How loneliness triggers mental disorders in sailors – Prof. Coker

Professor of Psychiatry in the Department of Behavioral Medicine, Faculty of Medicine, Lagos State University, Ikeja, Professor Olurotimi Coker believes that shipowners and regulatory bodies, particularly the Nigerian Administration and Maritime Safety (NIMASA), must be aware of the mental health of seafarers. This aspect of seafarers’ well-being, according to the researcher, has been neglected for too long.
In this exclusive interview, he talks about the need for psychological fitness and mental assessment of seafarers and what shipowners and NIMASA can do to facilitate crew member wellbeing.

How can shipowners provide emotional support to ship crews?

Shipowners can provide emotional support to seafarers by training shipboard health personnel on how to recognize crew members who show symptoms of emotional distress. If medical personnel are not trained to recognize these mental health conditions, they will not know how to deal with and treat them. Indeed, initially, mental health disorders begin to manifest physically with signs and symptoms of malaria, weakness, body aches and fatigue. These are like the first signs of malaria or typhoid fever. So, if the attending medical staff does not know that such a physical illness may underlie certain mental disorders such as anxiety disorders, depression, panic, then there may be a problem.
Also, while researching, I discovered that most ships did not have medical personnel on board. I don’t know how true that is – that a certain ship that usually has more than 30 crew doesn’t have medical personnel. This is something we need to raise awareness about. Even if the crew members are 10 years old and leave for two weeks, there should be medical personnel who must take care of their physical and mental health on board.

Loneliness is associated with being at sea for several months. If not treated early, what can it lead to?

Loneliness is also one of the causes of mental health disorders. During the outbreak of the COVID 19 pandemic which forced many people to stay at home for five to six months, especially the elderly, the incidents and prevalence of mental disorders increased dramatically. People had nowhere to go and listened to negative news about the pandemic. It triggered a lot of anxiety, panic and depression in people. Now let’s make an analogy with someone who is on the boat for four weeks. If this person does not have stable emotional health, social well-being, does not make friends easily on board and is not engaged in creative activities, what will happen to them?
Loneliness can trigger certain mental disorders in seafarers such as anxiety, panic, phobia, depression and those who had physical or mental health issues prior to embarkation may experience a resurgence of these conditions on board. Someone who lacks social well-being, i.e. the ability to initiate and maintain relationships, to make friends easily, would be alone for eight weeks if a sea voyage lasts that long. And that’s why we advocate that they create recreational activities like karaoke; let them learn to sing and dance on board, play table tennis if possible, and indoor games to keep these sailors busy when not on duty.

Recently you said that kissing and hugging a spouse is one of the ways to maintain mental order. How to achieve this given the long stay of sailors at sea?

Well, the idea behind it all is that charity starts at home. Love, unconditional agape love begins at home. If you are at home, get closer to your spouse. Hug her, kiss her, so that when you’re away you still think about that bond of love and hope and yearn to want to come back to that love soon. It is therefore essential that you not only become closer to your spouse, your children, your siblings, your parents, and this is also part of social well-being. Family is the only unit of socialization and if you don’t have love in your family then you are in trouble. Can you imagine someone who leaves for four to six weeks and has an argument with his spouse before leaving the house. He would certainly have some emotional discomfort while he was away and of course such a person would not be eager to return home. Therefore, this does not only apply to seafarers, it also applies to everyone. Whether you are a sailor or not, you need to be very close to your spouse and family members to have adequate emotional well-being.

What about seafarers’ health assessment?

Well, you know if you want to start working anywhere, you will be asked to take a physical exam to check if you are physically fit to work. So for someone to go for a very hectic job for four to six weeks, you have to be physically strong. Now most people do not know that it is not necessary to be strong physically but also mentally and emotionally to withstand the danger they encounter at sea. That is why we propose for physical well-being , mental and emotional seafarers. When they don’t assess them and determine who is mentally fit, they would crumble at sea. and would not participate in all work duties. It is therefore very important that mental health conditions are assessed and assessed before embarking on this long journey.
It is also essential that we assess their mental health upon arrival. It’s like a soldier going to war. Upon their return, they have the briefing called psychological first aid so that when they return to society, they will socially integrate into their families and into society. They wouldn’t have what we call post-traumatic stress disorder. Now, if they were attacked by pirates at sea or if someone died, or if they had turbulent waves, you know that can be very scary; it could affect their family life and productivity when they return, as they may have suffered from post-traumatic stress disorder. Post means weeks, months and years after overwhelming trauma, so they may still be disturbed. And when they are disturbed, unfortunately no one recognizes that their emotional conditions have been affected while they were at sea. That is why sailors must be assessed before and after embarking on a voyage and that is the Nigerian Maritime Administration and Safety Agency (NIMASA) has to do. If NIMASA cannot do it, Mission to Seafarers should do it and other maritime industry NGOs. This is where the media comes in to inform people and educate them about seafarer mental health.

What are the medical measures to be applied to perform therapy at sea?

Medical staff should be trained in how to recognize the signs and symptoms of common mental disorders, including anxiety disorders, panic, phobia, and then depression. Thus, these medical personnel would have been trained or should be trained on how to perform counseling services known as talk therapy on board. And in the milder and moderate stages of mental disorders, you can treat them with talk therapy, which is just counseling. After recognizing the signs and symptoms, you then counsel the person on how to use psychological strategies to overcome the signs of fear of the unknown, increased heart rate, fear of water, etc. Thus, the individual recognizes the manifestation of the state of mental health. and tips for overcoming them. In severe cases, the staff then prescribes medication to help them overcome these manifestations.

A person is advised to rest for at least eight hours. How can this be achieved in a bustling megacity like Lagos?
This should also apply to those who do not live in Lagos. However, in Lagos, this does not even apply to everyone except those who work in Ikorodu and CMS who have to travel two or three hours to get to their place of work. So if you don’t get your eight hours of sleep and don’t get the brain and all the other organs of the body to rest and recuperate, it leaves you vulnerable to physical and mental health disorders. This is why sleep is very important for human beings and eight hours has been said to be the best. However, in situations where you can’t get your eight hours, try to get at least six. One should try to get a minimum of six hours and if six hours is not possible, get five hours.

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