Mark Hughes recognises that the highs and lows of football can leave players and managers vulnerable to suffering from mental health issues or contemplating suicide and that education to help save lives is vital.

Managers are joining together through their trade union, the League Managers Association (LMA), to raise awareness of a training programme designed to help people spot the signs that someone close to them might be feeling suicidal.

The aftercare available to young footballers when they are released from club academies has been in the spotlight in the last year.

Former Manchester City and Stoke boss Hughes has given his backing to a 20-minute online course designed to help LMA members become more suicide aware, and said: "It's difficult in football clubs, there are a lot of emotions and disappointments – more disappointments than successes if we're honest.

"And being able to recognise when someone is struggling with those disappointments and maybe they're losing their job and showing signs that they're struggling to cope with decisions that will impact them, that must help the guys making the decisions as well.

"I think there was an attitude within football (when Hughes played) that if you showed weakness you were told, 'Just get on with it, pull yourself together' and be stronger mentally.

"Clearly now we know it's very difficult to maintain your mental health at a constant level, sometimes it ebbs and flows and you need help.

"For me as a young player, I came from a small town in north Wales and I know for a fact it would have been very difficult for me to hold my hand up and ask for help that I possibly needed at that time.

"There were occasions when I was anxious about my future, where my career was going to lead, when I was struggling and not playing well. It never got to the point where I felt in danger, but that support wasn't there. It's definitely improved, but you can always add to that."

The LMA is working with the Mayor of Greater Manchester, Andy Burnham, in supporting the Shining A Light On Suicide campaign run by the area's Health and Social Care Partnership, which is designed to help break the stigma around talking about suicide, suicidal feelings and suicide bereavement.

Mental health is an issue among managers as well as players, with Leyton Orient director of football Martin Ling one of the few who has spoken out about the difficulties he has faced during his time in management.

Hughes said: "Sometimes you're forever trying to make the right decisions and allow people to prosper, and sometimes there's no one there to help you, and that can be a real issue.

"It's important to be able to open up. It's not easy for everybody, people internalise thing and men are more guilty of that than anybody, we keep things to ourselves and we don't want to talk about times or issues that we're struggling with and that can be detrimental to your health. We've got to encourage everybody to be more open."

LMA chief executive Richard Bevan said Ling's words, and the death by suicide of former Crawley head coach Dermot Drummy, had helped the organisation learn lessons about how to equip and support managers in the often ruthless environment they operate in.

"Martin Ling has spoken really well and we've been on a steep learning curve in recent years," Bevan said.

"It's coming back to that last point, it's making sure the manager and the coach has access to the right toolkit to survive and thrive in the game. We focused on providing mentors, one-to-one support, that's been one of the great lessons Martin has helped us learn.

"Dermot was a highly-respected manager and a coach. He was actually studying on the LMA Diploma of Football Management at the time and he was a wonderfully down-to-earth and caring man. There was much learning after he died by suicide to what we should be doing internally."

Bevan said he had been speaking to his counterpart at the National Hockey League Coaches' Association in Canada about the mental toughness that a leader has to have to push through difficult times and whether you can teach, learn and develop those skills.

Bevah said: "Absolutely you can, and that's one of the investments over the next couple of years – access to those live learning situations and your ability to cope with those difficult times and survive through what we all know is a volatile, fragile at times and lonely at times industry of being a football manager, or a manager of any of our national sports."

Suicide is the biggest killer of men under 49 and women aged 20 to 34. More than 200 people a year die by suicide in Greater Manchester and research has shown that up to 135 people are affected by each death.

:: A 20-minute Zero Suicide Alliance training course is available to access for free at https://shiningalightonsuicide.org.uk/learn-to-save-a-life/.

:: If you are struggling to cope call Samaritans on 116 123 or text Shout to 85258.