Has Tyson Fury shone a spotlight on boxing's mental health problem?

Britain's Tyson Fury, the heavyweight world boxing champion. Photo / AP

There is no hiding in boxing, at least not physically. Once the lights pale and the starting bell lets out three shrill rings, the only thing that matters is two fighters going blow-for-blow until one of them is drubbed senseless.

But when the fervent roar of the crowd subsides and the adrenaline rush mollifies, what then becomes of the men left bloodied and broken in a dark changing room? In such an unforgiving industry, where aggression and testosterone reign undisputed, are boxers really the steely masochists we consider them to be?

The news that Tyson Fury, the WBO and WBA heavyweight champion, has again withdrawn from his rematch with Wladimir Klitshcko citing mental health problems may hold some answers.

Declared "medically unfit" to fight by Peter Fury, his uncle turned trainer, Tyson was on Monday lambasted by boxing promoter Eddie Hearn for disrupting one of the sport's most lucrative title bouts.

By opening up about his inner demons, in Hearn's eyes, Fury is guilty by admission: he has confessed to one of boxing's cardinal sins. "[They] needed to get hold of him," he says, "give him a slap and say: 'Pull yourself together, you're the heavyweight champion of the world.'"

To those unversed in the code of boxing such vitriol may seem startling, but Hearn is not alone in his irritation. Boxing is a business which spares no time for tears; a sport where mental health is not so much an afterthought as it is an outright taboo.

How then, to deal with Tyson coming clean? Easy, says Hearn. "He will be stripped of his titles and, after a legal battle, he'll say: 'No more, I'm done.'"

For breaking rank and attempting to shine a spotlight on his sport's hidden gremlins, Fury may now face his greatest challenge to date: changing his sport's outlook on mental illness. But in the eyes of other boxers who, like him, were unable to cover up the cracks in the veneer, this fight may be one too far.

"Before Tyson Fury there have been many boxers that have battled with the same issue," says Leon McKenzie, a British middleweight currently challenging for the national belt. "It shouldn't take a world champion to come forward for people to take notice. There are so many issues in need of tackling and, right now, not enough is being done."

"The problem is that boxing is a business," Leon tells me. "First and foremost, Eddie Hearn is thinking about the fight. Granted, Fury's personality and the way he has previously conducted himself hasn't helped. But the bigger picture is far more important, because mental health is a serious issue.

"'Shut up and get on with it' always seems to be the approach in boxing when mental health is involved. Like so many boxers before him, if Fury's struggling with issues he'll probably have to retire. That's the reality."

Leon speaks from experience. A former Premier League footballer turned boxer, grappling with a messy divorce and fading from the limelight, he attempted to commit suicide in 2009.

Thankfully, his father Clinton McKenzie, himself an ex-boxer, was on hand to save his son. But in boxing-the sport to which he turned to help find refuge in retirement - he found no emotional support.

"Suicide Leon, that's what they called me," he says quietly. In 2015, McKenzie became the subject of callous name calling in the run up to his fight with John McCallum, his opponent in an eliminator contest for the British super-middleweight title.

"He just keeps playing the violin and wanting people to feel sorry for him," McCallum said at the time. "It's self-seeking attention."

"People like John are just uneducated; he's just a boxer at the end of the day. Unfortunately he just wanted to put on some gloves, do all the trash talking and psychological warfare. But what he ended up doing was launching into something really personal. When you're saying things like 'I'm going to put you back into depression', that gives our sport a nasty edge that isn't welcome or necessary."

Few people would begrudge Leon for wanting revenge for such spiteful rhetoric. But in his eyes, opponents like McCallum speak more out of ignorance than malignancy.

"They don't understand mental health," Leon adds. "I've lost a lot of people in my life because of suicide, including my sister, whose birthday it would have been today. When you lose people through mental health issues, it changes your perception; you become humbled by it. That's what we need to change - the kids fighting today who don't understand or know how to conduct themselves."

McKenzie is just one of many British boxers to have teetered on the edge. Down the years, some of Britain's greatest fighters - Herol Graham, Ricky Hatton and Frank Bruno to name three - have struggled to stay above board.

Given the expectation and the intense pressure of preparing for a fight with global appeal, it hardly surprising that mental illness is so rife among boxers. So why, then, do those charged with its regulation and promotion appear so unscrupulous in their attitudes on the issue?

"The answer is I don't know," says Leon. "All I can say is that those that point the finger and say 'just get on with it'; their opinions aren't helping our sport. When I've hung up my gloves I'd like to be able to sit down with the associations and look at a better way of protecting boxers. If there's a way of changing perceptions, helping boxers out of a hole, then surely that's got to be the way forwards in the future."

For Dr Caroline Silby, an internationally recognised sports psychologist, the latest fallout over Tyson Fury's wellbeing has only underlined the need for a seismic change in how boxing deals with the problem.

"These comments about Fury aren't helpful," she says. "For too long depression and mental health has been boxing's dirty little secret."

Having worked extensively with Olympians and boxers throughout her career, Silby is all too aware of the current perception of fighters; who often feel forced to internalise their problems until the issue reaches breaking point.

"It's hard for people to believe that such successful athletes could feel depressed or anxious," Selby explains. "We have this ingrained view of them as high-functioning professionals, but what is so often overlooked is that behind the mask, they are still developing and trying to figure out how to cope with the immense pressure that comes with being an elite athlete."

Working closely alongside the American boxing associations, Silby says that, increasingly, support networks are being implemented to help US boxers deal with their "invisible" health concerns. Looking at the sport holistically, she believes progress at international level begins by recognising that a fighter's mental health is as integral to their success as their physical condition.

"From the team managing the boxer through to the sport's promoters, there needs to be a point when someone says 'enough is enough'. On the treatment side there needs to be standard procedures implemented on treatment, on diagnosis. Prevention is key; we have to provide systems for recovery so that these issues do not fester under the surface.

Otherwise we reach the point of no return - where a boxer is self-harming or on the brink of suicide, where the impact is so evident that there has to be intervention," she says. "They may be champions, but the bottom line is that there is a person behind the marketing and the public face."