On-board emotional support
What are the realities of mental health support for crew? Tony Nicholson, MedAire, explores this issue…
Mental health remains one of the most neglected global health issues, and the yachting community is no exception, explains Tony Nicholson, director for MedAire.
A recent survey of yacht crew found that more than 70 per cent have either suffered mental-health problems or know someone who has. Sadly, those crewmembers also said that no support was put in place to help them cope when they were struggling with stress and general mental health on board. The vast majority of the respondents (75 per cent) said the industry was not doing enough to tackle mental-health problems of crew.
While companies in traditional industries have been offering employee assistance programmes for years, these have rarely been made available to yacht crew, either because of the small number of staff or the temporary nature of vessel employment.
However, when the demographics of yacht crew are reviewed, taking in to account the lifestyle and work pressures, it is clear that emotional and mental-support services should be offered as standard to crew.
In the best of circumstances, the 20s are a challenging age for mental health. While major depression can occur at any age, the average age of onset is in the mid-20s. Biology, life’s transitions, the invincibility of youth, alcohol consumption and possible drug use and experimentation contribute to the emotional highs and lows. For crewmembers, those stressors are magnified – close quarters, long hours, little sleep, away from family and friends. It can be a recipe for feelings of isolation, desperation and powerlessness that can quickly get out of control, putting the individual and others at risk.
A recent survey of yacht crew found that more than 70 per cent have either suffered mental-health problems or know someone who has ... The vast majority of the respondents (75 per cent) said the industry was not doing enough to tackle mental-health problems of crew.
Many vessels are not equipped to – or even aware of how to – provide mental-health services to their crewmembers. Furthermore, many crewmembers with such conditions are reluctant to share personal information and may be fearful of being stigmatised.
These realities led MedAire to extend its capabilities to offer emotional-support services. Designed specifically for the unique needs of those who live and work on yachts, MedAire Emotional Support Services assists captains and their crewmembers to deal with psychological and emotional issues where short-term counselling is appropriate.
The need for immediate consultation services is illustrated by the experience of a crewmember in Japan. Fearful that the medication he was taking for a depressive disorder would run out, the crewmember cut his doses in half. Unfamiliar with local medical protocols, he found it difficult to find help and began experiencing suicidal thoughts and exhibiting violent behaviour.
We built our emotional-support programme to remove the barriers to getting crew the help they need. One of the biggest concerns we heard from crewmembers was that they were too embarrassed or uncomfortable to tell their captain that they were having trouble. They didn’t want their personal struggles to be common knowledge among the rest of the crew.
Captains and management companies have a responsibility to promote crew health and well-being, support crewmembers at risk and have plans in place to respond to people showing warning signs of emotional distress. Crewmembers should be encouraged to seek help and be referred to mental-health professionals who can support them when they are at shore AND when they are at sea.
Best practices for creating a culture of emotional support
1. Allow crewmembers to access professional mental-health and emotional-support services privately and confidentially.
2. Ensure support is available 24/7, anywhere in the world. Emotional turmoil isn’t limited to the daylight hours.
3. Consider the worst-case scenario. Emotional issues can quickly escalate. Have a support service to coordinate emergency medical services on a 24/7 basis, including emergency referrals to mental-health facilities and doctors, medical-treatment expense insurance, emergency medical payments, medical evacuation or repatriation, dispatch of medical specialists and emergency travel for family members.
4. Create the culture. Emotional and mental support is a ‘must have’, not a ‘nice to have’.
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