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Former NHLer Bob Probert #42 of the Chicago Blackhawks, taken during the NHL game against the Bufallo Sabres at the HSBC Arena in Buffalo, New York. Probert died on July 5, 2010 after collapsing during a boating trip on Lake St. Clair. Rick Stewart /NHLI/Getty ImagesRick Stewart/Getty Images

The recent death of Winnipeg Jets forward Rick Rypien has led to reflection and soul searching among NHL executives as they struggle to come to terms with the dangers and pressures faced by a hockey enforcer. One executive even sees a link between substance abuse and depression and a fighter's high-stress job, concussions and other injuries.

National Hockey League executives – and coaches and players – agree that the job of a hockey fighter entails both mental and physical stress. These players may only be on the ice for a few minutes for each of the 82 games in the regular season but they know they will risk injury to their heads, hands and elsewhere in a fight.

Buffalo Sabres general manager Darcy Regier, who talked about his sense Wednesday that there was a link to depression, spoke of reading about premature deaths among ex-football players and then thinking of the long list of hockey fighters who died young and/or were diagnosed postmortem with degenerative brain disease.

"I am not an expert but my personal view is I really think there is a relationship," Mr. Regier said. "You read about problems in football, the dementia, early deaths and all that. To think that's not going to happen to someone who is in 20 fights a year. …"

The question came up at the NHL's research and development camp in Toronto on Wednesday, where Mr. Regier and his fellow NHL executives were talking as much or more about the death of Mr. Rypien as they were about experiments concerning rule and equipment changes.

Mr. Rypien, 27, was found dead in his home in Crowsnest Pass, Alta., on Monday. He made his living in the NHL with his fists and also battled depression for more than a decade.

In a little more than a year, Mr. Rypien and three other current or former NHL fighters died prematurely. Bob Probert died at the age of 45 from a heart attack in July, 2010. Derek Boogaard, 28, died of an accidental overdose of alcohol and oxycodone on May 13, 2011 and Barry Potomski, 38, who played 68 NHL games over three seasons, died of a heart attack 13 days later. Every player except Mr. Potomski was known to have significant off-ice issues, although Mr. Rypien did not have a history of concussions in his NHL playing career.

This is not a recent phenomenon. In 1992, former Toronto Maple Leafs enforcer John Kordic died of a heart attack at the age of 27 after a confrontation with police that was fuelled by cocaine and steroids. Steve Durbano, considered one of the wildest players to ever skate for an NHL team, died of liver cancer at the age of 50 in 2002 after fighting substance-abuse for years. At 73, Reggie Fleming was almost 30 years older than Mr. Probert when he died in 2009 but both men were found to have degenerative brain disease.

"It's a brutal job," said Tampa Bay Lightning GM Steve Yzerman, who was Mr. Probert's teammate and friend during their playing days with the Detroit Red Wings. "No matter how good and how tough these guys are, you're going to hurt your hand, get hurt by a punch.

"As a goal-scorer, if you have an off-night, you don't get a goal. As a fighter, you're out there with a 250-pounder and if it's not your night, you get hurt."

However, Mr. Yzerman stopped short of saying there could be a link between stress and injuries and depression and substance abuse. Several other GMs said they don't know but think answers will come in the growing scientific research into concussions.

Mr. Regier was the only general manager questioned to say he believes there is a link, although he stressed he is not a medical expert. He also departed from most of his peers when he was asked for a solution.

"Get fighting out of the game," Mr. Regier said. "I don't know what else you can do.

"I've always thought, ultimately, society will remove it from the game. I don't know when that will happen but I think it's going to happen. I think there will come a time when it will no longer be an accepted part of the game."

However one expert, Calgary Flames sports psychologist Dave Paskevich, also believes there is a connection.

Mr. Paskevich noted that in addition to the demands of his job, Mr. Rypien had to deal with the death of his girlfriend in a car accident when he was a teenager playing junior hockey.

"This is very anecdotal but having his girlfriend killed going to watch him play in junior, people say it might have been a trigger," Mr. Paskevich said. "If he doesn't have the requisite coping mechanisms, it could put him on the path to clinical depression. Then you couple that with the demands of his role [as an enforcer]

"When you look at the NHL, you have to go on a case-by-case basis. The NHLPA goes to every club and tries to educate the players and obviously some players reach out. Depression is very personal. It's important for the clubs to address it and I think more people are looking at coping skills and mental management now."

Both NHL commissioner Gary Bettman and former player Mathieu Schneider, now special adviser to the NHL Players' Association executive director, said Wednesday they believe the joint management-union programs, such as a 24-hour help line and the substance-abuse program, are effective. But both agreed they should be reviewed in the wake of the deaths of Mr. Rypien and Mr. Boogaard.

Mr. Schneider said part of the problem is the macho culture in all professional sports. It pushes players to ignore injuries and to keep psychological problems or mental illness to themselves.

"Maybe it would have been better if Rick [Rypien]had been able to lean on some teammates," Mr. Schneider said. "But those types of things have always been kind of taboo. You just don't talk about it, whether it's the NFL, NBA or NHL.

"When a tragedy like this happens, you examine it and try to see what could have happened differently to make the outcome different. We all have to ask those questions."

Colin Campbell, the NHL's director of hockey operations, thinks each player's case is unique and cannot necessarily be linked to common causes. But he says the league has a much different approach now than in the 1980s when he was an assistant coach with the Red Wings and unofficially in charge of trying to solve Mr. Probert's substance-abuse problems, with little success. In those days, the official NHL response to any substance problem was usually a lifetime suspension.

"With the league you had no out, so you had to hide [the problem]" Mr. Campbell said. "It was so much harder. Now, it's the opposite.

"With Bob [Probert] we'd sweep it under the carpet. We'd send him someplace for two weeks and bring him back. We couldn't be upfront and use professionals."

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