On Wednesday, February 21st, 2018, the Seamen’s Church Institute held a Seafarer Mental Health roundtable at the International Seafarers’ Center in Port Newark, NJ. In attendance were representatives from flag states, shipowners, P&I Clubs, the medical profession, academia, and seafarer welfare agencies.
The day began with a discussion of seafarers’ medical certificates, and the mental health factors that must be considered when issuing them, including which diagnoses, therapies, and medications are deemed to be disqualifying. The distinction between “fitness for certification” and “fitness for duty” was considered, including the question of when different roles in a ship’s hierarchy demand different levels of medical fitness.
The topic of PTSD caused by piracy incidents was discussed; it was pointed out that PTSD is not diagnosable until at least 6 months after the traumatic incident. After such an event, almost everyone affected will display immediate, short-term reactions, but these aren’t necessarily predictive of ongoing mental health problems. The stigma facing piracy survivors was discussed; an increased awareness of the effects of trauma in society more generally often has the counter-productive result of prejudicing fellow crew members against survivors of such an attack. The point was made that the economic impact of mental health problems going untreated can be much greater than identifying and treating it as it occurs.
Turning to the topic of mental health problems among seafarers, the exacerbating factors of life at sea were discussed. These include the isolation seafarers often experience, and the separation from common support networks (friends and family), as well as work-related stress issues, relationship issues, problems adapting to ship life, and the blessing and curse of an increase in communication capabilities.
It was observed that, according to at least one company’s data, many self-destructive threats and acts happen during a seafarer’s first contract, when they are relatively young (19-27 years). This may be because of the “healthy worker effect”: those who are robust enough for a life at sea are the ones who continue past the first few years and continue their career as seafarers.
Various strategies were discussed regarding mitigating the risk of suicide among seafarers, with training and awareness being viewed as key to this. SCI’s representatives gave an overview of the ASIST (Applied Suicide Intervention Skills Training) workshops offered by the Institute. The possibility of using e-learning tools to raise awareness of risks and intervention strategies was also raised: SCI has a 40 minute e-learning module on suicide awareness that is tailored to the inland river industry. Plans are underway to adapt it to the international fleet.
The discussion moved to the challenges of gleaning accurate statistics on deaths by suicide in the maritime context. There is also the problem of differentiating between accidental death and death by suicide in some cases. Added to this is the fact that blue water suicides offer a “skewed sample” when they happen off-vessel. Once at home, when seafarers are off-contract, any deaths that occur are under the radar for companies.
The idea of providing a form for mental health evaluations that ship owners could use was suggested; some companies already have this provision. The feeling is that being on the front-end of an investment in health and wellness pays dividends by reducing claims for companies and maximizing productivity.
All in all, the roundtable provided a forum for stimulating, in-depth discussion of the many important issues surrounding seafarer mental health. To read the official, in-depth report on the topics covered, see the PDF below.
 Attendees: Captain Steve Bomgardner and Ruphene Sidifall, Esq. of Liberian International Ship and Corporate Registry; Dr. Adrienne Buggs of USCG’s Office of Merchant Mariner Credentialing; Danielle Centeno and Boriana Farrar, Esq. of the American P&I Club; Dr. Rafael Lefkowitz of Yale School of Medicine; Jennifer Love of Royal Caribbean Cruises; Dr. Conor Seyle of the One Earth Future Foundation; and SCI staff, the Rev. David M. Rider, President and Executive Director; Douglas B. Stevenson, Esq., Director of the Center for Seafarers’ Rights; Dr. Naomi Walker, Director of Communications; and Cora Koehler, Seminary Intern.