Suicide is now the foremost cause of deaths among seafarers, an “… isolated, vulnerable, and globally essential workforce.”
As the global death toll from COVID-19 increased, spreading fear and panic across nations, the mental health of seafarers stranded at sea became a growing concern. The concern grew with the number of reported suicides and suicide attempts on board ships stranded offshore or in port.
“It’s now the foremost cause of deaths amongst seafarers,” the Seafarers Hospital Society (SHS) in the UK disclosed in June 2020.
Crisis situation
“We’re all living in a crisis situation at the moment with huge stresses and strains. But the strain on seafarers is particularly acute. It’s a tough job at the best of times, but now, with so many seafarers working well beyond the normal contract period, the strain is beginning to show. They’re anxious about their families, anxious about their health, and anxious about the future,” said Sandra Welch, recently appointed CEO of the centuries-old organization, which offers support to seafarers of the British merchant marine.
The concern about seafarers’ mental health and the link to suicide was only recently addressed in the final report of a “Seafarer Mental Health Study” conducted by Dr. Rafael Lefkowitz and Martin Slade of the Yale Occupational and Environmental Medicine Program. The research was financed by the ITF Seafarers’ Trust* and the final report was released in October 2019.
The goal of the Yale-ITF study was to determine rates and factors associated with mental health conditions in seafarers, and identify opportunities for preventive interventions. More than 1,500 seafarers on various types of vessels were included in the study.
Seafarers with “suicidal ideation” were defined as those responding: “several days”, “more than half the days”, or “nearly every day” to the question: “Over the past two weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?”
Key findings
• 25% of seafarers completing a patient health questionnaire had scores suggesting depression (significantly higher than other working and general populations).
• 17% of seafarers completing a generalised anxiety disorder questionnaire were defined as seafarers with anxiety.
• 20% of seafarers surveyed had suicidal ideation, either several days (12.5%), more than half the days (5%), or nearly every day (2%) over the two weeks prior to taking the survey.
• Incorporating all demographic, occupational, and work environmental factors, final determinants of seafarer depression, anxiety, and suicidal ideation included work environmental factors (non-caring company culture, violence at work), job satisfaction, and self-rated health (the strongest predictor of anxiety and depression).
• The most significant factor associated with workplace violence was seafarer region of origin. Seafarers from the Philippines and Eastern Europe were most likely to report exposures to workplace violence.
• Depression, anxiety, and suicidal ideation were associated with increased likelihood of injury and illness while working on board the vessel.
• Seafarer depression, anxiety, and suicidal ideation were associated with increased likelihood of planning to leave work as a seafarer in the next six months.
• Periods in work/life cycle associated with high risk of mental health issues included, most notably, during extension of a voyage.
The authors noted that while comparative data was limited, the analysis suggested that seafarers have higher rates of depression than other working populations. It emphasized the need for appropriate mental health policies and management strategies in what they described as an “… isolated, vulnerable, and globally essential workforce.”