Seafarer Mental Health: Taking a Holistic Approach

Captain Yves Vandenborn, director of loss prevention at The Standard Club, says improving the mental health of seafarers is critical but cannot be done in isolation. It needs to be part of a holistic approach to ensuring their overall wellbeing, which includes a diverse range of physical, emotional and organisational factors. 

Recent articles in The Maritime Executive^{1, 2} have rightly put a spotlight on the mental health of seafarers. Industry statistics seem to confirm that mental illness is a growing concern at sea, and this is now being reflected in P&I club claims data. At The Standard Club, for example, we have seen an increase in mental-health-related claims since 2015 – although these still account for less than 1.5 percent of all illness claims the club sees.

According to Ray Barker, head of operations at the International Seafarers’ Welfare and Assistance Network (ISWAN), "Over the last four years, ISWAN has noticed an increase in the number of seafarers calling our helpline suffering from a variety of mental health issues. There is also a consensus that the number of seafarer suicides has increased."³

Whatever the exact numbers are, a suicidal seafarer is not good for anyone on board a ship – or anywhere near it. Apart from the suffering of the individual involved, there are potentially huge risks that their unexpected actions, reactions or even inaction could have on other people, property and the environment.

As Barker warns, "This trend should be of grave concern to all those in the maritime industry. Tackling this problem and reversing this trend should be at the top of the agenda for those with the power to affect change in the lives of seafarers."

Many factors to address

So what can be done? Barker identifies various factors that can adversely affect mental health at sea, including: social isolation, long voyages, fatigue, separation from family, increased pressure, lack of crew cohesion, lack of shore leave, harassment and bullying, and precarious employment. 

To that long list we would also add: post-traumatic stress, poor physical health, bad diet and lack of exercise, all of which impact on a seafarer’s mental health. Clearly a holistic approach is required, one which monitors and nurtures every aspect of a seafarer’s wellbeing and happiness. 

We recently launched a special issue of our loss-prevention publication Standard Safety³ to help shipowners and operators address the many and varied factors that affect seafarer wellbeing. In addition to ISWAN, we had contributions from Medical Rescue International, Halcyon Marine Healthcare Systems, CarePoint Medical Diagnostic and Wellness Clinic, Health Metrics Inc. and March on Stress. The issue can be freely downloaded from our website and contains a lot of practical advice. 

Exercise and mental health

Take exercise for example. In an article entitled "Keeping fit to succeed"³ Antonio Robert Abaya of Health Metrics provides guidance on suitable shipboard exercise routines and sports activities, and explains why these should be encouraged. As he says, "when one exercises, there is a release of the “happy hormones” serotonin and endorphins, promoting a sense of happiness, well-being and contentment."

Indeed, the direct connection between fitness and mental health was highlighted in The Mission to Seafarers’ latest Seafarers Happiness Index.⁴ This cites a September 2018 paper by Yale University researchers, which found that people who exercised for 45 minutes three to five times a week had 1.5 fewer "bad days" than similar non-exercisers.⁵  

However, it is important to note that some mental-health issues – such as post-traumatic stress disorder (PTSD) – can be difficult to detect or monitor. Professor Neil Greenberg of March on Stress says seafarers who are known to have witnessed shipboard accidents should be offered professional assessment. "Unfortunately, evidence shows that most people with PTSD do not seek help until their life falls apart or a crisis occurs."³

Social support and supervision

Greenberg also says there is, "strong evidence that good social support and effective supervision whilst on board a vessel are far more important predictors of mental health status than whether someone had a poor childhood, is poorly educated or has a prior history of a mental health disorder." He concludes, "there should be investment in ensuring that a ship’s crew is enabled to properly support each other and to identify those who need professional help." 

We fully endorse Greenberg’s recommendations as well as all the other advice in Standard Safety. Seafarers are still the "magic" ingredient in shipping industry: their unique combination of intelligence, dexterity, resilience, flexibility and humanity are still a long way from being replicated by machines. As such the physical and mental wellbeing of seafarers remains critical to the future health of the shipping industry. 

References

1. Laursen W, Misquoted, The Maritime Executive, 13 November 2018, available here.
2. Szymanaski K, Looking Behind the “Fake News”, The Maritime Executive, 14 November 2018, available here.
3. The Standard Club, Standard Safety: Seafarer Wellbeing, October 2018, available here.
4. The Mission to Seafarers, Seafarers Happiness Index: Quarter 2 2018, 10 September 2018, available here.
5. Chekroud S et al. Association between physical exercise and mental health in 1·2 million individuals in the USA between 2011 and 2015: a cross-sectional study, The Lancet Psychiatry, 1 September 2018, 5(9): 739–746, available here.