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TORONTO (Reuters) - Determining whether the sudden deaths of three players was related to their enforcer roles is something that must be explored, a leading sports psychologist and former National Hockey League tough guy said on Thursday.
Still reeling from the deaths of Winnipeg Jets center Rick Rypien and New York Ranger Derek Boogaard, the NHL was rocked again on Wednesday as recently-retired tough guy Wade Belak was found dead in a Toronto hotel at the age of 35.
On the surface, the deaths appear eerily similar, Rypien, Boogaard and Belak all made a living on the unforgiving fringes of the sport, bare knuckle brawlers who literally had to fight opponents to keep a place on their teams.
Belak's death, the third in under four months, raised some uncomfortable questions as to whether the three players are part of a tragic coincidence or a deadly problem.
"There are some things about that particular job which might make somebody more prone to depression," Dr Don Malone, head of the Psychiatric Neuromodulation Center at the prominent Cleveland Clinic, told Reuters.
"I'd be very surprised if we were able to come up with a common link but nevertheless it is something that ought to be looked into."
Rypien battled depression for about a decade and was found dead at his home this month at the age of 27 while Boogaard's death at 28 was ruled accidental and caused by a lethal combination of alcohol and painkillers. No cause of death has been given for Belak's death.
The deaths have set off alarm bells with the NHL and NHL Players' Association, who issued a joint statement on Thursday promising to review substance abuse and behavioral health programs available to players.
"While the circumstances of each case are unique, these tragic events cannot be ignored," the statement said. "We are committed to examining, in detail, the factors that may have contributed to these events and to determining whether concrete steps can be taken to enhance player welfare and minimize the likelihood of such events taking place."
In the wake of the deaths, players who have filled the enforcer role have opened up about the unique pressures and demands they live with each night waiting for the tap on the shoulder that sends them over the boards looking for a fight.
Cam Connor, who split eight fight-filled seasons between the rough-and-tumble World Hockey Association and NHL, lived and worked in what he likened to a House of Pain.
"I had that task of having to scrap way more than I wanted to and there is a lot of pressure that goes with that," Connor told Reuters. "No question that it is a tough job.
"But I think the only thing these three individuals had in common was the game of hockey and that they were fighters ... that is where it stops."
To survive as an enforcer some turned to alcohol and drugs to help cope with the demons that, according to Connor, keeps some players awake at night.
While Connor does not see a link between the recent deaths and their work he says the NHL could do more to identify those at risk, including more random drug tests to find players on painkillers, which he says is a telltale sign of problems.
"If you got these painkillers or any other drugs in your system, maybe that's when they could say, 'OK, let's have a talk,'" said Connor. "Maybe it is the pressure coming at you but there is a reason you're doing it.
"Maybe they can identify a few people who fit into that danger category."
Drug and alcohol use can signal depression agrees Malone, but sometimes, such as in the case of Belak, who was about to embark on a new career providing radio analysis for one of his former teams, the signs are not so obvious.
"There are a couple of things you can look at with someone like this who was outwardly doing well, outwardly adjusting well and then - boom," said Malone. "One possibility, he (Belak) was hiding it.
"The other thing is something may have happened emotionally and it was a very impulsive act. We don't know."
Editing by Frank Pingue