Medical Director, Dr. Edgardo Antonio A. del Rosario
Del Rosario Pandiphil Inc.

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This column features the article contributed by our Association to "Mariners' Digest Vol.75", published in October 2024 by the Japan Shipping Exchange, Inc.

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Highlights

In this article, Dr. Edgardo Antonio A. del Rosario, Medical Director of Del Rosario Pandiphil Inc., our correspondent in Manila briefly talks about the next steps after awareness in order to achieve a truly inclusive maritime industry with regards to mental health; including policies against harassment and bullying, and eliminating the stigma commonly associated with mental health issues/illnesses.

Seafarers' Mental Health and Working Environment

“The only thing constant in the world is change” is a quote credited to the Greek philosopher Heraclitus. And change, for some more than others, can be a source of substantial distress that can adversely affect an individual’s mental health especially in cases wherein the individual is ill equipped to adapt to these changes. Thus, it is increasing the likelihood of developing mental health issues such as mood disorders like depression, and stress related disorders like anxiety and adjustment disorders.

The World Health Organization defines mental health as a state of well-being in which an individual can realize his/her own potential, cope with the normal stresses of life, work productively and make a contribution to the community. Inclusive in the understanding of this definition is the role of the environment in order for an individual to achieve his/her potential, ability to cope and optimum productivity.

In the case of seafarers, the role of the work environment is probably most significant because the duration of seafarer contracts can be as long as eight months in many cases, and even up to one year for some. And unlike land-based workers, the environment is essentially the same for seafarers, the vessel, whether they are on duty or off duty.

Preventing mental illness is the first priority

The maritime industry's awareness of the seafarer’s mental health is nothing new and is of increasing interest as they believe “the best way to protect the stakeholders’ interest is to protect their interest;” which among many things, probably core, is the seafarer. In fact, there are numerous references online from several maritime industry stakeholders on either how an individual can overcome mental health issues/illness or how to detect and handle mental health concerns on board the vessel.

But as Benjamin Franklin famously once said: “an ounce of prevention is worth a pound of cure,” more efforts on prevention (not only on treatment) are an aspect that can still be greatly improved.

Awareness is indeed key but it is only the first step towards the ultimate goal of inclusivity with regards to mental health in the maritime industry. Although a top down approach can easily be seen as ideal, stakeholders should be able to institute concrete policies at their level that can help prevent the development of mental illnesses and/or deterioration of the mental health of our seafarers while on board the vessel.

This policy should be written clearly and posted in a conspicuous area both in the manning agency facility and the vessel. Implementing rules and regulations (IRR) should also be clearly written and easily accessible by all for proper guidance of those concerned.

What to do if you were harassed on board

Take on harassment and bullying, for instance, the International Chamber of Shipping and International Transport Workers’ Federation:“Guidance on Eliminating Shipboard Harassment and Bullying” provides excellent advice for both shipping companies and seafarers alike. When you make a company policy statement on harassment and bullying, it is recommendable you indicate the followings:

• A message from the Chief Executive or equivalent in the company.
• Set out the company’s commitment to the elimination of harassment and bullying from on board ships and the goal of a working environment in which there is respect for the dignity and wellbeing of all seafarers.
• Contain pertinent contact information to enable seafarers to report incidents without difficulty.

[source] Guidance on Eliminating Shipboard Harassment and Bullying (Published in 2016 by International Chamber of Shipping / International Transport Workers’ Federation), Page 14

[source] Guidance on Eliminating Shipboard Harassment and Bullying (Published in 2016 by International Chamber of Shipping / International Transport Workers’ Federation), Page 14

Probably a common thread in a lot of cases of harassment and bullying is between a junior personnel as the victim and the more senior personnel as the apparent oppressor. Hence, while the seafarer is on-board the vessel, the seafarer should probably report directly to the captain as the most senior officer.

In case the complaint is against the captain, the contact information of a designated senior management officer should also be readily available and accessible.

Further, the captain and/or designated senior management officer handling the complaint will be directly responsible for the welfare of the apparent victim at least for the foreseeable future or the term of the contract. Also, the subject of the complaint should be informed that they should not take any actions possibly elicit resentment by the victim, intentional or otherwise, even at the slightest.

Treatment and elimination of the stigma surrounding seafarers diagnosed with a mental illness

Another company policy that may greatly improve the mental health of seafarers is a policy to eliminate the stigma commonly associated with mental health conditions.

From the pre-employment medical exam perspective and a psychological assessment (i.e. personality test, intelligence test) may have some value.

However, it should not be perceived as an indicator of the absence of mental health issues and/or the possibility of a seafarer developing a mental illness during the terms of his/her contract.

And from the post-employment medical perspective, when a seafarer is medically disembarked and later diagnosed with a mental health issue/illness, a policy should include that a seafarer should not be automatically disqualified and/or make him/her unfit for further sea duties.

The nature of mental illnesses varies greatly, and some, such as those commonly associated with stress like acute stress disorder and adjustment disorder can be successfully managed and treated in a relatively short (i.e. within two to three, or four months) span of time. Hence, it should probably not be considered an absolute cause of permanent unfitness to return to work at sea.

A good example of this is a seafarer with multiple contracts under his/her belt, who had a significant life event occur (i.e getting married, wife pregnant, having children) that may now be impacted by being out at sea for prolonged periods of time differently as opposed to when he/she was single. His/her mental health may be adversely affected by this stressor, he/she may develop changes in behavior that is later diagnosed as an adjustment disorder. A single episode, with successful completion of psychotherapy, support and reassurance from both his/her family and employer, he/she may still be gainfully employed as a seafarer, perhaps at best with some temporary modifications at the interim such as but not limited to shorter contracts.

Simply stated, a mental illness should probably not be considered an absolute contraindication for working at sea. The circumstances surrounding and/or contributory factors to the development of the mental illness should likewise also be considered together with the relevant specialist assessment and clearance.

In closing, and it can never be overstated, awareness is the key and indeed as the first step; but moving forward robust policies, enforced and regularly monitored for strict compliance, is probably the next crucial step towards the ultimate goal of a truly inclusive program to promote and to protect the mental health of our seafarers. It is essential that a company makes an effort on loss prevention, with a focus on the work environment to prevent the occurrence of mental health issues, not only on providing assistance once mental health issues have already arisen.

Reference:

Guidance on Eliminating Shipboard Harassment and Bullying (Published in 2016 by International Chamber of Shipping / International Transport Workers’ Federation)

https://www.ics-shipping.org/wp-content/uploads/2020/08/ics-itf-guidance-on-eliminating-shipboard-harassmentbullying.pdf