Online mental health support is helping seafarers

The Seafarers’ Hospital Society is funding free access for UK-based seafarers to an online mental health support service, which is needed now more than ever

mental health depression

One in four people will experience a mental health problem in their lifetime. New research says the fiscal impact of this fact is as great as the human cost.  

Poor mental health costs the UK economy up to £99 billion annually, according a new study by consultancy Thriving at Work, which last month published an independent review of mental health and employers on behalf of the Department for Work and Pensions and Department of Health (accessible here). 

Globally, mental health problems are estimated to cost at US$2.5 trillion, a figure that is expected to rise to $6.0 trillion by 2030. The World Bank recently identified mental health as a Global Development Priority, which recognises the critical impact mental health has on economic development and well-being. 

But working at sea can be an intense environment that can exacerbate the feelings of isolation, fatigue, depression and stress that workers encounter. Life onboard ships can be monotonous for long periods and multinational crews who share no common language may leave seafarers feeling as though they have no one to turn to. Seafarers might be worrying about how to provide for those at home and feeling the stress of needing to make money.

Shift patterns, increased workloads and fast turnaround times at shore lead to fatigue, which can exacerbate these negative feelings. Alcohol and drugs, often used to alleviate feelings of stress or depression, have a further negative influence on behaviour and emotions, and can pose safety risks. 

Suicide rates among seafarers experiencing mental health issues have more than tripled since 2014, according claims data released earlier this year by the UK P&I Club. In 2015, suicide was cited as the cause of death in 15.3% of identified mental health cases, having risen from 4.4% in 2014. 

New recruits appear to be among the most vulnerable. Of the crew suicides notified to the UK P&I Club in 2015, some 40% of those who died were cadets.

“It’s only recently that mental health generally and specifically amongst seafarers is receiving the attention it deserves, with the British Government allocating increased funds to improve historically underfunded services, celebrities opening up and sharing their stories about their own struggles, and a real shift in attitudes in the way the press reports mental health stories,” says Lysanne Wilson, health development manager for the Seafarers’ Hospital Society (SHS).

Some 3.8% of merchant seafarers and 1.7% of commercial fishermen who participated in a 2009 study by the Institute of Occupational Medicine said they had experienced mental health issues.  

A 2016 study by the Seafarers International Research Centre showed an increase in psychiatric disorders among those serving at sea and a deterioration in other aspects of seafarers’ mental health. 

Shipping organisations have stepped up their approach to the problem. Marine insurer the American Club recently urged employers to take the mental health of their crew more seriously. For its part, the UK Chamber is working on developing mental health guidance for seafarers and employers, plus another project to be announced in the coming months. 

The SHS has also taken action to tackle mental health issues at sea. Over a year ago, the charity commissioned online service the Big White Wall (BWW) to fill what it perceives as a gap in the support that is available currently.

“As a charity committed to supporting the health and welfare of seafarers we have a responsibility to do what we can to address the gap in provision of mental health and wellbeing services to the seafaring community,” Lysanne Wilson explains.

“Seafaring presents particular challenges – how can you access regular mental health services when you’re at sea for days or weeks on end?”

The BWW is an online mental health and well-being service that is manned by mental health professionals and offers self-help programmes and one-to-one counselling. 

Normally there is a charge to access the BWW, but the Seafarers’ Hospital Society is funding free access to the service for seafarers accessing the service in the UK, while in port or onshore. The NHS and UK armed forces are among other organisations that have commissioned BWW to undertake mental health work.

The programme gives seafarers the tools with which to help themselves – visitors can either take themselves on a course or receive “face-to-face” counselling from trained professionals via Skype, or offer group support on BWW’s online chat room. 

The service can be used completely anonymously – the only question seafarers will be asked is whether they are officers or ratings.

Any seafarer based in the UK or using the internet at UK ports can access the service free of charge. The service, however, is only available in the English language and requires internet access, which can be restricted on some vessels.

BWW focuses on providing early-stage support for common mental health and well-being problems such as feeling down, depressed, anxious or stressed, in order to prevent further deterioration.

“If seafarers cannot access the support they need to improve their health and well-being, there is a risk they will deteriorate into more severe forms of mental illness that will prevent them from working,” says Lysanne, “potentially impacting on other crew members, creating hardship for them and their families if they can no longer work or need to take time off and resulting in gaps in expert crew to be filled.

“In severe cases, depression can result in suicide, and several studies have shown that suicide rates among seafarers is higher than in the average population, causing distress for the crew, devastation for families and increased costs for shipowners who have to deal with these crises,” she continues.  

Merchant seafarers in the UK have had access to the BWW service for over a year now. Since its launch, nearly twice as many officers as ratings have used the service, two-thirds of whom work on deck, the SHS says.  

Aside from BWW, several different seafarer mental health initiatives are up and running. ISWAN offers immediate response to seafarer calls via its 24-hour multilingual helpline, SeafarerHelp, which is now available via WhatsApp. ISWAN’s long-running Seafarers’ Health Information Programme also includes guidance in its ‘Mental Care’ segment, and has issued guidance on how best to develop a ship-based mental health programme.

The Sailors’ Society Wellness at Sea programme includes support that is broken down into five aspects: social, emotional, physical, intellectual and spiritual wellbeing at sea. 

It’s difficult to know how many people have been affected by mental health issues while working at sea – it's still an issue ‘hidden’ behind stigma. This might be explained by a certain culture of ‘machismo’ among seafarers, where any form of illness is perceived as weakness.

Ironically, keeping mental health issues hidden leads to an increased risk of deterioration in physical health. The Mental Health Foundation has stated that the health of mind and body are so intertwined that they should not be thought of as separate. 

“Depression has been linked to 67% increased risk of death from heart disease and 50% increased risk of death from cancer. This is because people with mental health conditions are less likely to receive the physical healthcare they're entitled to,” explains Lysanne.

“Mental health service users are statistically less likely to receive the routine checks (like blood pressure, weight and cholesterol) that might detect symptoms of these physical health conditions earlier. They are also not as likely to be offered help to give up smoking, reduce alcohol consumption and make positive adjustments to their diet.

“Seafarers, spending their lives at sea, are even less likely to physically be able to access these types of support and prevention services,” she goes on.  

The SHS has plans to reach even more of the nation’s seafarers and will roll out the BWW service for fishermen on November 13th. That being said, BWW is still a relatively new offering for those at sea, so the more seafarers who use it, the better adapted to the shipping industry the service will become. It also requires the support of employers.

“If shipowners provide the appropriate support to address the increased risks faced by their crews and create a culture where it is ok to talk about how you are feeling, and can access services like the BWW, this will help,” says Lysanne.