Mental Illness: The Silent Killer Stalking Seafarers
Liz Lagniton interviews both an affected seafarer and a psychiatrist on mental health risks and ways to mitigate this invisible yet deadly killer.
By Liz Lagniton, Philippine correspondent, Maritime Fairtrade
Over the four years he has been a ship oiler, 24-your-old Clyde Drexler Dublin always enjoyed getting a break from the engine and gazing at the serenity of calm seas from onboard the bulk carrier Michalis L.
But all that changed in the first quarter of 2020 when he and his 17 other Filipino shipmates learned that the deadly COVID-19 was officially classified as a global pandemic while they were out at sea.
“It was only in April last year when I heard about COVID-19 being classified as a global pandemic because we don’t have internet onboard. I found that out when we arrived at the port and was able to buy a local SIM card,” Clyde told the Maritime Fairtrade from Manila where he is awaiting his new vessel assignment.
Since then, Clyde and hundreds of thousands of other seafarers took on another risk aside from the inherent danger and physical exhaustion of a life at sea: the threat of mental illness.
“The stress and anxiety I felt last year had a bigger impact on my mental health,” Clyde admitted. “You can’t avoid depression when you’re away, isolated for long periods. Then there’s this COVID-19 that adds to your worries and fears.”
Mental illness is widespread
Psychiatrist Romel Papa, head of the psychology department of the Associated Marine Officers and Seaman’s Union of the Philippines (AMOSUP), said depression is one of the most common mental illnesses among seafarers.
“Why are they sad? Because they are far away and worry about how their family is doing,” Dr. Papa told the Maritime Fairtrade in an interview. “One way to beat depression is to communicate more often with your families back home.”
But Clyde and his 17 crewmates were among the many seafarers who had no way of getting in touch with their loved ones because they were not allowed internet access unless in an emergency.
“We can only access the internet once we get to the ports and buy local SIM cards,” said Clyde, referring to subscriber identity module cards inserted in mobile phones and other devices.
Consequently, seafarers who have been out at sea for six to eight months began to worry not only about their personal safety from the novel coronavirus but also the safety and wellbeing of their families.
Access to internet can fight depression
In recent years, a number of experts on maritime research say providing seafarers’ internet access helps keep them cheerful and mentally stable while at sea.
Dr. Papa agreed with this study and said, “With internet access, seafarers no longer worry too much about their families back home as they get real-time communication. It can also help lessen their loneliness and anxiety when they’re at sea.
“The availability of today’s technology where they can text or chat on Viber, Facebook, or any app that will keep them in touch with their families is a big relief for our seafarers.
“Because of today’s technology, seafarers’ life at sea is much better compared to the old times when there was no internet, and seafarers needed to write a letter or send voice mail in order to communicate with their loved ones.”
Problem of no access still exist
“The problem, however, is that there are still some shipowners whose vessels have no internet access,” Dr. Papa said, adding that this may have serious consequences for the mental wellbeing of seafarers.
“They feel isolated when they have no connection with the world. They are even more nervous when they’re not doing anything. But when they communicate more often with their family, it eases their anxiety and the sadness disappears.”
Clyde agreed and said he didn’t mind that he had to spend US$20 so that he could talk to his family for 30 minutes.
“My anxiety was really high at that time. I was very worried. I could do nothing to protect my family because I was on board. We’re isolated. We’re in the middle of the ocean. This COVID-19 pandemic has exacerbated my worries for my family’s health and safety. My mental health was affected because of the uncertainty brought about by this pandemic,” Clyde said.
“Every time I read or watched the news on social media, and saw that many people were infected and some even died, that ignited my anxiety. So, I don’t care if I have to spend US$20 just to talk to them. I have to hear their voices to calm myself, to lessen my anxiety.”
Clyde said while there was relief every time he talked to his family, there was still a lingering worry that he should physically be with his family during these trying times.
When told of Clyde’s complaints, Dr. Papa said it is only normal to feel scared due to the uncertainty of the current situation.
“Not just seafarers, all of us are traumatized by this COVID-19 and have, at some point, asked ourselves what if we get infected? Will we die? The unique fear of seafarers is that they are so far away from home,” Dr. Papa added.
Urgent need to address mental health
While governments and international organizations praise the contribution of seafarers in maintaining the global supply chains, they are not doing enough to address the challenges and allay the fears faced by seafarers in these extraordinary times.
When the pandemic began, many countries prevented crew members from leaving their ships. Worldwide travel restrictions were imposed and consequently affected the movement of seafarers who were held onboard for unprecedented periods of time long after the end of their contracts.
Clyde said many of his seafaring friends have been trapped onboard since the start of the pandemic in 2020, with no certainty of when they could go home.
“Some of them have been at sea for almost two years already. They were caught in the COVID-19 restrictions last year and ended up trapped at sea — with extended contracts. I saw frustration in them. They get angry easily, so don’t kid around with them. Sometimes, the relationship onboard is not harmonious anymore.”
Clyde added that at one time he heard his friends jokingly said “What if we just stop the engine so we can all go home?”
“Even if it’s just a joke, it’s still scary knowing that they already have thoughts like that,” Clyde said. “They are desperate to go home because they want to see their families.”
Dr. Papa said such signals of depression must be addressed immediately.
“They can still perform their functions normally. It means they can still cope with the depression,” the psychiatrist said. “The irritability, the anger, that’s natural for someone trapped. However, the question is when is the breaking point and how can they deal with it?”
Ways to cope
Dr. Papa said winning against depression is important because healthy minds are crucial in maintaining good relationships and in reducing human errors on board a ship.
He advises seafarers not to rely on alcohol to fight depression because it can actually worsen the situation.
“Some may think that when they are anxious, drinking alcohol can help them. Do you know that alcohol can make it even worse because when you drink too much, especially if you’re far away, you will have more difficulty sleeping and that in turn make you feel worse?
“We have to look for good coping mechanisms, like exercise and other activities that do not entail drinking alcohol or taking addictive substances. Let’s do our job. Don’t self-medicate, particularly with alcohol or drugs. Do something else that is more productive.”
Importantly, Dr. Papa also suggested that shipowners invest not only in internet connections in their vessels but also in leisure facilities that will make seafarers more active.
Aside from constant communication with families, Dr. Papa said having conversations with other crew members also helps.
“Filipinos are good at telling stories, they tell and share their stories, and they can easily relate to each other’s stories. So, sharing experience can help seafarers cope with loneliness and depression.”
Dr. Papa also said that when seafarers themselves are caught in difficult mental health challenges, or if they feel or spot other seafarers not behaving normally and unable to work properly, it is time to act and seek professional help to receive medical attention.
When to seek medical help?
In looking for danger signs, Dr. Papa said he always keep an eye out for behavioral changes that indicate a change from ordinary sadness into clinical depression, which will then require medical attention.
“In AMOSUP for instance, we evaluate the functional level of the seafarer. At some point in our lives, all of us become lonely. But not to the point that we can no longer work. So, look at a seafarer and determine if he is still functional.”
AMOSUP, Dr. Papa said, has several programs like telehealth consultations and other such services that can help troubled seafarers, which because of limited resources, are open to AMOSUP members only.
“Filipino seafarers are resilient,” he said. “If you look at the Filipinos’ behavior, they are used to this kind of life, and they will not sacrifice their seafaring career that offers a better financial opportunity for them and their families just because of loneliness.”
Light at the end of tunnel
Many seafarers who suffer from depression or mental illness do not report to their captains because they are afraid of being fired. Nevertheless, seafarers must still find ways to mitigate this health risk.
There are no one-size-fits-all solutions as each seafarer’s personality and circumstance is unique. Therefore, they have to try various methods before settling on the ones that best suit them.
Clyde tried different mechanisms to cope, and among them is constant prayer.
“I believe in the power of praying. I know God will not abandon me and my family in these trying times. I surrendered all my worries and fears to our Almighty God, and let Him take care of everything.”
He also cultivated friendships to meet his need for socialization and to find partners in fighting depression.
Clyde considered himself a winner in the good fight. His contract was not extended and he was able to go home in October last year and has since been reunited with his wife and three children.
“I can say that I’m okay now and ready to return to sea. Even though I’m a bit sad because I’ll be separated from my family again, I have to do it to be able to give my children a better future,” Clyde said, after six months on land.
The difference is Clyde now knows what to do when the going gets tough. He constantly reminds himself that he is not alone, that many others have it worse than he.