Crew mental health and TIMS
Dr. Rachel Glynn-Williams
Clinical Psychologist, Clinical Director of Recall Recover Ltd
It is really encouraging to see that issues concerning mental health in the maritime sector are finally achieving the wider prominence they have long needed. Inevitably, Covid has had something to do with this. The plight of seafarers stranded on vessels for months on end triggered an increase of empathy and concern among many people ashore, as they encountered lockdowns and similar confinements of their own on land.
Until recent times, the issue of mariners’ mental health was still overshadowed by a common but outdated perception
of seafarers as a breed apart. Unhelpful views of mental health would hold anything other than hardy resilience as a sign of weakness and lack of fitness for the job.
For those from certain backgrounds and cultures, it could also be a source of shame or fear. Modern views recognise that seafarers make up one of the most resilient workforces in the world, but are still human, with all that entails: nevertheless, stigma can still make it difficult to speak out.
The pandemic has given those who are land-based a sobering insight into the anguish and apprehension caused by separation from loved ones for an undefined length of time, with restricted freedoms and limited access to recreation; conditions which come as standard for the seafarer. Maritime workers ashore have been subject to extreme restrictions, both personal and professional, which have made their welfare an important area of concern. However, for the sea- going workforce the vastly extended periods of isolation at sea, lack of shore leave, breakdown in crew changes and continued uncertainties have brought unprecedented challenges.
According to an estimate from the International Chamber of Shipping, approximately 400,000 seafarers were to all intents and purposes imprisoned on board vessels at the highest point of the pandemic, well beyond the terms of their contract. Worried about their own and their families’ wellbeing, uncertain about when (or even if) they and relief personnel would be permitted to travel, and to access and leave vessels, the problem for seafarers has been exacerbated by the slow and patchy recognition from governments of seafarers as key workers, as recommended by the IMO and many maritime organisations.
Lacking therefore in even the most fundamental rights and entitlements, it’s hardly surprising that crews reported an increase in depression, anxiety and even incidence of suicide. (Slišković, 2020).
Pre-existing causes for concern
However, the fact is that the pandemic merely highlighted and underscored issues that numerous maritime research bodies, charities and support organisations had already identified as causes for urgent concern. In November 2019, only a few short months before the pandemic hit, a benchmark study commissioned by the ITF Seafarers’ Trust and carried out by Yale University warned of a worryingly high incidence of depression and suicidal ideation among the 1,572 serving seafarers of differing ranks and nationalities who participated in the survey. In the two-week period before taking part in the Seafarer Mental Health Study, 25% reported symptoms of depression, 20% had had thoughts of suicide or self-harm, and 17% suffered from recent anxiety.
These findings are echoed in the SIRC/ IOSH Seafarers’ Mental Health and Wellbeing report which noted vessel crews’ predisposition to poor mental health, and the ways in which safety and efficiency can be dangerously compromised by stress and trauma. Working in a high-risk profession, miles away from family and friends, worried about a lack of job security, fearful of being criminalised for inadvertent contravention of environmental regulations... these are all just some of the basic difficulties which unfortunately go with these sea-going occupations. The adversities quickly mount up when we receive reports of bullying, intimidation or sexual harassment, and learn of some seafarers’ experiences of insufficient training, low or non-existent job satisfaction and issues with fatigue.
Maritime workers ashore have been subject to extreme restrictions, both personal and professional
Such findings unquestionably make for grim reading; but there are meaningful efforts being made to destigmatise mental health in the maritime community and turn towards areas of previous neglect. These initiatives include, for example, providing guidance to seafarers to improve and protect their mental wellbeing through self-care, and increasing social and physical recreation on board. More broadly, steps are being taken to highlight the role of companies, flags and legislative enforcement in enhancing working and living conditions. There is some momentum now towards boosting and safeguarding the mental health of seafarers, with some highly encouraging signs.
Making positive steps
Clearly, a continuum of engagements regarding mental health can now be seen across the maritime industry. Some companies may only have just begun their journey. But others’ initiatives are showing traction through active engagement and a palpable enthusiasm to take things forward.
Several firms have started to make mental wellbeing conversations standard for new recruits and cadets, and repeat these on a regular basis. Some are introducing mental health champions on board each vessel, with training for all on how to have helpful conversations around mental health.
Leading the field in raising awareness and providing mental health support and guidance are organisations such as ISWAN, with their SeafarerHelp – a free, multilingual, 24-hour helpline for sailors and their families which is also available in app form. ISWAN’s Mentally Healthy Ships, authored by Dr Pennie Blackburn, Consultant Clinical Psychologist, is a very welcome, professionally grounded asset for the industry, assisting shipping companies and operators to develop and deploy effective mental health policies as well as identify warning signs and respond appropriately. Increasing numbers of maritime companies, agencies and associations are reflecting on their policies and procedures, promoting mental wellbeing amongst crews and making available helplines, app-based mental health solutions and professionally devised and staffed psychological therapy services. The energy behind mental health initiatives within the maritime industry has been reflected in the encouraging increase in relevant webinars and conferences, such as the First Global Conference for Seafarer Mental Health and Wellbeing, staged in May 2021 by IMarEST (Institute of Marine Engineering, Science and Technology). It has been a privilege for my associates and myself at Seaways Psychology Services to continue supporting seafarers throughout the Covid pandemic, remotely providing professional clinical assessment, psychological therapies and also mental health and resilience training to crews aboard vessels and shoreside staff. In addition, it has been hugely rewarding to work in creative collaboration with marine casualty investigator Capt. Terry Ogg to establish Recall Recover Ltd this year, and to include our integrated, trauma-informed interviewing and wellbeing approaches as part of the Qwest Care product provided by Qwest Maritime.
Recall Recover Ltd – supporting seafarers at the most difficult times
At Recall Recover Ltd, we have developed a new, trauma-informed approach to marine casualty investigation interviews, which places a key emphasis on the wellbeing of seafarer witnesses and the wider crew. We know that when we experience a shocking and frightening event, the human response to stress response brings emotional, behavioural and cognitive changes, which can impact the ease with which someone can recall events for a period of time. The model of interviewing that Capt Ogg and I have developed, called TIMS® (Trauma- informed Interviewing in a Marine Setting), is designed to manage the human stress response, with the twin aims of supporting the seafarer witness whilst providing the best conditions for them to offer a more dependable and detailed account of events.
Tremendous progress has been made in raising awareness of mental health in seafarers, and maintaining that momentum is a crucial focus
Alongside TIMS®, we offer easy access
to a Crew Wellbeing Continuum (CWC), providing for all crew the opportunity for psychological first aid and, where post- trauma reactions remain, ongoing and structured psychological support. Our key value at Recall Recover is that we do what matters, as well as what works, and we have been delighted with the industry response to our work, seeing our enthusiasm reflected back to us by our customers and colleagues. These values make Recall Recover a natural fit with Qwest Maritime’s Qwest Care. Their endorsement of Recall Recover is a clear demonstration of the company’s commitment to crew welfare and to innovative and effective casualty management planning.
A call for an industry-wide commitment to professional mental health in maritime
Tremendous progress has been made in raising awareness of mental health in seafarers, and maintaining that momentum is a crucial focus. It is important that as an industry we continue to support seafarers directly in the roles that they occupy, but also that this support works at every level – from task, role, crew and vessel through to company, flag and international regulation – in order to identify, remove or minimise those factors that impact upon mental wellbeing. Physical health, climate and safety on board have quite rightly become standing items across many maritime agendas, and it would be very encouraging to see mental health, with its broad, central relevance to all human factors on vessels, move towards parity with these issues which are already firmly embedded in the sector.
Mental health at sea is everyone’s business, and everyone can play a part in its improvement. But this does not mean that it is easy to achieve. It can be quite a task to try navigating through the field of mental health promotion, prevention and recovery when there are so many different approaches, levels of training and types of practitioner available, with varying philosophies and traditions. It is important that organisations don’t feel they have to be experts themselves in mental health, but it is also vital to know when to reach out for appropriately qualified, accredited clinical practitioners when deciding upon and devising ways of supporting seafarers and shoreside staff.
Learning can be taken here from the aviation industry. As a result of the Germanwings murder-suicide incident
in 2015, where the co-pilot responsible was found to have had unreported severe mental health difficulties, the regulatory body in aviation now requires that individuals providing mental health services must demonstrate appropriate qualifications and accreditations. Harm can be done where interventions and approaches are not informed by best available clinical practice, particularly when incidences relate to clinical issues of depression, suicide and trauma.
It is encouraging to see such interest, enthusiasm and progress being made in maritime mental health. Naturally, not all companies are at the same stage of development in their mental health considerations and offers, but more are now turning towards a positive direction. There remains unequal access for seafarers to onboard cultures and provision that make space for the ordinary human responses to what life and work present. However, by taking steps to raise awareness, understand and manage where possible the risks and facilitators to mental health for seafarers at various levels of industry – and drawing upon professional input where necessary – the benefits across the industry will be apparent.
Slišković , A. (2020) Seafarers’ well-being in the context of the COVID-19 pandemic: A qualitative study. Work 67 (2020) 799–809