Why mental welfare training is vital

Safety is everybody’s responsibility; a seafarer who is psychologically distressed in not safe for all and I am pleased to provide example with our experience from helping seafarers who are onboard. Especially during the pandemic, there were many challenging cases of seafarers who were distressed, asked for help and joined three to five times of a counseling session, even online. Finally, these seafarers were able to finish their contract and get home well.

But how is the psychological status of our seafarers onboard? I would like to highlight a 3-step framework for seafarers’ mental health.

First, let’s recognize what a mental health crisis looks like. This is any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community. Remember: what you can name, you can tame. What you can feel, you can heal. Everybody’s responsibility is to recognize mental health situations onboard, especially people around you that may already have or have been having a mental health crisis.  When you recognize it, you can resolve it.

Warning signs of mental health crisis:

• Inability to perform daily tasks like bathing, brushing teeth, brushing hair, changing clothes
• Rapid mood swings, increased energy level, inability to stay still, pacing; suddenly depressed, withdrawn; suddenly happy or calm after period of depression
• Increased agitation verbal threats, violent, out-of-control behavior, destroys property
• Abusive behavior to self and others, including substance use or self-harm (cutting)
• Isolation from school, work, family, friends
• Loses touch with reality (psychosis) – unable to recognize family or friends, confused, strange ideas, thinks they’re someone they’re not, doesn’t understand what people are saying, hears voices, sees things not there
• Paranoia

Some common mental health cases that we have seen onboard are:

• Anxiety, Panic attacks
• Grief & loss of life onboard
• Crew conflict & aggressive behavior
• Distress due to pirate attack
• Trauma / witness to injury
• Lack of concentration/focus, reports of poor memory
• Depressive symptoms
• Suicide attempts
• Reports of bullying
• Sexual harassment

Once you see the signs, it is important to consider the timeframe and the extent of the mental health crisis; in particular, how long the changes in personality or daily functioning have been occurring and how much difficulty they’re causing to self and others.

In crisis times, people need connection than correction. So take it seriously when others says expressions such as: “Nothing matters anymore.”, “You’ll be better off without me.” , “Life isn’t worth living.” even if they make no sense and train seafarers to be aware of the following signs of suicide:

• Giving away personal possessions
• Talking as if they’re saying goodbye or going away forever
• Taking steps to tie up loose ends, like organizing personal papers or paying off debts
• Making or changing a will
• Stockpiling pills or obtaining a weapon
• Preoccupation with death
• Sudden cheerfulness or calm after a period of despondency
• Dramatic changes in personality, mood and/or behavior
• Increased drug or alcohol use
• Withdrawal from friends, family and normal activities
• Failed romantic relationship
• Sense of utter hopelessness and helplessness
• History of suicide attempts or other self-harming behaviors
• History of family/friend suicide or attempt

How seafarers are able to recognize the aforementioned signs is part of their training. The second and third steps with regards to seafarers’ mental health status are ‘result’ and ‘refer’. In case of a mental health crisis, apart from recognizing, we need tools and tips on how to resolve the crisis. In that regard, make sure to assess the immediacy of the situation to help determine where to start or who to call.

• Is the person in danger of hurting themselves, others, or property?
• Do you need emergency assistance?
• Do you have time to start with a phone call for guidance and support from a mental health professional?

The above three things are good guiding points to move from recognition to resolution.

‘’We have two ears and one mouth so that we can listen twice as much as we speak’’  -Epictetus

Especially in such crises, we should be re-listening and acting we sound be responsive instead of becoming reactive. From shore to sea, we need to be able to respond accordingly, especially once the crisis is being recognized.

There are many techniques that may help de-escalate a crisis, such as:

Dos

• Keep your voice calm
• Avoid overreacting
• Listen to the person
• Express support and concern
• Avoid continuous eye contact
• Ask how you can help
• Keep stimulation level low
• Move slowly
• Offer options instead of trying to take control
• Avoid touching the person unless you ask permission
• Be patient
• Gently announce actions before initiating them
• Give them space, don’t make them feel trapped

Don’ts

✘ Don’t make judgmental comments

✘ Don’t argue or try to reason with the person

Best practices that we have seen onboard

• Leaders on the ship have training/briefing on recognizing and resolving mental health crisis
• Communication process and escalation management for Mental Health Crisis is in place, and implemented
• Mental Health is included in the agenda during safety briefings. Posters can serve as visual reminders.
• Buddy system: helping others helps you.
• Strong collaborative effort between seafarers and shore team. They know and trust each other.
• For Psychological help providers: speaks the language, responsive to ship and shore, maritime-specific
• Medical chest inventory is updated and no essential meds missing
• Only if necessary for extreme cases: 24/7 watch for the those who pose high risk, Crew taking turns, open doors as much as possible

As such, preparation is everything. People in crisis times act in default mode. It’s all about people. What you put in priority reflects the company. A holistic approach to people helps to establish a life relationship within any organization and not just a work relationship. What is more, do not forget to include the family when you are thinking about crew welfare. When you equip the family, the crew onboard will be in a better state of mind. Overall, it is important to provide the right training and tools in order seafarers to feel healthy, valuable, connected and be their best selves!

Above article is a transcript from Dr. Christian Lubaton’s presentation during the 2023 Crew Welfare Week.

View his presentation herebelow

The views presented are only those of the author and do not necessarily reflect those of SAFETY4SEA and are for information sharing and discussion purposes only.