Not all wounds are physical: Psychological first aid for seafarers in conflict zones

The IMEQ ASSESSMENT CENTER has introduced a Psychological First Aid (PFA) guidance manual aimed at supporting Masters and officers managing crew wellbeing during stressful or critical onboard incidents, particularly in high-risk transit areas such as the Strait of Hormuz.

The guidance provides a clear, operational framework for delivering short, structured interventions onboard. It focuses on stabilizing crew after distressing events, maintaining calm and effective leadership communication, ensuring the distribution of verified information to reduce uncertainty, supporting crew cohesion and operational safety, and identifying early signs of psychological distress among seafarers.

The organization emphasized that the manual is not a clinical tool, but rather a practical leadership resource designed specifically for maritime operations. It is intended to help Masters and officers respond effectively to human factors challenges while maintaining safety, control, and continuity of vessel operations.

The development of the guidance included contributions from several industry and medical stakeholders. IMEQ ASSESSMENT CENTER acknowledged Health4Crew, with special recognition to Laura Benzonana, Health4Crew CEO, for the medical input. Additional thanks were given to the UK P&I Club, with appreciation extended to Sophia G., Crew Health Programme Director, and Captain Konstantinos Karavasilis, Regional Director-Loss Prevention, whose review and professional feedback helped strengthen the final publication.

This initiative reflects a shared industry commitment to integrating mental health into safety and operational performance 

… said the Center in a LinkedIn post.  

Likely psychological effects onboard

In a recent article, marine psychologist and IMEQ’s Managing Director, Alexandra S. Kaloulis, made clear that in maritime settings, geopolitical stress often appears gradually rather than dramatically. Common reactions among seafarers in such environments may include:

• sleep disturbance, especially before high-risk transits
• heightened anxiety during watchkeeping
• irritability or emotional withdrawal
• hypervigilance after alerts or security advisories
• increased interpersonal tension within the crew
• mental fatigue in addition to physical tiredness
• guilt associated with family worry at home

Preparing for PFA 

According to the guide, a PFA session aims to:

• communicate verified information to the crew
• maintain a calm and structured leadership presence
• ensure distressed crew members are monitored and supported
• activate company support resources when necessary
• coordinate follow-up actions with senior officers and shore management

Preparing for a PFA session involves several key actions. Confirm verified information about the incident before briefing officers. This ensures that all communications are accurate, allowing officers to provide the right support and guidance to the crew during this critical time.

Briefing the officers is essential for effective communication with the crew. Gather the crew, only when it’s safe and practical without causing panic, ensuring essential operations are maintained. This structured approach lays the groundwork for a successful PFA session, creating an environment of safety and support for everyone involved.

Practical actions masters can take onboard

According to IMEC, for a master onboard, Psychological First Aid means four things: stay prepared, notice changes early, speak calmly, and know when to escalate.

1. Stay calm and be seen

Crew members often take emotional cues from the master. If the master appears steady, clear, and present, anxiety onboard is less likely to spread.

• Keep your tone calm and controlled.
• Be visible in key areas of the vessel.
• Do not disappear into silence unless absolutely necessary.
• During tense periods, regular presence matters.

Calm leadership does not remove danger, but it helps prevent panic.

2. Give clear, honest updates

In high-risk situations, uncertainty can create more distress than facts.

• Tell the crew what is known.
• Explain what is being done.
• State clearly what the crew should do next.
• Do not give false reassurance.
• Do not repeat rumors.
• If something is unknown, say so directly.

Clear communication reduces speculation and helps people feel the situation is being managed.

3. Watch for early signs of distress

Do not wait for a breakdown before acting.

Look for:

• unusual silence
• irritability or anger
• crying
• shaking
• poor concentration
• repeated mistakes
• sleep problems
• withdrawal from others
• conflict between crew
• difficulty performing normal duties safely

Early intervention is always easier than trying to manage a crisis later.

4. Speak to affected crew privately

If someone appears distressed, approach them respectfully and away from others when possible.

Use simple questions such as:

• “Are you alright?”
• “What feels hardest right now?”
• “Do you need a short break?”
• “Is there something you need immediately?”

Do not challenge, shame, or expose them in front of the team.

5. Listen without pressing for details

A distressed crew member does not always need to explain everything. They may only need a calm, respectful moment and practical support.

• Let them speak if they want to.
• Do not force them to describe frightening events.
• Do not interrupt too quickly.
• Focus on what they need now.

Psychological First Aid is about stabilizing the present moment, not investigating the full emotional story.

6. Check basic needs first

A tired, dehydrated, hungry, or overloaded crew member will usually cope worse.

Check whether the person has:

• had water
• eaten
• slept
• taken any necessary medication
• had a short pause from pressure
• spoken to someone they trust

Sometimes the first useful intervention is rest, hydration, quiet, and basic human support.

7. Reduce overload

When someone is overwhelmed, too much noise, too many questions, or too much operational pressure can make things worse.

• Move them away from crowds or chaos if possible.
• Limit the number of people speaking to them.
• Give one instruction at a time.
• Avoid creating a scene around them.

The goal is to reduce stimulation and help the person regain control.

8. Use short grounding techniques

If a crew member is panicking, frozen, or mentally overwhelmed, help them return to the present moment.

Say:

• “You are safe right now.”
• “Sit down.”
• “Take one breath at a time.”
• “Focus only on the next ten minutes.”

Simple grounding can reduce panic and help the person function again.

9. Keep routine as stable as possible

Routine creates psychological stability.

Where operationally possible:

• keep mealtimes regular
• maintain watches as predictably as possible
• give updates at consistent times
• protect rest periods
• avoid unnecessary disruption

Predictability helps reduce fear and gives the crew a sense that the vessel remains under control.

10. Use a buddy system

Do not leave a distressed crew member isolated.

• Pair them with a trusted colleague.
• Ask the colleague to stay observant.
• Encourage quiet company rather than constant questioning.
• Make sure concerns are reported early.

This is especially useful during long passages when distress may build gradually.

11. Encourage short contact with home where possible

For many seafarers, fear for family can be as stressful as fear for themselves.

If communication channels allow:

• help crew send a short message home
• allow brief reassurance contact where feasible
• understand that even a small update can reduce anxiety significantly

This can make a major difference to emotional stability.

12. Respond professionally to stress behaviour

A frightened or exhausted seafarer may become irritable, distracted, emotional, or withdrawn.

• Correct unsafe behaviour firmly
• avoid insults or humiliation
• do not treat stress reactions as weakness
• maintain discipline, but keep it measured

Professional correction preserves authority better than aggression.

13. Know when onboard support is not enough

Some situations require immediate medical or specialist attention.

Escalate urgently if someone shows:

• suicidal thinking
• severe panic that does not settle
• confusion or disorientation
• violent behaviour
• inability to perform essential duties
• signs of emotional collapse
• complete withdrawal from functioning

Good leadership includes recognizing when the situation is beyond what can be managed onboard.

source : safety4sea