Participants Manual MMHA BSM Master

Participants Manual
Maritime Mental Health

Awareness
Spotting the Signs and Responding to
Concerns
Senior Officers and Shoreside Staff
ALL RIGHTS RESERVED. This manual is designed for participants only. Please do not share it with others. Any unauthorised
use or reprint of this material in part or in full is prohibited without the express permission of the author. Permission
should be sought through ISWAN. Every effort has been made to ensure the information contained herein is evidence
based and clinically sound, however it does not take the place of clinical advice. Neither ISWAN, Dr Pennie Blackburn,
Consultant Clinical Psychologist nor associate trainers take any liability for application or interpretation of the contents.
Maritime Mental Health Awareness. ©Dr Pennie Blackburn, Consultant Clinical Psychologist 2023. ALL RIGHTS RESERVED. 1
Module 1: Maritime Mental Health Awareness
60 mins Introduction to Mental Health
What do we understand by Mental Health?
Why don’t we talk about mental health at work?
45 mins Overview of Types of Mental Health Problems

Biopsychosocial Model of Mental Health
120 mins Mental Health at Sea

Risks and Stressors
Good Practice for Mental Health on Board
Psychological Wellbeing at Sea
Module 2: Psychological First Aid: Spotting the Signs and First Response
15 mins Learning Review – Mental Health Quiz
30 mins The Role of Senior Staff in Managing Mental Health
90 mins Psychological First Aid

Look Listen Link
Spotting the Signs
First Response
Supportive Action
60 mins Putting Learning into Practice
15 mins Q&A
Course Evaluations
What is Mental Health?
The World Health Organisation defines mental health as “a state of well-being in which every
individual realises his or her own potential, can cope with the normal stresses of life, can work productively
and fruitfully, and is able to make a contribution to her or his community.”
We all have a range of emotions on a
day-to-day basis. Our emotions
change all the time as we respond to
events, experiences, our
environment, and the circumstances
of our lives. Some emotions are
positive and inspire us or motivate us
and others can be more challenging
and make it difficult for us to
function as we normally would.
Our mental health is affected by
many things in work and in life,
(stress at work, bereavement,
relationship breakdowns, illness,
financial worries and so on) or
mental health problems can come on
without any obvious identifiable
cause. Some mental health problems
are mild or moderate and some are more challenging and can affect our ability to function on a day to day basis.
Anyone can be affected by mental health problems, of any age, personality or background.
In the west we tend to understand mental health problems within

what we call a biopsychosocial model, i.e. the complex interaction of
• biological factors (like genetics, brain chemistry and

physiological responses),
• psychological factors (such as emotions, thoughts and

behaviours, attitudes & beliefs, coping skills) and Bio
• social factors (our environment, circumstances, culture,
family and so on)
underpin mental and very often our physical health. Psycho
It is important to be aware that people from different cultures may
understand mental health differently; it can be understood within a
religious or a spiritual framework (in some cultures e.g., curses or
malign spirits might be considered the cause of mental health
problems). The emotional expression of distress may vary across
Social
cultures as can appropriate ways of coping. Stigma may be much
greater (in some cultures it is extremely shameful to express negative
emotions and, in some cultures, mental health problems can be
considered contagious and may be actually feared) but in some more
emotionally expressive cultures it may be more acceptable.
Mental Health Problems – Mix and Match Exercise
write the correct disorder in the gaps below:
GENERALISED PHOBIA
PANIC PSYCHOSIS /
DEPRESSION ANXIETY RELATED
DISORDER SCHIZOPHRENIA
DISORDER DISORDERS
People with ________ disorder display excessive anxiety or worry, most days for at least 6
months, about a number of things such as personal health, work, social interactions, and
everyday routine life circumstances. The fear and anxiety can cause significant problems in
areas of their life, such as social interactions, school, and work.
___________ disorder symptoms include:
• Feeling restless, wound-up, or on-edge
• Being easily fatigued
• Having difficulty concentrating; mind going blank
• Being irritable
• Having muscle tension
• Difficulty controlling feelings of worry
Having sleep problems, such as difficulty falling or staying asleep, restlessness, or
unsatisfying sleep
People with this disorder have recurrent unexpected _________. Sudden periods of
intense fear come on quickly and reach their peak within minutes. ________ can occur
unexpectedly or can be brought on by a trigger, such as a feared object or situation.
During a _________, people may experience:
• Heart palpitations, a pounding heartbeat, or an accelerated heartrate
• Sweating
• Trembling or shaking
• Sensations of shortness of breath, smothering, or choking
• Feelings of impending doom
• Feelings of being out of control
People with this disorder often worry about when the next attack will happen and actively
try to prevent it by avoiding places, situations, or behaviours they associate with them.
Worry about it and the effort spent trying to avoid it, cause significant problems in various
areas of the person’s life.
__________is a chronic and severe mental disorder that affects how a person thinks, feels,
and behaves. People with ________ may seem like they have lost touch with reality.
Symptoms of _________ usually start between ages 16 and 30. The symptoms of
__________ fall into three categories: positive, negative, and cognitive.
People with positive symptoms may “lose touch” with some aspects of reality and suffer
with thought disorder, delusions or hallucinations.
Negative symptoms are associated with disruptions to normal emotions and behaviours,
including flat mood, loss of pleasure in everyday life, Difficulty beginning and sustaining
activities.
Cognitive symptoms of ________ may be subtle or more severe and patients may notice
changes in their memory or other aspects of thinking. Symptoms include: Poor “executive
functioning” (the ability to understand information and use it to make decisions), Trouble
focusing or paying attention, problems with memory.
A _______ is an intense fear of certain objects or situations. Although it can be realistic to
be anxious in some circumstances, the fear people with this disorder feel is out of
proportion to the actual danger caused by the situation or object.
People with _______:
May have an irrational or excessive worry about encountering the feared object or
situation
Take active steps to avoid the feared object or situation
Experience immediate intense anxiety upon encountering the feared object or situation
Endure unavoidable objects and situations with intense anxiety
________is a common but serious disorder. It causes severe symptoms that affect how
you feel, think, and handle daily activities, such as sleeping, eating, or working. To be
diagnosed with ______, the symptoms must be present for at least two weeks.
If you suffer with the following signs and symptoms most of the day, nearly every day, for
at least two weeks, you may be suffering from _______:
• Persistent sad, anxious, or “empty” mood
• Feelings of hopelessness, or pessimism
• Irritability
• Feelings of guilt, worthlessness, or helplessness
• Loss of interest or pleasure in hobbies and activities
• Decreased energy or fatigue
• Moving or talking more slowly
• Feeling restless or having trouble sitting still
• Difficulty concentrating, remembering, or making decisions
• Difficulty sleeping, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Aches or pains, headaches, cramps, or digestive problems without a clear physical
cause and/or that do not ease even with treatment
Mental Health at Sea
The prevalence of mental health problems at sea is not well known. Given
the known stressors of a life at sea, we would expect that the figures are at
least as high as the general population. There are some indications from Key Findings from the ITF
the literature that mental health problems may be significantly higher but Seafarers’ Trust Yale
more research is needed. What is clear is that there are a lot of stressors
inherent in a life at sea and the coping strategies that people use on shore University Seafarer
are every often not available on board. So it is important to be aware of
the issues. Below is a list of many of the factors that is written about in the
Mental Health Study [3]
literature. Not all will apply to everyone. The percentages in brackets come
28% of 1572 Seafarers screened
from the IOSH/SIRC Seafarers Mental Health and Wellbeing Study
positive for Anxiety or Depression (cf.
[Sampson et al 2019]. It may be a useful exercise to think about the factors
gen population estimates of 6% in
that do apply in your context, what you or others could put into place to German study and 5% in oil and gas
mitigate against these factors where that is possible and promote positive workers using the same study
mental health and wellbeing. methodology)
Interpersonal factors Seafarers who screened positive for
 Isolation [1] anxiety and depression were twice as
 Loneliness [2] likely to have suffered an injury at
 Separation from and missing family (80% [2]) [3] work the previous year. This is also
 Receiving bad news from home (69%) [2] true of illness.
 Bereavement or sickness at home [2]
 Personal relationship problems [2] 35% of those with depression asked
 Absence from key life events in family / friends nobody for help.
 Inability to communicate effectively with friends and family at home
Low job control was associated with
both depression and with increased
Contractual issues injury.
 Short term or voyage only contracts
 Financial concerns 20% of Seafarers reported suicidal
 Insecurity of Contracts ideation on several days or more
 Contract length [3] during the 2 weeks prior to the
 Voyage Extension [3] survey.
The highest statistically significant
Interpersonal Factors on board determinants of depression, anxiety
 Uncaring work environment/lack of caring company culture [3]
and suicidal ideation were:
 Bullying and harassment
• A Non-caring company culture
 Exposure to threats and violence [3]
 Physical assault (15%) [2] • Violence at work
 Sexual harassment (5%) [2] • Low Job satisfaction
 Sexual assault (4%) [2] • Self-rated health problems
 Language and cultural communication barriers
 Small crew Seafarers who screened positive for
 Falling out with colleagues (38%) [2] depression, ranked isolation from
 Living and working in close proximity in a confined space with the same people family, trouble sleeping, contract
for long periods length and supervisor demands as the
highest contributing factors.
Management Problems
 Supervisor demands [3] Seafarers from the Pacific
 Being blamed for things that were not my fault (72% had experienced this and region/Philippines (11%), Eastern
77% of those said it made them feel down) [2] Europe and India (9%) were 4 times
 Being shouted at (48%) [2] as likely to report exposure to
 Discrimination (60% had experienced, 72% of those said it had made them feel workplace violence as those from
down) [2] Western Europe.
 Falling out with superiors (40%) [2]
Isolation on board
 Being the only woman on board (47% of women [2])
 Being the only person from my country on board (44%) [2]
 Too much time alone (35%) [2]
 Lone working (27% of 55% who had experienced it) [2]
 Not being able to make friends (20%) [2]
 Not being able to fit in (19%) [2]
Work demands
 Lack of control over work, pace of work and decisions relating to work [3]
 Lack of adequate training [3]
 Low job satisfaction [3]
 High number of calls at port (46%) [2]
 Fear of criminalisation
 Fear of job loss
 Periods of intense activity and periods of boredom
 Increasing bureaucratisation
 Excessive or unmanageable workloads or deadlines (60%) [2]
 Low levels of time off [2]
 Role responsibilities (e.g. Master’s responsibility for crew, health and safety and smooth operation of the vessel)
Occupational Exposure
 Noise, vibration, heat, tight working spaces (particularly engine room) 1
 Occupational exposures: Working alone, heavy lifting, dust smoke, chemical and sharp objects
 Being afraid due to bad weather (46%) [2]
 Risk of piracy
 Adverse weather conditions
 Customer / Owner demands (cruise and superyacht crew in particular)
 Exposure to drugs & alcohol (particularly superyacht crew)
Hours of Work and Rest

 Shift work
 Long working hours
 Low levels of time off (mean working days of 6.5 a week)
 Lack of shore leave/ None or very limited shore leave/ being prevented from taking shore leave (52%) [2]
 Fatigue (61%) [2]
Living Conditions
 Poor living conditions on board
 Shared cabin spaces
 Sleep problems [3]
 Quality of sleep and rest facilities
 Co-existing Medical & physical health problems [3]
 Lack of access to primary healthcare [3]
 Injuries and Illness [3]
 Seasickness (42%) [2]
 Feeling trapped (42%) [2]
 Lack of options and facilities for recreation, leisure, and physical exercise
 Poor food (60% 69/88), [2] lack of preferred food and limited food options, quality and quantity [3]
 Poor internet access (higher frequency of email and internet access related to lower risk of depression and suicidal
ideation) [3]
 Lack of access to coping strategies available on shore
 Lack of options and facilities for recreation, leisure, and physical exercise
1
Exposure to noise, has the same physiological effects as stress and has been implicated noise-induced stress has been implicated in the
development of disorders of the cardiovascular system, sleep, learning, memory, motivation, problem-solving, aggression, and irritability.
Psychological Wellbeing at Sea
The evidence says that:
Intentionally engaging in activities to strengthen our psychological wellbeing will have a positive effect.
If we can turn this into habits this will have a long-lasting impact on our wellbeing and physical health.
So what can YOU do?
ISWAN’s Good mental health guide Psychological Wellbeing at

Sea has lots of tip techniques and strategies for promoting
psychological wellbeing on board.
This guide and the others in the series can be downloaded from
the ISWAN website https://www.seafarerswelfare.org/seafarer-
health-information-programme/good-mental-health
Psychological First Aid
Psychological First Aid is a simple framework for helping people in distress so that they feel calm and supported in
coping. It does not require specialist mental health intervention and can be used on board to provide initial support 2.
You do not need to be a psychologist to provide psychological first aid. The model guides you how to notice problems
and provide basic support such as facilitating access to other sources of support and making reasonable adjustments
to work patterns. Managing common mental health problems and work-related stress on board in this way, can
prevent problems from worsening, ensure the smooth running of the vessel and even save lives.
2
You may need access to clinical technical support in cases of emergency or where you may be unsure about how to
proceed or whether specialists help is needed, your company should have information about where you can get this
professional advice.
Recognising the Signs
With somewhere in the region of 300 mental health problems identified in the Diagnostic Manual (DSM-5); each with
specific signs and symptoms, it isn’t possible to create a definitive list of signs which would be useful. Perhaps the
most important thing to notice is when someone is acting differently from normal; being quiet when they might
normally be chatty or isolating themselves when they are normally friendly and outgoing.
Officers and crew mates may be in a good position to notice changes, but crew turnover and differences in cultural
expressions of distress may make it more difficult to spot the signs. It is good practice to ask about wellbeing and
make it part of the everyday.
Mood & Behaviour Signs

• Acting differently from normal
• Irritability and quick to anger
• Disputes with colleagues
• Isolation & withdrawal
• Talking and engaging with others less
• Changes in mood, seeming more sad or anxious than usual
• Loss of sense of humour
• Taking less care over appearance (not shaving / showering)
Health Related Signs

• Increased smoking or use of Drugs & Alcohol
• Not sleeping
• Fatigue
• Changes in eating patterns
• Headaches or aches & pains frequent minor illnesses
• Sickness absence
Work Related Signs

• Working to a lower standard than normal, not getting tasks completed, neglecting responsibilities or
forgetting tasks may all indicate low mood or loss of motivation.
• Poor memory, concentration and/or difficulty making decisions
• Complaints about workload or lack of support from management may indicate a rising sense of pressure and
difficulty coping.
• Being Late for shifts may indicate a loss in motivation or energy
• Over-working may also indicate difficulty keeping up with tasks or a sense of pressure of workload
Responding to Signs of Concern
If you and / others have noticed some signs that something might not be right with a person; trust your
instinct and act on it. Acting early may help to prevent problems from worsening and help the person feel
supported and valued.
Normal work planning meetings, appraisals, reviews or line management meetings can provide a natural way
of integrating mental and physical wellbeing into everyday management processes and create a supportive
culture that promotes wellbeing. These work meetings can be good opportunities to discuss workload and
coping; which may enable the individual to raise any concerns at an early stage or for you to ask directly.
Many People will say they are

ok even when they are not.
[#AskTwice:]
 If you are concerned; ask
further but be sensitive.
“You don’t seem yourself, is
there something bothering
you?”
 Let them know it is ok if
they don’t feel like opening
up to you, and ask if there
is someone else they might
feel more comfortable to
If you have noticed some signs, it is time for a talk to (at home or at work)
conversation.  Let them know you are
Approach the person and arrange a time to talk happy to talk another time
• Reassure the person that they are not in trouble
 Be aware of
Create the space to Talk  Power differences; both in
relation to the hierarchy on
• Chose an appropriate place to talk; somewhere private and
the ship and
comfortable for you both.  Cultural differences. Some
• Chose a good time for both you and the person cultures will feel much more
• Make sure you have enough time to talk properly. able to talk than others
 Bullying and Harassment
Prepare yourself for the conversation  Fear of the impact of
• Remind yourself of the signs you’ve noticed disclosure on future
employability or current
• Be prepared that the person might not want to talk or talk to you work
(it’s still possible to help) You may need to think
creatively about how to
support someone who
doesn’t feel able to talk to a
senior officer about any
problems that they are facing,
e.g. to identify a close crew
mate, someone in a less
threatening hierarchical
position, arrange a ship visitor
at the next port or give them
the details of SeafarerHelp.
Essential Skills of Listening
Remember: We all do the best that we can, given the situation we are in and the knowledge, skills, and
resources that we have at the time
Taking Supportive Action
Facilitate access to alternative sources

of support
• “Is there anyone else you can talk to as well?” (Friends, family, crew mates…)
• Support through your Company (Occupational Health, telemedical services, HR)
• Online and Telephone Support (Helplines)
• Port Welfare (facilitate access at next port)
• Self-help guides
• Other Information, services, and help
Supportive Action
[NB: don’t be tempted to rush into action or offer immediate or simple solutions.]
• Help problem solve to address practical problems where possible

• Give or facilitate access to information / advice
• Make reasonable adjustments to work if appropriate which could include:
Hours of work
o Manageable changes to start and finish times
o Managing overworking – ensuring rest times, shore leave
o Temporary or permanent changes to shift patterns
o Temporary reduced hours (gradually building back up)
o Adjusting break times (e.g. equal amount of break time, but in shorter, more frequent
chunks)
Workload:
o Temporary reallocation/delegation of some role responsibilities (be aware of impact on
others)
o Extra training, or coaching, mentoring or increased support and supervision
o Short term support with managing or prioritising workload
o Adjusting deadlines where possible
Mediation and conflict resolution:
o Addressing bullying & harassment
o relationships with supervisor or crew mates
Physical Environment
o Minimise exposure to noise, provide adequate PPE.
o Ensure physically safe working practices
o Quieter space for breaks (away from workstation) and rest hours.
Follow Up
• Arrange check-in meetings
• How have you been?
• How are things now?
• Have you managed to get some support from ….
• Follow up on any reasonable adjustments or other actions taken
If you are concerned about suicide risk

• Act on your concerns or observations
• Manage your thoughts and fears
• Ask gentle introductory questions
• Ask Directly about suicidal thoughts
• Assess the risk
• Make A Safety Plan
• Keep the person safe and access expert help
• Take Care of yourself
Support for Yourself

• Be Aware of your company’s mental health policy
• Document
o the support you are providing
o your reasoning
• Access Support for yourself (emotional and technical)
o Occupational Health/ HSE /HR
o Telemedical Services
o Organisational helplines
o External professional expertise
Supportive Conversation Practice Quick Reference Guide:

What to ask
1. How are you?
 Be relaxed and open and prepared to listen without judgment
 Starting the conversation can be as easy as asking
 Are you ok? How are you?
 Mention specific things that you’ve noticed that has given you pause for concern like “I’ve
noticed that you seem to be a bit more stressed than usual” or “you haven’t quite been
yourself recently and I’m wondering if you are ok?”
 What’s been happening recently?
2. Listen without Judgment
 Don’t try to rush to solutions
 Give space and time to talk
 Listen openly without judging their experience
 Acknowledge that things seem tough for them at the moment
3. Encourage Action
 “How would you like me to support you?”
 “What might help you to manage this situation?”
 Provide information or assistance to access further support or support from others
 Arrange a follow up meeting to check-in and Look at reasonable adjustments to work patterns
or workload if appropriate
 If adjustments will impact on crew mates and cannot be made without others noticing;
discuss what to say to them.
 Make sure all staff feel equally treated
 Be as open and honest with the team as confidentiality allows, to prevent gossip or
resentments arising.
 If you have concerns about risk – keep the person safe until emergency support can be
accessed
4. Arrange follow up meeting(s)
 to check-in to see how things are going
 follow up the impact of any adjustments or actions taken
 agree to keep in touch and be there for them
NB: Make a written record of your meetings and your reasoning for taking or not taking specific actions, as
an aid memoire and for evidence if it was ever needed
Psychological First Aid: Case Scenarios
PRACTICE CASE 1
You are Sagar,

You noticed that Dagat doesn’t seem himself, he normally greets you with a smile and asks after your
family, but he seems unusually quiet. Every so often you notice that he has stopped working a is staring into
space; you’ve asked him if he’s ok but he said “yes, yes, I’m fine” and went back to his work.
You are Dagat, ETO

You were due to be relieved at the last port, but your reliever tested positive for COVID. You are desperate
to go home, you received word a couple of days ago that your mother is extremely sick, she’s in hospital
and may not live long. You are due in port on Monday, and you asked the captain to allow you to sign off,
but he says he needs you until relief can be arranged, but he doesn’t know when that will happen. You can’t
afford to lose your contract with the company, you have the whole family to support and you’re paying for
the hospital bills, so you don’t want to seem unprofessional; but you’re worried sick and finding it hard to
concentrate on your work.
PRACTICE CASE 2
You are Deniz,

Your cabin is next to Marina’s. You heard her sobbing during the night last night and she didn’t come to
breakfast this morning.
You are Marina,

You are a deck cadet; you completed your studies coming top of the class and are now on your second
voyage. You have always wanted to go to sea, but your parents are not so keen on a their daughter being in
a male dominated environment. You want to change the industry from the inside and be the first female
captain in the company. It hasn’t been easy though; people are always making comments. For the most part
you try to ignore it; but last night the Chief invited you to his cabin for a ‘nightcap’ after watch duty; you
didn’t know how to refuse so you agreed; once inside he tried to kiss and touch you; you screamed and
managed to run away but you were up all-night crying, and you don’t know what to do now.
PRACTICE CASE 3
You are Tenger,

You have sailed with Captain Morzu, several times before and always found him professional and easy to
work with. He seemed fine when he signed on a few weeks ago but over the last week or so he’s been
missing meals and shutting himself in his cabin; you’ve noticed you’ve woken him up more than once during
the day, he’s seems distracted and various bits of paperwork just haven’t been done. He scolded the deck
cadet this morning, and you’ve noticed people are starting to keep out of his way. What do you do?
You are Captain Morzu,

You signed on 3 weeks ago; last week your wife called you in a panic; your son had a motorbike accident
and was rushed to hospital. Crew change has been a nightmare recently, it’s been a really busy time on
board with lots of port calls and a huge amount of paperwork, so you don’t want to add to the problem,
and you decided you should keep calm, there’s nothing you can do at home anyway. A few days ago, you
woke up in a cold sweat thinking you may never see your son again, you can’t sleep, you can’t eat, the
paperwork is a disaster and it’s really beginning to show.
Glossary of Terms
Mental Health is a state of well-being in which every individual realises his or her own potential, can cope with
the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his
community. (World Health Organisation definition)
Psychological Wellbeing is a state of emotional wellbeing in which people can function well and live and work
productively, are engaged with the world and the people around them and have a sense of life satisfaction.
Mental Health Problems or Mental Illness is an emotional or psychological problem that interferes with daily
functioning in life, such as in work or education, relationships with others and/or leisure.
Counselling and Psychotherapy are talking therapies that involve a trained therapist listening to you and
helping you find ways to deal with emotional issues or a period of distress. There are many different
approaches to counselling. The titles are not legally protected and therefore, anyone can call themselves a
counsellor or psychotherapist, so in seeking a counsellor always check their registration with the appropriate
professional body. Counsellors are registered with the BABCP (https://www.babcp.com) and Psychotherapists
are registered with the UKCP (https://www.psychotherapy.org.uk).
Clinical Psychologist is a mental health professional who is extensively trained to understand and work with
mental health and the impact of mental health problems on life. The term Clinical Psychologist is a legally
protected title and in order to practice, a Clinical Psychologist must be registered with the HCPC
(https://www.hcpc-uk.org).
Occupational Psychologist: are professionals who are concerned with the performance of people at work and
in training, and with developing an understanding of how organisations function and how individuals and
groups behave at work. Their aim is to increase effectiveness, efficiency and satisfaction at work. Occupational
Psychologists are registered with the HCPC (https://www.hcpc-uk.org).
Psychiatrist: is a medical doctor who has specialist training in the diagnosis and treatment of mental health
problems.
Psychological First Aid: is an evidence informed brief intervention to reduce suffering and connect people to
appropriate support following a crisis or major event. PFA involves humane, supportive and practical help that
can be provided by provided by non-professional people who have received some training.
References
[1] ITF, “Summary Report on Social Isolation Depression and Suicide Workshop,” 2016. [Online]. Available:
https://seafarerstrust.org/wp-content/uploads/2018/07/Seafarers-Social-Isolation-Depression-and-
Suicide-Workshop-Write-Up-August2016.pdf.
[2] H. Sampson and N. Ellis, “Seafarers’ Mental Health and Wellbeing,” IOSH, 2019.
[3] R. Lefkowitz and M. Slade, “Seafarer Mental Health Study,” ITF Seafarers’ Trust, 2019.
ALL RIGHTS RESERVED. Any unauthorised

use or reprint of this material in part or in
full is prohibited without the express
permission of the author. Permission
should be sought through ISWAN.

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Participants Manual

Maritime Mental Health

Senior Officers and Shoreside Staff

45 mins Overview of Types of Mental Health Problems

120 mins Mental Health at Sea

30 mins The Role of Senior Staff in Managing Mental Health

90 mins Psychological First Aid

60 mins Putting Learning into Practice

In the west we tend to understand mental health problems within

• biological factors (like genetics, brain chemistry and

• psychological factors (such as emotions, thoughts and

Hours of Work and Rest

ISWAN’s Good mental health guide Psychological Wellbeing at

Mood & Behaviour Signs

Health Related Signs

Work Related Signs

Many People will say they are

Facilitate access to alternative sources

• Help problem solve to address practical problems where possible

If you are concerned about suicide risk

Support for Yourself

Supportive Conversation Practice Quick Reference Guide:

You are Sagar,

You are Dagat, ETO

You are Deniz,

You are Marina,

You are Tenger,

You are Captain Morzu,

ALL RIGHTS RESERVED. Any unauthorised

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