Before, During, and After: Systemic Approaches to Trauma Support in Seafarers

Before, During, and After: Systemic Approaches to Trauma Support in Seafarers

Alexander Dimitrevich, Daniel Conor Seyle
Copyright: © 2022 |Pages: 15
DOI: 10.4018/978-1-7998-9039-3.ch020
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This chapter will review the environmental and social stressors that seafarers face regularly and the associated risk of significant behavioral health impact with a particular focus on the risk of traumatic stress impacts. It will present research suggesting that such impacts have economic and performance impacts, in addition to their human impact, and research demonstrating that such impacts can cost-effectively be mitigated by relatively simple behavioral health interventions. Finally, it will propose a “before, during, and after” strategy that manning agencies and shipowners can adopt to equip seafarers with the appropriate tools to mitigate the impacts of maritime stressors.
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In 2019, one of the authors of this chapter was asked by the family of a chief engineer to contact him, as they were deeply concerned about his mental state. At the time, the engineer was aboard a ship anchored in Spain, near Barcelona. Several of the engineer’s crew mates had tested positive for Covid-19 after showing symptoms, meaning he was forced stay on board for another three months due to coronavirus-related travel restrictions. He spent nine months in total on the ship. The COVID-19 pandemic has had a major effect on our lives. Many of us were facing challenges that can be stressful, overwhelming, and cause strong emotions. Public health actions, such as social distancing, and travel restrictions were necessary to reduce the spread of COVID-19, but they made seafarers more isolated and lonelier, many of them were in situations where their hopes to be home soon dashed and that contributed to their stress and anxiety. The engineer didn’t have any coronavirus symptoms, but his test came back positive, so he had to isolate in his cabin. His anxiety grew as he realized it would take medical staff days to board the ship if he needed treatment or oxygen. On the fifth day of isolation, the engineer was convinced he didn’t have Covid-19 – but he had to remain in the cabin. He couldn’t see or speak to anyone, and his phone and WiFi connection weren’t reliable, so he tried reading a book. Gradually, the engineer’s anxiety turned to anger; he started thinking everyone on the ship and in the company’s, office was conspiring against him. When I first spoke to him, he was sure his cabin’s plug sockets and phone were bugged with listening devices. The engineer thought about jumping overboard, with little care about whether he would die or reach the shore. During times of extreme stress, people may have thoughts of suicide. These thoughts can be intrusive and frightening which aggravates mental health issues however suicide is preventable and there are many ways how to cope and this needs to be a part of training for seafarers along with information and signs to watch for, and how to respond if they notice these signs in themself or others.

On that first call, the author managed to stabilize him – and he agreed to involve the captain for his benefit. He contacted the captain, who was quite responsive and understood the crisis response procedures for someone with a mental health issue, the company’s designated person ashore and crew managers. The captain organized a 24-hour watch outside the engineer’s cabin, while the company arranged his repatriation without a medical escort as quickly as possible. Once the engineer had disembarked at the nearest port, he visited a psychiatrist. We then arranged for him to see mental health professionals in his hometown. A tragedy was avoided thanks to the engineer’s family members, the captain and the shipping company’s crisis management procedures. This case illustrates several issues that this chapter will develop. First, COVID (and future pandemics) pose more than a physical risk to seafarers. COVID is a significant stressor, and regardless of the physical effects on seafarers can cause stress and concern. Secondly, COVID-19 interacts with other significant stressors to seafarers. Seafarers face major psychological stressors from their work environment. These include issues of isolation, fatigue, threats due to the industrial workplace aboard ship, maritime hazards, and interpersonal challenges with other crewmembers. COVID-19 interacts with these stressors to increase seafarer distress. However, this case also illustrates how support and therapy can help seafarers recover and do their work.

This chapter will develop these arguments and present a review of the major stressors that seafarers face and the likely behavioral impacts on seafarer wellbeing and work performance. Also, this book chapter reviews how these interact with COVID and the likely future pandemics to follow. Finally, the authors will introduce the “Before, During, and After” model for seafarer support that provides a framework that shipowners, manning agencies, seafarers, and seafarer support organizations can use to develop tools for reducing the likelihood of significant or lasting distress.

Key Terms in this Chapter

Psychology: As a social science, psychology also encompasses the natural sciences. Because the directly observable behaviors of organisms are also included in the field of psychology. Therefore, with the science of psychology, it is possible to study the behavior of animals as well as humans. Psychology, which examines interpersonal communication as well as internal processes, also examines in-group behaviors and intergroup relations.

Chronic Stress: Stress is a biological response of the body to challenging situations. It causes the body to release hormones such as cortisol and adrenaline. These hormones help the body to take action, for example, by increasing heart rate and breathing frequency. Many factors that increase psychological pressure, such as dangerous situations, length of working hours, difficult working conditions, exams and sports events, can trigger the stress response.

Post-COVID-19: People with severe symptoms of COVID-19 often have to be treated in a hospital intensive care unit with mechanical assistance such as ventilators to breathe. Just surviving this experience can make a person more likely to develop post-traumatic stress syndrome, depression, and anxiety later on.

Post-Traumatic Stress Disorder (PTSD): Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.

Seafarer Mental Health: They are negatively affected by the fact that the uncertainty of the process affects the spirit world of the person rather than staying on the ship for a long time, and the lack of clarity about when the ship's crew can return to their homes rather than staying on the ship for a long time. It adversely affects the spirit world of the personnel staying on the ship for a long time and causes stress.

Trauma: Physical and emotional abuse within the scope of mental trauma (concussion), sexual abuse, natural disasters (such as earthquake, flood, storm, etc.), being affected by fires, traffic accidents, wars and conflicts.

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