesised that racehorse trainers reporting greater levels of
career dissatisfaction and financial difficulties, and lower levels of social support, would
increase the presence of symptoms associated with CMDs.
2. Methods
2.1 Procedures
Licensed trainers over the age of 18 (n = 450) were invited to participate by the Irish
Horseracing Regulatory Board (IHRB). Participants were recruited through July-August 2019
with survey reminders sent at two- and four-week intervals. Information about the study was
sent via email and text messages by IHRB to licensed trainers, with this procedure blinded to
the researchers for privacy and confidential reasons. Participants completed an anonymous
and confidential online survey on survey website Survey Monkey. After reading a
participation information sheet, participants provided informed consent. The electronic
questionnaire took around 20 minutes to be completed, with data saved automatically on a
secure electronic server only accessible by the lead researcher. Upon completion of the
questionnaire, numbers for mental health helplines and support services were provided for the
participant to contact if the participants felt distressed or concerned. Ethical consent for the
study was provided by a local Third Level Institutions Research Ethics Committee (REF:
18/HSES/06).
2.2 Participants
7
Licensed trainers (n = 450) were contacted to take part in the study, of which 124 (81% male;
18% female; 1% preferring not to say) completed the questionnaire, representing a response
rate of 28%. Participants ranged in age from 24 to 85 years old. Participants trained horses
across both codes of racing, with 14% training flat horses, 44% training national hunt horses,
and 43% training both flat and national hunt (dual) horses. On average, trainers had trained
racehorses for 14 years (SD = 10.9) and worked 64 hours per week (SD = 21.5). Nearly one
in two (48%) trainers reported not having a period of three days or more holiday from work
in the past 12 months, and 73% reported not having a day off work in the previous two
weeks. All characteristics of the participants are presented in Table 1.
Table 1: Participant characteristics of racehorse trainers in Ireland.
n
124
Trainer response rate
28%
Age in years, M (SD)
47.3 (12.0)
Gender
Male, n (%)
Female, n (%)
Prefer not to say, n (%)
100 (81)
22 (18)
2 (1)
Code of racing,
Flat, n (%)
National Hunt, n (%)
Dual (both Flat and National Hunt), n (%)
17 (14)
54 (43)
53 (43)
Highest level of education reached
Primary school, n (%)
Junior Certificate, n (%)
Leaving Certificate, n (%)
Third Level Education, n (%)
Other, n (%)
9 (7)
30 (24)
35 (28)
41 (34)
9 (7)
Years as a trainer, M (SD)
13.9 (10.9)
Number of winners, M (SD)
Range
78.1 (159.6)
0-1100
Working hours per week, M (SD)
63.6 (21.5)
Numbers of horses in training, M (SD)
Range
15.7 (19.2)
1-150
Members of staff employed (part or full-time), M (SD)
Range
Number of times when trainer had a period of three or more days off work
in the past 12 months
Never
Once
Twice
3.4 (5.4)
0-40
59 (48)
46 (37)
11 (9)
8
2.3 Measures
Demographic and general lifestyle data was collected including age, gender, predominant
code of racing training horses in (e.g. flat, national hunt or dual purpose), educational level
reached, years‟ experience as a trainer, number of winners, working hours per week, number
of horses in training, and number of staff employed. Internal consistency of the scales used in
the present study were measured using Cronbach‟s alpha coefficient. Validated
questionnaires were used to capture prevalence data and included:
Psychological distress – Assessed using Kessler Psychological Distress Scale (K10) [13].
The questionnaire uses a 5-point Likert scale ranging from 1 (none of the time) to 5 (all of the
time) with scores ranging from 10-50. A cut-off point of 22 or more indicates symptoms of
distress with higher scores representing higher symptom levels. Internal consistency for the
questionnaire was calculated at 0.93.
Depression – Depression was measured using the Center for Epidemiological Studies
Depression (CES-D) [14] questionnaire. The 20-item questionnaire encourages participants to
respond to questions relating to symptoms that have occurred over the previous seven days.
Scoring is completed on 4-point scale ranging from 0 (rarely or none of the time) to three
(most or all of the time). Scores ranged from 0-60 with greater scores representative of
greater depressive symptom levels. A score of 16 or more was used as the threshold as has
been used previously in research (e.g. 10). A score of 0.81 was calculated for the internal
consistency of the questionnaire.
Three times
Four times or more
Number of days off work in the last two weeks
No days
One day
Two days
Three days or above
6 (5)
2 (1)
90 (73)
20 (16)
8 (7)
6 (4)
9
Generalised Anxiety – Generalised anxiety was measured over the previous two weeks using
the Generalised Anxiety Disorder (GAD) [16] questionnaire. The 7-item questionnaire is
scored on a four-point scale, ranging from zero (not at all) to three (nearly every day). Higher
scores indicate higher symptoms levels, with a score of 10 or more indicative of generalised
anxiety disorder. Internal consistency for the questionnaire was calculated at 0.93.
Adverse alcohol use
Alcohol consumption was measured using the three item Alcohol Use Disorders
Identification Test (AUDIT-C; e.g. how many standard drinks do you have on a typical day?)
[17]. Scores between zero and three are collected for each question, with a sum of all three
scores producing a final alcohol use score. A score of five or more was indicative of adverse
alcohol use. Internal consistency for the questionnaire was calculated at 0.82.
General help-seeking questionnaire - One question from the general help-seeking
questionnaire [18] was included which required participants to select the type of mental
health professional (e.g. psychologist/psychiatrist), if any, that they had previously visited for
personal or emotional problems.
Associated risk factor questionnaires were also completed:
Career dissatisfaction
Career dissatisfaction was measured via the Greenhaus scale (e.g. I am satisfied with the
success I have achieved in my career) [19]. Using a 5-point scale, scores were measured from
extremely dissatisfied (1) to extremely satisfied (5). A total score of 5 to 25 was reported by
summing up the answers to the five questions, with a lower score indicating greater levels of
career dissatisfaction. A score of 0.90 was calculated for the internal consistency of the scale.
Social support
10
The Multidimensional Scale of Perceived Social Support [20] was employed to measure
perceived social support. The 12-item questionnaire contains three subscales consisting of
four questions each, measuring specific types of social support which included support from;
(i) significant others; (ii) family; (iii) friends, and; (iiii) total social support. Each scale was
computed by summing the four specific questions on each subscale and obtaining a mean
value by dividing each subscale by four. Total social support was computed by calculating
the average score from all 12 questions. Internal consistency for each subscale ranged from
0.93 to 0.96.
Financial difficulties
Financial difficulties were measured by the use of two questions which related to trainers‟
perception of paying bills (e.g. think back over the past year and rate the difficulty you had in
paying your bills) and money left over at the end of each month (e.g. at the end of each
month, do you end up with: more than enough money left over, some money left over, just
enough money to make ends meet, not enough money to make ends meet). A maximum score
of seven was possible, with a score of ≥4.5 indicative of financial difficulties. Receiver
Operator Characteristics (ROC) identified ≥4.5 as the appropriate cut-off point with a
sensitivity of 0.832, specificity of 0.138, and area under ROC curve 0.92. The variable was
subsequently transformed into a dichotomous variable of low financial difficulties and high
financial difficulties.
2.4 Statistical analyses
Data were analysed using statistical software programme IBM SPSS 24.0 for Windows.
Descriptive data (mean, standard deviation, range) were performed for all variables.
Prevalence rates of symptoms for CMDs were calculated. Prevalence rates and cut-off points
were provided for risk factors where appropriate. Binary univariate logistic regression,
11
expressed as odds ratios (OR) and related 95% confidence intervals (CI), was conducted to
analyse the potential relationships between CMDs (psychological distress, depression,
generalised anxiety, adverse alcohol use) and risk factors (career dissatisfaction, social
support, financial difficulties).
3. Results
3.1 Prevalence of Symptoms of CMDs
Prevalence of symptoms of CMDs among racehorse trainers in Ireland varied for depression
(41%), adverse alcohol use (38%), psychological distress (26%), and generalised anxiety
(18%). In total, 45% of participants met the criteria for at least one CMD, 32% for at least
two CMDs, and 21% for at least three CMDs. One fifth (21%) had accessed a mental health
professional for support with their personal or emotional problems, with a doctor/GP the most
commonly selected (15%). All prevalence rates are presented in Table 2.
Table 2: Prevalence of symptoms of mental health disorders and risk factors of racehorse
trainers
Symptom Measure (potential range)
K10 (10-50), M (SD)
Range,
17.9 (7.5)
10-42
CES-D (0-60), M (SD)
Range,
16.7 (8.7)
0-58
GAD-7 (0-21), M (SD)
Range,
AUDIT-C (0-12), M (SD)
Range,
5.1 (5.3)
0-21
3.9 (3.3)
0-12
Caseness cut-off (percentage meeting cut-off score)
K10 score ≥ 22, n (%)
33 (26)
CES-D ≥ 16, n (%)
51 (41)
GAD-7 ≥ 10, n (%)
AUDIT-C ≥ 5, n (%)
22 (18)
47 (38)
Met caseness for at least one CMD, n (%)
Met caseness for at least two CMDs, n (%)
Met caseness for at least three CMDs, n (%)
56 (45)
40 (32)
26 (21)
Number that have ever seen a mental health professional to get help for personal or
emotional problems (GHSQ) n (%)
12
Male 19 (19)
Female 7 (32)
Other 0 (0)
Any source
26 (21)
Psychologist
4 (3.2)
Doctor/GP
19 (15.3)
Psychiatrist
4 (3.2)
IHRB Senior Medical Officer
4 (3.2)
Counsellor/Other (not specified)
15 (12.1)
Abbreviations: Common Mental Disorder (CMD); Kessler Psychological Distress Scale
(K10); Center for Epidemiologic Studies Depression (CES-D); General Anxiety Disorder
Questionnaire (GAD-7);Alcohol Use Disorders Identification Test (AUDIT-C); General Help
Seeking Questionnaire (GSHQ) - Participants were able to select multiple sources of support,
thus the number accessing individual supports (e.g. psychologist) does not equal the any
source figure.
3.2 Prevalence of Risk Factors
Mean score for career dissatisfaction was 15.5, and although as a group the participants were
above the threshold for career dissatisfaction (>12), only 28% met the criteria for career
dissatisfaction. Sixty-four percent reported experiencing financial difficulties within the past
year. Mean scores on all social support scales indicated that trainers perceived they had
moderate to high levels of social support. See Table 3 for all risk factor information.
Table 3: Risk factor prevalence among racehorse trainers in Ireland.
Symptom Measure (potential range)
Career dissatisfaction (5-25), M (SD)
n (SD)
15.5 (5.0)
35 (28)
Social support (0-7), M (SD)*
Total social support
Significant other
Family
Friends
5.4 (1.3)
5.6 (1.5)
5.4 (1.5)
5.0 (1.5)
Financial difficulties (1-7), M (SD)
n (SD)
5.1 (1.5)
79 (64)
*cut-offs not provided for social support measures
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3.3 Associations between Prevalence (presence versus absence) of Symptoms of CMDs
and Risk Factors
Table 4 presents associations (expressed as odds ratios OR related and 95% confidence
intervals) from binary univariate logistic regressions between prevalence of CMDs and risk
factors in Irish racehorse trainers. Career dissatisfaction, lower levels of social support, and
financial difficulties significantly increased the likelihood of meeting the criteria for
psychological distress, depression, and generalised anxiety.
4. Discussion
The findings from the present study are the first to explore racehorse trainer mental health in
Ireland using validated screening questionnaires. In total, 45% of trainers met the criteria for
at least one CMD, including depression (41%), adverse alcohol use (38%), psychological
distress (26%), and generalised anxiety (18%). Moreover, 32% of trainers met the threshold
for at least two CMDs, and 21% for at least three CMDs. Career dissatisfaction, financial
difficulties, and lower levels of social support increased the likelihood of meeting the criteria
for psychological distress, depression and generalised anxiety. The findings also highlight
that only a fifth of trainers had sought support for their personal or emotional problems.
Table 4: Binary univariate logistic regression analysis, expressed as OR and their 95% CI‟s, between CMDs and assessed risk factors
among racehorse trainers in Ireland.
Psychological distress
Depression
Generalised anxiety
Adverse alcohol use
OR
95% CI
p
OR
95% CI
p
OR
95% CI
p
OR
95% CI
p
Career
dissatisfaction
0.22
0.09-0.51
.001
0.19
0.08-0.46
<.0001
0.29
0.11-0.76
.011
1.13
0.5-2.53
.771
Social support a
TSS
SO
Family
Friends
0.50
0.35-0.71
.<.0001
0.52
0.80-1.68
<.0001
0.54
0.38-0.78
.001
0.94
0.72-1.24
.680
0.69
0.53-0.89
.005
0.73
0.85-1.88
.015
0.71
0.54-0.93
.014
0.88
0.70-1.13
.288
0.69
0.53-0.89
<.0001
0.56
0.69-1.49
<.0001
0.61
0.45-0.82
.001
0.87
0.68-1.13
.273
0.55
0.4-0.75
<.0001
0.58
0.76-1.71
<.0001
0.58
0.42-0.81
.001
1.15
0.9-1.48)
.267
Financial
difficulties
0.07
0.02-0.32
<.0001
0.18
0.53-3.96
<.0001
0.06
0.01-0.49
<.0001
1.37
0.64-2.92
.775
Note:. a Lower scores = lower levels of social support. Abbreviations: TSS – Total social support; SO – Significant other.*
14
Of the limited data available, findings from our study suggest that depressive symptoms may
be greater among racehorse trainers in Ireland than other racing jurisdictions previously
reported. A greater proportion of racehorse trainers met the threshold indicative of a
depressive disorder in the present study (41%) compared to trainers studied in Australia
(32%) [1]. Whilst this finding may represent differing levels of CMD symptoms between
racehorse trainers dependent on their location and unique occupational characteristics,
findings should be interpreted with caution. Methodological assessments between the two
studies differed, with the use of a validated questionnaire in the present study (CES-D), and a
self-made questionnaire in the Speed and Andersen [1] study. In this study, trainers were
asked to rank how often they felt depressed or anxious on a 6-point Likert scale measuring
from never to always. Using a validated questionnaire exploring symptoms over a specific
time period may have provided more accurate and effective results for analysis.
Consequently, future research may seek to determine differences between the stressors,
lifestyles, and mental health of racehorse trainers in differing racing jurisdictions, particularly
important given the mean score for depressive symptoms was above the cut-off score of 16 in
the present sample.
Due to the dearth of information relating to racehorse trainer mental health, a useful
occupational comparison may be made to farmers given the similarities between the two roles
which includes working with animals, long working hours, financial difficulties, working
rurally, and potential social isolation [11]. Epidemiological studies exploring farmer mental
health rates have reported figures between 29% and 24% for mild anxiety and depression
[11]. In the United States, using the same questionnaire as the present study (CES-D),
prevalence rates were reported at 9.3%, with a mean score of 6.1 [21], which was
considerably lower than the mean score of 16.7 reported in the present study. Research in the
United Kingdom reported much lower rates of depression (4.2%), likely due to the
15
methodological approach undertaken (Revised Interview Clinical Schedule) [22]. Thus, in
studies that used self-reported questionnaires, it appears that prevalence of symptoms
associated with CMDs among Irish racehorse trainers may be greater in comparison to other
similar working domains, with particular emphasis on depression prevalence (41%).
The number of trainers seeking help for personal or emotional problems was relatively low in
this study, with 21% reporting seeking help from a mental health professional. Similar rates
of help-seeking (21%) were also reported among racehorse trainers in Australia [1], although
the authors reported on intention to seek help, rather than actual engagement with
professional mental health services, so clarity around precise help-seeking estimates is
difficult to ascertain. Furthermore, most of the participants in the present study were male. A
lack of help-seeking among males has been documented within the literature, which often
relates to masculinity [23] and conforming to certain „masculinity scripts‟[24], but also the
stigma linked to seeking and accessing professional support [25]. Indeed, in the present study,
a greater percentage of female trainers (32%) had previously sought help in comparison to
male trainers (19%). Currently in Ireland, a 24/7 helpline is available to anyone who works in
the racing industry if they wish to discuss any issues they are experiencing. However, given
only one fifth of trainers reported talking to a mental health professional about their personal
or emotional problems, it suggests that trainers may not be utilising the service. Exploring
factors which may inhibit racehorse trainers accessing support services represents an
important future direction of research.
Two-thirds of trainers reported financial difficulties. Trainers were between five and 16 times
more likely to meet the criteria for distress, depression, or generalised anxiety if experiencing
financial difficulties. Past research has identified that racehorse trainers report significantly
lower financial wellbeing scores in comparison to non-trainers (e.g. other individuals
working within the racing industry) [6]. Thus, financial difficulties appear to be a key stressor
16
for racehorse trainers, with issues around staffing levels and wages, cash flow, levels of debt,
not obtaining enough work (e.g. number of horses in training) to cover financial outgoings,
increasing costs, and poor prize money [1]. In the current climate, throughout the COVID-19
pandemic, this stressor may be exacerbated due to reductions in prize money. Horseracing is
extremely competitive; therefore, trainers cannot solely rely on training fees and prize money
to support their business and are usually required to partake in other forms of business
activity such as buying and selling horses, further emphasising the unpredictability of life as a
racehorse trainer. Consequently, organisations and key stakeholders might consider the
impact that financial difficulties can have on an individual‟s mental health. Workshops,
support programmes, and training modules that include business advice and information
relating to managing periods of financial adversity would be useful given the prevalence of
trainers experiencing financial difficulties. Racehorse trainers are required to attend a
racehorse trainer licensing course prior to receiving their trainer license, therefore they
represent an opportunity to facilitate the abovementioned training recommendations.
Moreover, educational courses throughout a racehorse trainers beyond the licensing course
career should also be facilitated.
Greater levels of career dissatisfaction were associated with meeting the threshold for
distress, depression and generalised anxiety, with 28% reporting dissatisfaction with their
careers. This figure is greater than the 16% previously reported among racehorse trainers in
another study [1]. In total, trainers in the present study that were dissatisfied with their
careers were between 3.4 to 8.3 times more likely to meet the criteria for one of distress,
depression or generalised anxiety. This finding corroborates previous research that has
identified the associations between prevalence of CMDs and career dissatisfaction [12]. Thus,
career dissatisfaction measures may be useful as an early screening measure to identify
mental health issues or challenges. Nevertheless, career satisfaction among racehorse trainers
17
appears high, with 72% classified as satisfied with their careers. One potential reason for this
is that working with horses may act as a stress-buffer for the trainers, with research
highlighting the positive impact working with horses can have on an individual‟s mental
health [26]. Further research is needed to identify other areas that may contribute to the career
satisfaction of trainers.
Trainers reported moderate to high levels of perceived social support, with social support
dimensions appearing to serve as a protective factor for meeting the criteria for distress,
depression and generalised anxiety. This may be due to the close-knit nature of the
horseracing industry, wherein significant others and family members often work alongside
one another. Indeed, anecdotally, a host of trainers currently working in Ireland have
continued the family business when a relative has retired from the sport. Research suggests
that positive or protective effects of social support are due to both direct and indirect
concepts, whereby mental health is benefited directly through close social relationships, and
indirectly via buffering in stressful situations [27]. Future research of interest would include
the potential disparity between perceived and received social support measures. Currently,
the effects of trainers receiving social support are not known, however previous studies have
identified that factors relating to specific stressors, providers and the recipient all play a key
role in the effectiveness of received support [28]. As such, careful consideration should also
be made to the type of intervention delivered to the individual (e.g. online vs face-to-face).
As with any research project, the present study is not without limitations. Firstly, whilst the
sample size was large (n =124), the survey response rate was 28% and it may be possible that
the data is not fully representative of the larger racehorse trainer population in Ireland. For
instance, the mean number of staff employed was 3.4 staff numbers, but the range varied
from 0 – 40. Similar concepts apply to the total number of horses in training reported by the
present sample, with the average number reported at 15.7, with the range between one and
18
150. Thus, it may be the case that our sample consists of smaller racehorse trainers, indicated
by the relatively low averages of horses in training and staff employed. However, findings in
the United Kingdom reported that majority of trainers employ one to five workers, and on
average train one to 19 horses [7], suggesting that the majority of racehorse trainer businesses
are smaller in stature. Furthermore, due to the anonymous nature of the study, with
recruitment procedures blinded to the lead researcher, non-response analysis could not be
conducted. Consequently, it is possible that those with mental health issues were more
inclined to respond to the questionnaire. Lastly, we acknowledge the limitations associated
with self-reported data in relation to mental health research. It is possible that trainers were
under or over-motivated to answer questions in a certain manner dependent on factors such as
lived experience or stigma. Nonetheless, the questionnaires were conducted anonymously so
it is hoped these issues were avoided.
5. Conclusion
The present study is the first study in Ireland to examine racehorse trainer mental health using
validated screening measures. Key findings include the prevalence of symptoms of CMDs,
with nearly one in two trainers (45%) meeting the criteria for any CMD, the most prevalent
being those meeting the criteria for depression (41%). Risk factors for trainer mental health
may include career dissatisfaction, financial difficulties and lower levels of social support.
Identifying and implementing specific bespoke interventions for racehorse trainers is a
challenge until the research and understanding around the varying areas of mental health and
mental illness within this population are better understood. As such, future research may
consider a broader approach given the nuances and unique nature of a career as a racehorse
trainer, moving beyond presence of symptoms, examining other areas reported to impact
mental health (e.g. identity, stigma), as well as the possible development of bespoke
interventions and support structures.
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Conflict of interest statement
The authors declare no conflict of interest.
Financial support statement
The lead author would like to thank the Irish Horseracing Regulatory Board for the funding
of an ongoing PhD programme which facilitated the development of the present study.
Acknowledgements
The authors would like to thank all participants for completing the questionnaire.
20
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