by Douglas B. Stevenson, Esq.
Director, Center for Seafarers' Rights
The Seamen's Church Institute
Mental health care has become very effective in treating a wide range of psychological or emotional issues. Mental health is as much a medical care issue as any other illness or injury, and it is not a function of any moral flaw or weakness. Despite the effectiveness of mental health services, many people do not take advantage of them.
To illustrate, the traumatic effects of a pirate attack on a merchant vessel can produce both physical and mental injuries. Imagine two seafarers injured during a pirate attack on their ship. One seafarer suffers a broken arm after being struck by a pirate. The other seafarer suffers an emotional injury: experiencing frequent and disturbing memories of the attack, trouble sleeping, irritability, outbursts of anger, and difficulty concentrating. Both seafarers were injured in the pirate attack. The seafarer with the broken arm will certainly seek and receive medical care. The other seafarer will likely remain untreated.
There should be no financial obstacle to the seafarer getting mental health care. One of a seafarer’s most treasured and enduring rights is the right to free medical care for any injury or illness incurred while employed on a ship. The illness or injury does not even have to be caused by the employment. As long as the illness or injury occurs during the term of employment, the shipowner must provide free medical care to the seafarer up to the point of maximum cure. After the point of maximum cure is reached, the shipowner must continue to provide medical care if employment on the ship caused the condition. Similarly, the shipowner must also provide medical care to a seafarer for an injury or illnesses caused by the employment that does not emerge until after the seafarer has signed off.
These traditional seafarers’ rights to medical care are enshrined in Regulation 4.2 of the ILO Maritime Labour Convention, 2006. The MLC, 2006 is expected to come into force in 2012. Neither traditional maritime law nor the MLC, 2006 specifically addresses mental health care, but court decisions over the past fifty years make it very clear that a seafarer’s right to free medical care includes a right to free mental health care.
A greater obstacle to seafarers seeking mental health care is the stigma of receiving the care. Seafarers may fear being labeled as a person with a mental illness and all of its associated stereotypes. They worry that they might lose their job because employers might not understand the injury or its treatment success. Likewise, flag authorities might make uninformed decisions on a seafarer’s medical fitness to work on a ship. Seeking mental health care can also have consequences for a seafarer’s social acceptance and self-esteem.
Some psychological conditions, as with physical injuries, can render a seafarer unfit for shipboard employment. But seafarers with some psychiatric illness, like those with some physical illness or injury, can be restored to full fit-for-duty status through appropriate treatment.
Much more work is required to address the stigmas associated with mental health care. Conditions such as Leprosy, tuberculosis, cancer and AIDS used to carry much greater stigmas than they do now. Where there is better understanding and improved treatments of diseases, social stigmas have diminished. Mental health care can restore people affected by emotional problems to rich and productive lives. Shipowners, as well as flag authorities, must become more familiar with mental health conditions and treatment to provide seafarers with appropriate care and restore them to productive lives and employment. The stigmas that keep psychologically injured seafarers from effective care must be fought so that they can benefit from available mental health care.