Carlo Zuncheddu
Following the continuous and dramatic global crisis in the maritime world resulting from the devastating Covid-19, it is urgent to continue to keep active attention on the mental health of seafarers.
The problem is above all for those who are still on board ships at anchor or moored and blocked in ports, the impossibility of flights for repatriation and the extension of contracts. Furthermore, when sad news such as the loss of a family member is received, the seafarer’s mental balance is unsettled without a shadow of a doubt.
The mandatory 14-day quarantine, according to the current procedures of the Companies, for those positive to Covid-19 but asymptomatic involves the mandatory isolation in the cabins with balconies.
The effects are manifested as sleep reduction, a continuous rumination on the family, a slight drop in mood and anxious state.
For this reason, the recent episodes of suicides and the episodes of psychopathological decompensation of seafarers on board of cruise ships should not be underestimated.
For years the document “The Seafarers’ Health Program” has existed, which contains useful information for seafarers to better enjoy their life onboard ships. The document is provided and freely downloadable by ISWAN.

The topics covered are the following: Good mental health, dental, fitness to work, food safety, healthy food, hydration, malaria and safe travel, overweight, skincare, sexually transmitted diseases.

The shipping companies, in collaboration with teams of psychologists and psychiatrists, are demonstrating a remarkable availability, sensitivity and commitment by organizing important webinars that can be attended by registering online.
One of the many projects of valid help for seafarers is organized by Costa Cruises.
In case of need, the on-board doctor contacts the HR department that activates the service for the management of the mental emergency and the PTDS (post-trauma stress disorder), making use of the important collaboration of a team of psychologists experts in EMDR (Eye Movement Desensitization and Reprocessing), including the presence of Dr Anna Barecka-Bocchiola.
Once the service is activated, following the privacy procedures, the crew is contacted and sessions are scheduled with the help of WhatsApp or other social applications.
Support makes use of EMDR, a structured psychotherapy method that facilitates the treatment of problems related to stress and traumatic events, such as suicide, depression, anxiety, phobias, acute mourning, somatic symptoms and addictions.
More information can be found on the website of Dr Anna Barecka-Bocchiola and of the Association for EMDR in Italy.
PTDS is a disorder characterized by the inability to overcome a terrifying event that has been experienced or witnessed. The disease can last for months or years, triggered by factors that can bring to mind the memory of trauma accompanied by intense physical and emotional reactions.
Symptoms may include nightmares, flashbacks, attempts to avoid situations that could evoke trauma, amplified reactivity to stimuli, anxiety or depression.
The Mental Health Gap Action Program (mhGAP) of the WHO considers both EMDR and CBT ‐ T (cognitive behavioural therapy focused on trauma) to be valid advanced psychosocial interventions for specific stress-related disorders (STR) and includes both in Guidelines for the management of conditions specifically related to stress.