Effects of the COVID-19 pandemic on the mental health of seafarers: A comparison using matched samples

Factors affecting mental health of seafarers on board merchant ships: a systematic review

OBJECTIVES

Merchant ships represent a peculiar working environment with several challenges and risks. The specific situation on board of ships may affect the mental health of seafarers more remarkably than ashore workers.

CONTENT

A systematic review of the literature has been carried out to identify the main causes of mood disorders among seafarers and the impact that these disorders have on their health. This review has analyzed the scientific literature published between January 2006 and December 2021 using the search engines PubMed, Web of Science (WoS) and Cumulative Index to Nursing and Allied Health Literature (CINAHL).

SUMMARY

Social isolation, distance from families, fatigue, stress and long work shifts represent the main causes of mood disorders among seafarers.

OUTLOOK

Strategies aimed at improving conditions of cohabitation on board, and a greater consideration of these problems are key for improving the mental health of workers at sea.

Vaccinating international seafarers during the COVID-19 pandemic

Despite their key role in the distribution of essential goods, seafarers were often overlooked in international COVID-19 responses. Border closures isolated them at sea, often for months beyond contract. Distributing vaccines to seafarers was inconsistent and often depended on the creativity of charities and industry and labour stakeholders. Even seafarers who received vaccinations often had them unrecognised in the ports they visited. These oversights should not be repeated in preparation for future pandemics. As a vulnerable population and as key international workers, seafarers' health should be prioritised by national and international health policy.

Factors Impacting Seafarers' Mental Health and Career Intentions

The main objective of the present study was to investigate factors related to seafarers' mental health. A sample of seafarers from 12 countries participated in the study. A list of stressors was used to assess both perception of exposure to these stressors and their subjective significance. The Symptom Checklist (SCL-90) was used to assess seafarers' mental health on 5 of 9 subscales: Depression, Anxiety, Hostility, Interpersonal Sensitivity, and Somatisation. Three significant findings emerged from the analyses. The first was that 3 types of stressors contribute significantly to mental health problems: (1) environmental factors (eg, vibration), (2) social problems (eg, bullying, homesickness, working alone), and (3) health problems (eg, physical injuries, viruses, and the illnesses). The second finding was that both stress and mental health issues determine seafarers' motivation for their work and their consideration regarding leaving the maritime industry. The third finding was that factors contributing to seafarers' consideration of leaving the industry were mainly related to social stressors such as isolation from family and friends, cultural differences at work, demands from supervisors, and bullying. Factors such as bad weather, working shifts, length of employment contract or a ban on disembarkment in ports were found to be relatively less important for seafarers as factors toward considering leaving the industry. The implications of these findings are discussed.

Psychosocial work environment and mental health among the global workforce of seafarers in the wake of the COVID-19 pandemic

BACKGROUND

The aim of this study was to investigate the impact of the COVID-19 pandemic on the mental health outcomes of international seafarers, who played a crucial role in maintaining global trade during the pandemic. The study examined how changes in psychosocial work environment and policies affected mental health outcomes among seafarers.

METHODS

We analyzed a survey including answers from 17,861 seafarers, serving on 44 different international commercial vessels with 154 different nationalities. Stress, anxiety, and depression were applied as outcome measures in this study. Three sets of independent variables were included; work-related consequences of the COVID-19 pandemic, general psychosocial work environment onboard, and socioeconomic variables. First, we applied binary linear regression, followed by a multivariate linear regression analysis.

RESULTS

The study found that changes in safety consciousness and clear communication from employers were associated with better mental health outcomes among seafarers. Eroded policies related to crew changes had a significant negative effect on mental wellbeing due to delays caused by national quarantine guidelines and travel restrictions. The results also showed a discrepancy in mental health outcomes between those onboard and those onshore, with stress being present in both groups.

CONCLUSIONS

The findings suggest that crisis management within shipping companies played an important role in mitigating adverse mental health outcomes during the pandemic. Clear communication from employers and emphasizing safety issues onboard were effective strategies for promoting better mental wellbeing among seafarers. However, delays in crew changes had a significant negative impact on mental health outcomes, highlighting the need for global cooperation and overarching agreements to protect international seafarers during times of crises.

The impact of COVID-19 on maritime pilots: Evidence and lessons

The COVID-19 pandemic led to port congestion and disruption to global logistics and supply chains. While previous research has examined the impact on port performance and economics, social issues, such as the impact on port personnel (including pilots), have been overlooked. In this context, this paper examines the challenges experienced by Chinese pilots during the pandemic through in-depth interviews with 28 pilots. It shows that the draconian pandemic control measures adopted in China, rather than the pandemic itself, impaired pilots' physical and mental health, reduced their availability, and introduced new safety hazards, which curtailed both the port's capacity and ability to provide efficient and safe pilotage and resulted in sub-standard services. The findings suggest that there is a serious issue regarding the absence of effective mechanisms for pilots to raise their health and safety concerns and how these might be addressed by port administrators and/or local authorities. Worker participation and involvement in occupational health and safety management was problematic. These findings have implications for pilot station management at both company and government administrative and legislative levels.

Fatigue during the COVID-19 pandemic: The experiences of Chinese seafarers

Though the COVID-19 pandemic is drawing to a close, very little is known about the impact of China's zero-COVID policy on Chinese seafarers. This paper examines Chinese seafarers' experiences of fatigue during the pandemic. It adopted a mix-method research design involving two quantitative surveys conducted with seafarers before and during the pandemic and 35 in-depth interviews with both seafarers and managers. All the participants were from two Chinese shipping companies. The comparisons between the two surveys show that Chinese seafarers experienced significantly higher levels of fatigue during the pandemic. The interview data suggest a range of factors underpinning the higher levels of fatigue including fear of being infected, increased workload, wearing of four-piece personal protection equipment (PPE), the deprivation of shore leaves, and the prolonged service time. More importantly, the data indicate that the draconian zero-COVID policy in China and the related policy guidelines for Chinese shipping companies and seafarers reinforce these factors. This research extends previous research by providing an exclusive and comprehensive examination of seafarer fatigue during the pandemic and revealing that the policies adopted by seafarers' home countries can have profound implications for seafarers' experiences of fatigue. Suggestions are provided at the end of the paper.

Fatigue at sea during and after the COVID-19 pandemic: A comparative study of two matched samples of seafarers

This paper examines seafarers' experience of fatigue during and after the pandemic. A multi-phase mixed methods research design was used, including two quantitative surveys (N_{during-pandemic=501} and N_{after-pandemic=412}) and 36 in-depth interviews. Applying propensity score matching the two samples to approximate the conditions of a randomized controlled experiment, the study shows that surprisingly seafarers reported higher levels of fatigue after the pandemic. Qualitative interviews with seafarers and ship managers reveal the underlying reason - the intensified ship inspection regime together with policy and regulatory updates/revisions in the immediate aftermath of the pandemic increased seafarers' workload and made seafarers more fatigued. The results of the two surveys also show that while fatigue risk factors differed between the two periods, fatigue risk can be managed and mitigated in both periods by implementing fatigue risk management policies and practices. Policy and management implications for improving seafarers' occupational health and safety are discussed at the end of the paper.

The Relationship Between Work-Induced Sexual Abstinence and Psychological Health of Chinese Male Seafarers: The Positive Influence of Job Satisfaction

The specific nature of the seafaring occupation keeps seafarers away from partners and shore life for long periods at sea. Therefore, seafarers suffer many challenges in the workplace including frustration of their sexual needs. This study aimed to investigate the relationship between work-induced sexual abstinence, psychological health and job satisfaction among seafarers. A mixed-method approach focusing on cross-sectional survey-based quantitative research was used. The sample included 617 Chinese active seafarers who experienced sexual abstinence on board. Hierarchical cluster analysis was conducted to divide the respondents into different groups corresponding to 14 psychological problems induced by sexual abstinence and experienced in the workplace. Multiple linear regression analysis was applied to identify the relationship between tolerance level of seafarers to sexual abstinence and their job satisfaction. Four distinct groups of seafarers, influenced differently by sexual abstinence, were identified, namely "Saint," "Adapter," "Average people," and "Sufferer" clusters. Multiple linear regression analysis indicated that tolerance level of seafarers to sexual abstinence was positively influenced by overall job satisfaction, perceived working environment, ability utilization for other jobs, own choice for working as a seafarer and perceived friendliness of co-workers, while it was negatively influenced by perceived job responsibility. The study innovates by examining the relationship between sexual abstinence and the psychological health of seafarers. It also extends the function of job satisfaction, which can contribute positively to the tolerance level to sexual abstinence. Management recommendations to address sexual abstinence issues are proposed to better protect the health and psychological well-being of seafarers and enhance operational safety on board.

A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic

Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.

Workplace Determinants of Depression, Anxiety, and Stress in U.S. Mariners during the COVID-19 Pandemic

United States (U.S.) mariners continued sailing throughout COVID-19. Many aspects of their work could make them prone to adverse mental health outcomes but research on workplace determinants of their mental health during COVID-19 is limited. Between January and July 2021 an online survey assessed the outcomes of increased depressive symptoms, increased anxiety symptoms, and increased perceived stress in addition to concerns, worries, and experiences when sailing during COVID-19, job satisfaction, and safety climate in n = 1384 U.S. mariners. Demographic measures were also collected. Logistic regression models (for depression and anxiety) and a linear regression model (for stress) were developed. We found that increased COVID-19 concerns and poor self-reported mental health were related to increased odds of likely depression and anxiety and higher stress. Mariners who experienced more adverse experiences aboard a vessel had increased stress and increased odds of depression. Poor sleep quality was also related to increased odds of depression, and poor vessel support/safety culture was related to higher stress. Differences in outcomes were seen by vessel type, age, and credential in regression analyses. Results from this study will help to prioritize interventions to minimize the mental health impacts of COVID-19, and influence evidence-based recommendations to improve the mental health of mariners going forward.

Seafarers' mental health during the COVID-19 pandemic: An examination of current supportive measures and their perceived effectiveness

As the current COVID-19 pandemic and the resulting crew change crisis exacerbates the mental health problem faced by seafarers, various maritime stakeholders have mobilised their resources and strengths to provide a variety of supportive measures to address the issue. This paper aims to find out what measures have been adopted in the industry and how widely they have been experienced/received by seafarers and evaluate their effectiveness. To achieve this aim, this research employed a mixed methods design involving qualitative interviews with 26 stakeholders and a quantitative questionnaire survey of 817 seafarers. The research identified a total number of 22 mental health support measures, all of which were perceived to have contributed positively to seafarers' mental health. However, not all of them were widely available to or utilised by seafarers. The findings also highlighted the importance of family, colleagues, shipping companies, and government agencies, as they are associated with the most effective support measures, namely communication with family, timely crew changes, being prioritised for vaccination, being vaccinated, and a positive and collegial atmosphere on-board. Based on the findings, recommendations are provided.

Building social support: The impact of workgroup characteristics, the COVID-19 pandemic and informal interactions

BACKGROUND:

Social support from colleagues is a key resource for employees and organizations, with beneficial effects on performance, employee well-being and resilience. Although the importance of social support is well-known, the factors that help to build and maintain social support are not equally well understood.

OBJECTIVE:

This study analyzes the impact of workgroup characteristics (i.e., workgroup composition regarding national diversity and tenure; workload) and the COVID-19 pandemic on employees’ perceptions of instrumental and emotional support, and examines the mediating role of informal interactions.

METHODS:

The study is based on responses from 382 seafarers to a cross-sectional online survey. Hypotheses were tested using OLS regression and mediation analysis using PROCESS.

RESULTS:

Workgroup composition regarding national diversity had indirect effects on social support through informal interactions around social foci (here: joint leisure activities). High workload and pressure from the COVID-19 pandemic reduced interactions around social foci, thus contributing to the erosion of perceived social support.

CONCLUSION:

The findings provide insights on the development of social support, suggesting that informal interactions provide an important mechanism for the development of social support at work. From a theoretical perspective, this highlights the value of a relational perspective on the development of social support, a perspective that is based on the insight that social support is embedded in social relationships. From a practical point of view, this indicates that organizations can proactively foster the development of social support through practices that shape workgroup characteristics and social foci.

Mental health and wellbeing of seafaring personnel during COVID-19: Scoping review

OBJECTIVES

We aimed to synthesize published literature on seafarers' mental health and wellbeing during the COVID-19 pandemic.

METHODS

This scoping review searched four electronic databases for literature on the mental health and wellbeing of seafarers during the COVID-19 pandemic.

RESULTS

Fourteen studies were included in the review. Few reported on the prevalence of mental health conditions. Only one compared mental health data gathered during the pandemic to pre-pandemic matched samples, suggesting symptoms of depression and anxiety were greater during the pandemic. There was some evidence that mental health worsened with longer stays on board during the pandemic and being on board longer than expected. Crew exchange difficulties forced many participants to extend their contracts or delay repatriation, often with little information as to when they might get to go home, leading them to feel they had no control over their lives and causing concern about fatigue and the potential for accidents and injuries. Participants described other challenges such as denial of shore leave; concerns about finances and future employment; loneliness and isolation; fears of COVID-19 infection; limited access to essential supplies; and feeling unsupported by management.

CONCLUSIONS

Maritime organizations must understand how best to support their staff in the aftermath of the COVID-19 pandemic and in any other prolonged crises that may arise in the future. Recommendations include ensuring that staff feel valued by their organization; enhancing work-related autonomy; ensuring that communication is accurate, consistent, and timely; and using lessons learned from the COVID-19 pandemic to inform emergency preparedness policies.