As a Medical Care Onboard Ships Instructor, I was alarmed when it was discovered that the greatest Health issue in the Maritime industry was Mental Health.
This fact follows a study of more than 1,000 seafarers by Yale University and the Sailor’s Society, where 26 percent of seafarers said they had felt “down, depressed or hopeless”. In May 2018, the UK Chamber of Shipping and seafarer’s trade unions launched detailed guidance for shipping companies on how to proactively support their Crew mental health.
There are a number of reasons why this Mental Health First Aid knowledge is relevant for your Yacht. Firstly, mental illnesses are common in yachting, and worldwide, and tend to affect people during their prime working years. Secondly, mental illness has a significant impact on productivity and can affect a person’s ability to work when left untreated. Thirdly, many people in yachting fail to seek appropriate professional help, often due to social stigma and having to admit one needs support. We have not created a space for Mental Health issues to be OK in yachting. Finally, crew and heads of departments are in a good position to pick up the early signs and symptoms of a mental illness in a crew member.
A mentally healthy yacht is one that:
- promotes a positive workplace culture,
- minimises workplace risks related to mental health,
- supports people with mental health problems appropriately and
- prevents discrimination.
Captains, Owners, Management companies and Head of Departments have a responsibility to their crew to provide a safe and healthy working environment which does not cause a mental illness or worsen an existing one.
There are a number of ways of defining the term ‘mental health‘. Some definitions emphasise positive psychological well-being, whereas others see it as the absence of mental health problems. The World Health Organisation has defined mental health as “a state of well-being in which the individual realises his or her own ability, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” Generally, it is better for our mental health to be employed than unemployed. However, it is the quality of the work and our workplace that is important.
Signs a co-worker might be developing a mental health problem
Early warning signs that may show up at work in someone developing a mental health problem include:
- not getting things done efficiently
- erratic behaviour
- emotional responses
- complaints of lack of management support
- fixation with fair treatment issues
- complaints of not coping with workload
- withdrawn from crew activities
- reduced participation in work activities
- increased consumption of caffeine, alcohol, cigarettes and/or sedatives
- inability to concentrate
- difficulty with memory
- loss of confidence
- unplanned absences
- conflict with team members/manager
- use of grievance procedures
- increased errors and/or accidents.
Physical / physiological signs
- tired all the time
- sick and run down
- persistent/resistant musculo-skeletal complaints
- reduced reaction times
- difficulty sleeping
- weight loss or gain
- dishevelled appearance
- gastro-intestinal disorders
What is a mental illness?
Mental illness is a diagnosable illness which:
- Affects a person’s thinking, emotional state and behaviour.
Mental illness disrupts the person’s ability to:
- Carry out daily activities, and
- Engage in satisfying relationships
Names of mental illnesses
There are many myths and misunderstandings about mental health problems. This is not helped by the variety of terms used to describe mental health problems. Slang terms, like ‘crazy’, ‘workplace psychopath’, ‘junkie’, ‘barking mad’ or ‘nuts’ promote stigmatising attitudes and shouldn’t be used.
How common is mental illness?
Mental illnesses are common across the world. Surveys of the mental health of the population have been carried out in many countries but are difficult to compare because they use different methodologies. However, the World Health Organisation has coordinated the World Mental Health Surveys in 14 countries, which included the 8 developed countries shown in the graph.
While the prevalence of mental illness appears to differ greatly across these countries, some of the differences are due to the fact that some countries assessed a broader range of mental illnesses, as well as cultural differences in how willing people are to report symptoms of mental illness in a survey. In all these countries anxiety disorders were found to be the most common type of mental illness, followed by mood disorders (e.g. depression) and then substance use disorders.
INTRODUCTION TO MENTAL HEALTH AND MENTAL HEALTH FIRST AID
The most common Mental Health Disorders in yachting seem to be, anxiety disorders, followed by mood disorders, and then substance use disorders.
Anxiety disorder is when someone’s symptoms of anxiety are causing them to have trouble at work or school, in their personal relationships or getting on with their day-to-day activities. An anxiety disorder differs from normal anxiety or worry because it is more severe than normal worries, it is long lasting and it interferes with the person’s life.
Substance use disorders occur when people become dependent alcohol or another drug (substances), or they use alcohol or another drug in a way that leads to problems at work, school or in the home, family or community. It also means that a person uses alcohol or drugs at a level that causes damage to their health.
Mood disorders are a group of mental illnesses which affect the way people feel (their mood). Depression is the main type of mood disorder. It is not just feeling down when something bad happens; it can go on for weeks or months, and gets in the way of daily activities, family and community relationships. Other mood disorders include bipolar disorder and perinatal depression.
Many people with mental illnesses do not receive any professional help. The WHO World Mental Health Surveys found the following percentages received treatment in the previous year in developed countries:
If mental illness is so common, why don’t people seek help.
Barriers to seeking help vary. Many things prevent people from seeking help for a mental health problem. They include:
- Stigma, e.g. being seen by colleagues as incapable
- Fear of discrimination, e.g. being fired from their job
- Cultural considerations
- Lack of access to mental health services, especially in Yachting due to foreign ports and remote posts.
- Religious considerations
- Lack of awareness
- Not knowing how to access services
- Fear of being sent to hospital
- Language barriers
- Financial considerations
- Lack of motivation (a possible symptom of a mental illness).
What is mental health first aid?
First aid is the initial help given to a person who is ill or injured before professional medical help can be obtained. Similarly, mental health first aid is the initial help offered to a person developing a mental health problem, experiencing a worsening of an existing mental health problem or in a mental health crisis. The first aid is given until appropriate professional help is received or until the crisis resolves.
How can Mental Health First Aid Training benefit Yachting?
Having a Mental Health officer on each vessel is going to be essential in the future of wellness in yachting. A Mental Health First Aid course trains you to be a Mental Health First Aider so that you can give initial support to colleagues developing a mental health problem or in a mental health crisis. In some organisations, the Mental Health First Aider is officially designated as a Mental Health First Aid Officer.
You might use your Mental Health First Aid skills when:
- a colleague’s ability to work is impaired by symptoms of a mental health problem.
- a colleague appears to be using alcohol or other substances to cope.
- a colleague appears to have symptoms of a mental health problem for which you believe they are not getting treatment.
- a colleague is experiencing acute distress because of problems at work or in their personal life.
- your family or friends have mental health problems
- you have a mental health problem yourself.
Why is Mental Health First Aid training good for Onboard Training?
There are many reasons why the workplace is a good setting for MHFA training to occur. There are benefits to individual employees, their work colleagues and the whole workplace.
- To increase all employees’ awareness of mental health problems.
- To encourage colleagues, clients, friends and family who are experiencing symptoms of mental health problems to seek appropriate professional help as early as possible.
- To assist colleagues who are using alcohol or other drugs to cope with a mental health problem to seek effective treatment.
Many yachts and their clientele are rich in cultural diversity. When providing mental health first aid to a person not from your own cultural background, it is important to be culturally competent and practise cultural safety. Being culturally competent when providing mental health first aid includes: Being aware that a person’s culture will shape how they understand health and ill-health. Learning about specific cultural beliefs that surround mental illness in the person’s community. Learning how mental illness is described in the person’s community (knowing what words and ideas are used to talk about the symptoms or behaviours). Being aware of what concepts, behaviours or language are taboo (knowing what might cause shame).Practicing cultural safety means: Respecting the culture of the community by using the appropriate language and behaviour. Avoiding doing anything that causes the person to feel shame. Supporting the person’s right to make decisions about seeking culturally-based care.
Mental health is a continuum ranging from good mental health to having mental illness. A person may vary in their position along in this continuum at different points in their life.
Mental illness is a diagnosable illness which affects a person’s thinking, emotional state and behaviour, and disrupts the person’s ability to work or carry out other daily activities and engage in satisfying personal relationships.
Mental health problem is a broader term including both mental illnesses and symptoms of mental illnesses not severe enough to warrant a diagnosis.
MSOS will share more information about Mental Health First Aid in the next 3 editions of the Islander. MSOS provide Bespoke Medical Training, including Mental Health First Aid. Our Nurses & Doctors have a vast experience in Mental Health Illness on and off the water, and while we do not have a specific 24/7 MENTAL HEALTH & WELLNESS service, our Tele-medicine platform provides professional counselling for yacht crew in distress & our MCA certified courses cover Mental Health First Aid & management in depth.
For more information about Mental Health & wellness in yachting, check out…
ISWAN Seafarers Help & Welfare
The Marine Wellness institute
Pan Air Buddy System
Give us a Shout
Workplace prevention of mental health problems: Guidelines for organisations http://prevention.workplace-mentalhealth.net.au
National Standard of Canada for Psychological Health and Safety in the Workplace (the Standard)Psychological Health and Safety in the Workplace http://shop.csa.ca/en/canada/landing-pages/z1003-landing-page/page/z1003-landing-page
Explanation of the terms ‘Prevalence’ and ‘Incidence” https://mhfa.com.au/file/2182/download
Some Disability Weights from the Dutch Burden of Disease Study https://mhfa.com.au/file/2162/download
Mental Health First Aid Reaches 1% of the Australian Populationhttp://anp.sagepub.com/content/45/10/808.full.pdf+html
By Manda J Beaver RN
MIPH, BSC Nurs, BSC Nut. Clinical Nurse, Certified Trauma Counsellor & Health Coach, MSOS Medical Training Instructor