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Suicides, deaths spur concerns over crew mental health

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By Dorie Cox

The Triton office was closed and the staff was on its way out when the phone rang. A woman’s voice said she was crew on a yacht. She and her fellow crew were afraid. They needed help.

The yacht engineer was using narcotics while on the job, she explained. He had verbally and physically assaulted crew members in the past. The woman said she had talked with her captain, but the engineer would not be let go.

“Can you help us?” the woman asked. “We don’t know where to turn.”

When I answered that call and could hear fear and anxiety in her voice, I realized a call to a news office was a  desperate act.

This added to the list of mental health challenges I have been covering on captains and crew in yachting. Just this year I have written about several crew suicides and suspected suicides, as well as deaths from drug and alcohol abuse. I have met yacht crew who have been assaulted and raped. And I’ve talked with the captains and crew – and family – most affected.

The effects of an unbalanced mental state show up in world news often. From 17 people killed by a troubled man at Marjory Stoneman Douglas High School in South Florida last spring to the suicides of celebrities such as actor Robin Williams, chef Anthony Bourdain, and designer Kate Spade, the conversation is playing out on TV shows and podcasts, in newspaper and magazine articles, and in seminars around the world. “I’m Listening,” a global event that took place on Sept. 9, aimed to end the stigma of talking about mental health (imlistening.org).

Yachting is not immune, but it’s not clear how far-reaching the issue is. Some say the lack of hard data should be the least of our concern.

“I’m aware of four cases of people taking their own life in the last 18 months,” said Tony Nicholson, projects team leader with MedAire, a medical support company. “For a small industry, that’s terrible. I don’t think we need statistics. Other industries with world travel take mental health very seriously. Whatever we can do to help can only be beneficial.”

We asked yachting veterans and mental health experts how the lifestyle of yachting affects crew’s mental health, what help is available when they feel overwhelmed, and how they can overcome those challenges to staying healthy.

Many crew and professionals say they see signs of concern – depression, anxiety, aggression, fear, eating disorders, and addictive behaviors – that may be exacerbated by the yachting lifestyle.

“Yachting is such a hard life, much more than people realize,” Norma Trease said. As a former crew, crew agent and editor-at-large at Yachting Matters, she has seen mental health concerns from all sides.

Behind the scenes on board

The goal with mental health is just that: health. Dictionaries describe it as a state of emotional and psychological well-being in which an individual is able to use his or her cognitive and emotional capabilities, function in society, and meet the ordinary demands of everyday life.

Problems arise when this healthy state is disrupted. And just one crew member can affect everyone on board, said Chief Stew Jodi Samuel Aves. Aves is an author and actively involved in education on mental health issues. For the past decade in the industry, she has seen common concerns on different yachts that personally affected her. Sometimes situations occur, such as a death in the family, that trigger mental health problems, and in other instances, crew come into the industry with problems, she said.

Coupled with that are unpredictable work schedules and challenging demands, long working hours, difficulty adapting to unfamiliar environments and cultures, feelings of isolation, unrealized expectations, and confined living and working conditions.

“It’s so different from life on land – you’re not even in charge of what you’re eating,” Aves said. “A lot of jobs require working long hours, but they go home at night. We’re away from our support, our people. All this makes it hard.”

Often captains and crew are not aware of how situations surrounding mental health can affect crew.

“The problem is that so many are taken by surprise, they had no idea,” Rebecca Castellano said of the mental health issues that arise. As a registered nurse and sales manager with Medical Support Offshore, she said, “I’ve got horror stories.”

Often the person themself may not know something is wrong, she said.

“Mental illness is difficult to diagnose; everyone gets happy and depressed,” Castellano said. “Get them on board, away from home, nothing is familiar, no family, crammed in with people they don’t know, clashes with language and culture, a boyfriend breaks up and the next thing you know, they break. If they are not rock solid, mentally stable, it is an equation for disaster.”

There is no way to know how crew will respond to anxiety and stress – “even when the interview goes well, they’re full of smiles and they look great on paper” – so crew have to be astute, listen to each other, notice if he’s sleeping too much or she’s eating too little, recognize if someone seems nervous or cries easily. These are all symptoms of mental stress, Castellano said.

And it isn’t just crew who are susceptible, it’s captains too, she added.

Help is available

Whether a mental health concern is from a pre-existing condition or develops while on the job, education can help. Crew can learn to be aware of their own actions, and senior crew can be alert to symptoms and guide fellow crew to help.

Mental issues should be treated like any other illness, Castellano said.

“If you saw crew who was physically sick and not getting the job done, you would say, ‘You need to stop and go to the doctor.’ Why would mental illness be treated any different?”

Medical Support Offshore’s call service offers guidance for mental health concerns. A call activates telemedical support and a doctor will get involved, she said. An example of a concern would be a depressed crew member who has locked himself in a cabin, Castellano said. A call to the hotline connects doctors who can offer advice on transportation, possible medication, advice for a suicide watch, or whatever is needed.

Karine Rayson, director of The Crew Coach, believes psychological education should be part of mandatory crew training. Rayson moderates a blog and hosts webinars to help crew because of things, such as bullying, that she saw as chief stew on superyachts.

“I have heard of accounts of some crew being targeted and having their belongings thrown into the toilet and their personal belongings being purposefully ruined,” she wrote to The Triton. “I have heard of crew being mistreated due to not consenting to ‘sexual favours.’”

She saw how such behaviors led to problems.

“Sexual harassment, verbal abuse and bullying trigger mental health conditions,” she said. “Psychological safety is as paramount as physical safety.”

Some first steps should include focus on the importance of good mental health, management of burnout, and increased awareness of the potential signs of problems, Rayson said. When crew reach out for help, they should be assured that they will be treated with sympathy, respect and discretion.

She also wants to address the fact that crew do not feel safe in terms of reaching out for support.

“Namely, fear of losing their jobs, their fellow crew members could be triggering their mental health issues, lack of information, or they are unsure of which governing body to turn to for support,” Rayson said. “There is a lot of work that needs to be done to change the existing culture and stigma attached to mental health within the industry.”

MedAire is working toward offering that support, Nicholson said.

To use remote medical services, the captain or officer historically needed to be informed of the request for help to authorize monetary approval before any treatment, Nicholson said. This appeared to be a roadblock to crew asking for help.

“With anxiety, bullying and isolation, crew may not want to take it further up the chain because of what they perceive they will have to do,” he said. “It can be tough to go through attitudes and stigma.”

MedAire now offers assistance that eliminates the need for advanced authorization. Even so, there has been some concern from captains.

“The feedback is that captains are not comfortable because they want to know what’s going on,” Nicholson said. “We respond that if crew are not reaching out to you, they’re not reaching out. What this does is it puts multiple levels of safety with the medical team first. This is confidential unless someone is a dangerous risk to themselves or others. Legally and morally, we have to alert [captains] for legal or medical help then. Multiple layers of safety are still there if someone needs support outside of standard counseling.”

Hope for health

Fortunately, support industries are working to foster communication and resources. The recent perceived increase in mental health-related incidents has created a sense of urgency, said Frank Brand, instructor and course developer at the Star Center in Dania Beach, Florida. Earlier this year during the Superyacht Summit, Brand was moderator of the seminar, “Health and Wellness on Deck: Making a Happy and Healthy Crew, Plus Recognizing Warning Signs for Mental and Physical Issues.”

“Recent research by IMO [International Maritime Organization] indicates that seafarers may be more likely than their shore counterparts to experience mental health problems,” Brand said. “Health care has historically focused on physical health. There is little or no mental health assessment to determine suitability.”

Awareness is growing, said Tom Holmer. He is project manager with International Seafarers’ Welfare and Assistance Network (ISWAN), which offers a help line to provide emotional support and counseling services, as well as seafarers centers and welfare workers. Much of the group’s work has been with merchant seafarers, but Holmer said yacht crew face similar issues. Because of that, ISWAN is compiling a survey to assess yacht crews’ mental health condition and needs. The results will be available in December.

“To put this in perspective, we know that seafarers can love their work,” he wrote in an email to The Triton. “They are professionals, most employers are well meaning, and good careers are available. But there can be cases of abuse, or other areas of need that might not be related to anything untoward on board, where independent support is sought.”

I have tried without success to reach out to that young woman so troubled by the unstable engineer. I don’t know the outcome for them. I do know that I was unprepared to help. I’m not a mental health professional, and neither are yacht captains and fellow crewmates.

But people are talking about it. And that is a start.

Dorie Cox is editor of The Triton. Comments are welcome below. To read a previous Triton story about suicide and its impact on yacht crew, click “Suicides devastate close-knit crews”.

Some resources:

U.S. National Suicide Prevention Lifeline – suicidepreventionlifeline.org, +1-800-273-8255
Crisis Text Line – text HOME to 741741
Crisis Services Canada – www.crisisservicescanada.ca, 1-833-456-4566
UK Samaritans – 116 123 (UK and Ireland), www.samaritans.org
Australia Lifeline – www.lifeline.org.au, 13 11 14
SeafarerHelp – www.seafarerhelp.org, +44 20 7323 2737, help@seafarerhelp.org

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About Dorie Cox

Dorie Cox is editor of The Triton.

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