Caitlin Vaughan, Project Manager at ISWAN, shares her thoughts on the maritime industry’s approach to seafarers’ mental health and why it is so important that efforts continue to grow.
It’s Mental Health Awareness Week in the UK and it seems particularly significant this year as COVID-19 continues to cause instability around the world. The consequences of the pandemic have been especially devastating for seafarers who have experienced job losses and uncertainty about when they can leave their vessel and see family. Many are stranded far from home and in great need of financial support. It’s not surprising that organisations such as ISWAN’s SeafarerHelp have seen an increase in seafarers experiencing stress, depression and anxiety. Tragically we have also seen a number of suicides of crew stranded on cruise ships. These are unprecedented circumstances, but what can we do to better protect seafarers who face extreme challenges even without a global crisis?
The World Health Organization estimates that 264 million people are affected by depression globally and states that “The burden of mental disorders continues to grow with significant impacts on health and major social, human rights and economic consequences in all countries of the world.”1. Seafarers, who spend many months away from home working in challenging conditions, may be more vulnerable to mental health issues than the wider population. Recent studies2,3 show that higher numbers of seafarers appear to suffer from depression than other working groups and that determinants of mental health disorders among seafarers include work environmental factors, job satisfaction, and self-rated health. Well documented connectivity issues at sea and working far from home can mean that access to support and confidential health care can be a major challenge to seafarers. Even when support is accessible, stigma surrounding mental health and worries about job security make it more difficult for seafarers to ask for help when they need it.
There has been a growing focus on the mental health of seafarers in recent years which may be largely due to the efforts of prominent figures publicly campaigning for improvements in awareness about mental health. This may also be in response to an increasing awakening, particularly among P&I Clubs and ship owners, that good mental health among employees is economically beneficial. Insurers are aware that better mental health can mean fewer accidents, repatriations, and as a consequence, costly claims. In addition, ship owners are acknowledging evidence that shows a happier workforce is more productive.
What has the industry done so far?
In response to these growing concerns, there have been a number of recent additions to the small body of research on seafarers’ mental wellbeing which have sought to examine the prevalence of mental health issues among seafarers, review the support that exists and offer recommendations on how to protect the mental health of seafarers. However, there are still large gaps in knowledge about the rates of suicide at sea as most Maritime Administrations do not collect data on suicide rates and because suicides can be misreported.
Maritime charities, unions and private companies have developed training and outreach programmes designed to improve the mental health of seafarers. For example, ISWAN has developed mental health awareness training which is adaptable for all seafarer ranks as well as for shore side staff who support seafarers. This accompanies the organisation’s Good Mental Health self-help resources for seafarers to learn coping strategies for managing their mental health while away at sea.
Anecdotally it would also appear that there has been an increase in the number of shipping companies providing their seafarers with confidential helplines which offer emotional support and counselling. Existing helplines such as SeafarerHelp have been focusing marketing efforts on raising awareness of their support in this area in recent years and new counselling helplines have been set up by unions representing a large number of seafarers such as NUSI.
There has been some work within national authorities and trade associations to pay attention to the mental health of seafarers. For example, the UK Chamber of Shipping issued guidance to shipping companies on developing a mental health awareness policy, and the UK Government Maritime 2050 people route map commits to producing mental healthcare guidelines and developing standardised training in the area for seafarers.
Why do we require mental health support services for seafarers?
Seafarers go months without seeing their families and friends while often lacking the means to contact them as much as they’d like due to low connectivity on board. Fast turnaround times in port and long working hours can mean there is little opportunity for adequate rest and time to take part in leisure activities, which are essential for good wellbeing. Multicultural crews and living in close quarters with colleagues who may not have anything in common can leave seafarers feeling isolated. As well as this, the effects of bullying and harassment can be far greater in a ship environment where there is no escape from the perpetrator. Working at sea can be dangerous and anxieties about risks of piracy and crises at sea can take their toll on seafarers.
Effective training in mental health awareness for seafarers and shore based maritime professionals working with seafarers can have a very positive impact on seafarers’ mental wellbeing and help to ensure they are well prepared for some of the challenges presented above. Training which increases understanding of mental health will also help to greatly reduce stigma. If mental health is no longer considered a taboo, seafarers will be more comfortable seeking help and/or talking about their problems with their supervisor or a colleague. Training can also be beneficial in helping seafarers to recognise that a crew mate may be struggling and also provide them with the skills and confidence to start a conversation. Likewise, it can equip seafarers and senior staff with the skills needed to effectively respond to a concern on board or within their company. Training can also successfully teach participants about the importance of self-care and looking after your own mental health during a voyage.
Yale University’s recent study4 into the mental health of seafarers recommends training in resilience for seafarers, particularly cadets, as a way to prevent mental health issues on board. The vulnerability of cadets, who have not been given adequate preparedness training, is something that has been highlighted through calls to SeafarerHelp.
Counselling and emotional support services should also be available to seafarers; these services can be the difference between life and death for a seafarer experiencing suicidal thoughts. They can also help seafarers to find ways to cope with life on board which may not have been possible without accessible support; and that can mean the difference between a happy, productive worker and a complex repatriation. The risks of serious trauma such as serious injury or pirate attack also make counselling and support services essential to seafarers. Port based welfare services providing face to face support such as those offered by the Mission to Seafarers, Stella Maris and Sailors’ Society are essential for the same reasons.
What we need to do for future generations?
Moving forward there needs to be a unified approach which looks at protecting the mental health of seafarers at government level, organisational level and the individual level.
Employers should be encouraged, with guidance from government bodies, to develop clear policies and procedures which protect the mental health of their seafarers and ensure that shore based staff have a deep understanding of how to support their colleagues. This should also include a focus on the onboard environment to make sure it is conducive to good mental health. For example, ensuring there are adequate facilities and opportunities for socialising and having time away from work duties. As well as this, policies should help create a culture where proper rest times are observed. Shipping companies should also be encouraged to take note of important research findings which show the benefits that improved connectivity on board can have on seafarers’ wellbeing.
There is an increasing amount of evidence for the links between diversity and inclusion in the workplace and the wellbeing of employees. This is likely to extend to the shipboard environment; ship owners can have a role in working towards a more equal gender balance on board ships which can have a positive impact on both men and women on board. A focus on training and encouraging seafarers to celebrate the cultural diversity of everyone on board can make a difference too.
Further research into seafarers’ mental health, its connection to working conditions and the prevalence of suicide would continue to benefit the industry’s response to this issue.
Government bodies have an important role to play in working to reduce the stigma and myths attached to mental health in wider society so that new generations of seafarer recruits will be more open and understanding of the issues surrounding mental health. Governments can also work to ensure that cadets receive effective training on building resilience and mental health awareness so that they are adequately prepared for life at sea.
In developing policies and procedures on mental health, it is important that governments and companies put protections are in place for seafarers who suffer from mental ill health so that they can return to work when they are well and so they are not discriminated against.
1 https://www.who.int/news-room/fact-sheets/detail/mental-disorders (accessed 15.05.20)
2 https://www.seafarerstrust.org/wp-content/uploads/2019/11/ST_MentalHealthReport_Final_Digital-1.pdf (accessed 15.05.20)
3 https://www.sailors-society.org/news/a-quarter-of-seafarers-show-signs-of-depression-says-new-report (accessed 15.05.20)
4 https://www.seafarerstrust.org/wp-content/uploads/2019/11/ST_MentalHealthReport_Final_Digital-1.pdf (accessed 15.05.20)