Why mental health matters: highlighting the issue of wellness at sea on the International Day of the Seafarer

To coincide with the event, Sophia Bullard, crew health programme director with the UK P&I Club, interviews Jason Tulipan, an experienced Australian mariner who has shared the story of how his mental illness caused him to lose everything and reach rock bottom, and how he has fought back.

Mental health affects crew of all ages, nationalities and ranks. A recent analysis of crew mental health revealed anxiety, social isolation, pressure of work and disturbed sleep can affect crew - all of which can negatively influence their mental health. A supportive and organised environment with open dialogue, respect and recognition for all ranks is essential when at sea.

The UK P&I Club was one of the first to implement standard medical forms and guidelines as part of its Crew Health Programme. Mental health is a core area of focus, with the Club producing regular bulletins, educational videos and joint-industry initiatives advising crew on the importance of mental wellbeing at sea.

Every ship should have someone onboard who is trained in mental health awareness just like first aid so they know what to look for, how to respond and where to access information for appropriate treatment options. Australian mariner Jason Tulipan

Interview

Sophia Bullard (SB): What attracted you to a career at sea?

Jason Tulipan (JT): As a boy I went out on harbour tugs and while watching the crews I knew then I wanted to be a mariner. It was like another world and the people I met were full of life, and so different. I started on small tugs on the NW shelf of Australia and by the time I was 19, I was master of small anchor-handling tugs.

Over the next 30 years, I was a master and chief officer on all types of vessels and worked in various maritime roles, from being a master of supply vessels to a marine consultant.

SB: How and when did you first recognise you had concerns with your own mental health? And what steps did you initially take to deal with it?

JT: When I was 17, I had a car accident that resulted in the death of my best friend. I didn’t deal with the trauma of that incident at the time and over the years, I had increasing anxiety episodes before being diagnosed with PTSD (post-traumatic stress syndrome) and depression. I was prescribed medication and went back to sea. Like many men, I dealt with my mental issues by working and playing hard.

During this period, I was prescribed strong addictive sedatives and I used them to self- medicate and mask the pain I was feeling inside. This would later develop into an addiction to alcohol and codeine. I managed this pretty well internally for many years and was considered a high achieving mariner with all the traits of a seafarer, full of energy and the life of the party.
When I moved into challenging marine management roles, I started using more and more codeine as well as alcohol to deal with all the stress. I had started to become unwell. I had low levels of internal resilience and each day became a never-ending process of taking something to deal with the high level of occupational stress and internal disquiet. I was on a treadmill of medicating myself to cope.

Everything came to a head when I was a project manager in Lumut, Malaysia. A platform sub-structure on a barge was ready to be towed to Australia when the barge tow bridle got fouled into the tow vessel’s propeller. The combination of dealing with the politics of the local businessmen, crew, client, an alcoholic master and my own issues, I became so unwell that I can’t really remember getting on a plane back to Australia until I woke up in hospital.

While in hospital, I knew it was serious as I had no real will to live or any idea of how to move forward. Typically, I was also struggling with family issues. To make matters worse, I was given sessions of electric shock therapy that negatively impacted my memory; thus, that period is very vague. The loss of self-respect and respect of colleagues was also hard to deal with. I was prescribed dexamphetamine and tranquilisers to switch myself on and off during the day and back in the office on light duties. The medication impaired my capability at work and I was now suffering severely from a poly-substance abuse situation.

My fall from being a very competent mariner and individual continued when I resigned from my job and lost everything and lived in my car until it was repossessed. Then, I met my wife and started a difficult but resolute journey of recovery.

SB: Do you think being at sea contributed to your mental health?

JT: I think being at sea contributed to my mental health, but wasn’t the most significant factor. I think that the unresolved issues with the car accident were more significant. It was compounded by not addressing it. But being at sea was also very positive; there was no alcohol or ability to mask issues with substances; I was eating healthily and maintaining good fitness; in some respects, returning to land was probably more challenging for me.

SB: Were you able to open up to friends, family or colleagues about your mental health?

JT: Unfortunately, at that time mental health issues were not spoken about. If you were unstable and unwell, it was best you kept it to yourself and not disclose to anyone you were taking medication to deal with it. I first started to talk to my mother and a close friend. It was not until many years later that I understood that I had a mental health issue.

Even when I was in hospital, it was difficult to discuss workplace stress and resiliency and mental health issues. Six months prior to the Malaysian incident, I did try and talk to a very senior manager about my issues with self-medicating with codeine, but there was no organisational protocol or awareness of mental health issues.

SB: What was the turning point for you?

JT: When your life is going well, it’s easy. But when life throws a series of curve balls, your resilience is sorely tested. And if you fail to respond proactively you can feel like you’re in the boxing ring with your life and you keep getting hammered.

In studies on resilience, it seems the shift only comes when we start to look deep within and start to respond, not react. That means adopting proactive strategies and not distracting or medicating. The epiphany for me was reading a self-help book on mindfulness that very clearly profiled the concept that it’s not what life throws at you that is important, but rather how strategically you respond. It also articulated very clearly that life is a perceptual game. That’s not to say that it’s easy to recover your mastery in life. It’s not. It was a hard road back. But I felt for the first time in years that I was back in control of my life. That was the beginning of a journey that enabled me to strip away the layers of depression, addiction and medication.

SB: When first experiencing mental health issues at sea, were you aware of any charity organisations or helplines that offered support?

JT: When first experiencing mental health issues at sea, there wasn’t a widespread acceptance of the public health and mental health issues. Today there are Employee Assistance Programme (EAP) providers, however my experience is that not many crew use this service for mental health issues because they are fearful around disclosure issues.

The main misconception about mental health is that people who suffer from a mental illness are weak people. This is complicated by another recent misconception that ‘they are playing the mental illness card’. This is now adding to the problem we have with supporting people to deal with and talk substantively on mental health issues.

SB: Do you think the stigma surrounding mental health has improved over the last five years?

JT: Yes, it is more out in the open and up for discussion. More could be done by a greater commitment to mental health education within the workplace and there is the need for some type of training and promotion on what is optimum mental health looks like – we need to have a process that allows our new workforce to be better educated in prevention, early warning signs, rather than catching it when it’s already started.

SB: What is preventing seafarers from seeking help?

JT: The reasons preventing seafarers from seeking help are really company, ship and crew specific. Any cohort of crew members needs to look at what the culture onboard is like in regards to mental health and is there is room for and compassion for the conversation to be raised onboard . It might also depend on what the seafarer is dealing with. If it is substance abuse, in most cases they may not wish to open up about anything to do with addiction as this opens up several considerations, like drug testing that they may have had to cheat or manage by ‘cold turkey’ strategies leading up to testing day. The worst-case scenario is the mariner still feeds the addiction while at sea, and has more the reason to hide it - a vicious cycle of dysfunctionality.

SB: Do you think there should be more awareness training of mental health issues onboard?

JT: After getting back on my feet, I did a Mental Health First Aid Course (MHFA). Later in my role as a marine superintendent for 300 mariners, working on a large offshore project, I had an opportunity to utilise some of the skills in this course to help with mental health issues people were dealing with. I received such positive feedback from my management on how training in mental health helped the project as a whole. That resulted in management seeing the value and being willing to discuss the real mental health issues people were facing in our industry.

I subsequently studied basic counselling and was the first - and still the only seafarer - to become an accredited instructor of MHFA. I realised this course required changing to suit our industry and put a marine context into the course in works with seaman. It was obvious that a crew member, trained in MHFA onboard any ship, could champion proactive mental health awareness onboard. The dividend to both social and financial capital was not lost on management.

Over the last four years, I have developed MHFA courses and gained great feedback from all sides of the industry on what works on what does not work in training for mariners. I have also seen the benefits onboard vessels just by being open to discuss mental health issues.

SB: Do you think mental health cases are increasing, or are we just more aware of them?

JT: I think we are becoming more aware of mental health issues, but there is no doubt the stress in peoples’ lives is definitely increasing. Suicide rates spiralling globally reflect that. If we don’t do some type of wellness or stress resilience awareness raising, more of us are sure to suffer the debilitating impact of mental health issues. I think effective training options are indispensable in both raising awareness and addressing this problem.

SB: How do you create an open culture onboard vessels, so that mental health problems are not hidden away?

JT: Firstly, the whole company needs to have commitment towards a positive MH culture and this needs to come from the CEO or similar down, and that is reflected in company policy that they promote good mental health. Personally, I believe that every ship should have someone onboard who is trained in mental health awareness just like first aid so they know what to look for, how to respond and where to access information for appropriate treatment options.

There should also be some proactive activities onboard to promote exercise, eating healthy and some type of mental wellness like mindfulness and access to those types of websites and books. There is no doubt mental health issues in the workplace are psychosocial hazards that need to be treated just as any other hazard we manage in the workplace.