In the past several years, there has been a marked rise in seafarers failing out of pre-employment medical examinations (PEMEs) for reasons related to mental health. In this article, we’re going to examine this increase in more detail, including the kinds of conditions that preclude candidates from maritime work, and make a case for adjusting our exclusion criteria in the face of a worldwide crewing crisis.

Losing Seafarers from the Workforce

In 2020, Nautilus International released an article examining this phenomenon among UK crew members. It found many seafarers excluded from maritime work for a wide range of mental health conditions, from minor to chronic.

From 2014 to 2020, the number of seafarers with failed, temporarily unfit or restricted certificates on the grounds of mental disorders nearly tripled, while the number with severe anxiety, depression or other mental illness deemed likely to impair performance jumped more than twofold.

In the past several years – and especially so since the COVID-19 pandemic – maritime operators are more aware than ever of mental health issues and their impact on crew members. However, more candidates now find themselves filtered out of the workforce as employers err on the side of caution, further exacerbating the crewing crisis.

At VIKAND, we are challenging the maritime industry to look deeper into what types of mental health issues lead to PEME failure, and to distinguish between manageable mental health “states” and unmanageable mental health “traits.”

State vs. Trait in Mental Health

Martin Hedman, VIKAND’s Director of Mental Wellness Practices, believes it is critical to distinguish between “state” and “trait” when it comes to mental health. A state is a temporary condition, while a trait is rooted in personality. The reason for this distinction is that people often fail to grasp the individual nature of mental health issues.

Take, for example, a seafarer who fails the PEME due to ongoing anxiety attacks and depressive thoughts related to the breakup of a relationship. On one hand, these symptoms could well be situational and temporary – a state – meaning he could safely resume work after proper support and counselling. On the other hand, these symptoms could be indicative of unstable personality traits. He may be emotionally unstable, undiplomatic or overly sensitive, and the breakup event simply revealed underlying issues that could lead to serious problems in the workplace.

When evaluators are distinguishing between state and trait issues, it’s critical to examine categorical explanations, such as:

• Stress reactions: These include acute stress reactions, chronic stress disorders, post-traumatic stress disorders, grief or adjustment disorders etc.
• Depression: Stuck in negative thought patterns that envelope an individual's perception and functionality.
• Substance abuse: Borders to a medical condition rather than psychological.
• Personality disorders, psychosis, neurodivergence or other trait-based causes

Level of Functioning Matters

On a certain level, seafarers dealing with stress, depressive thoughts, low energy or other issues can still be considered “fit for duty” if they display an acceptable level of functioning. Let’s go back to the seafarer who’s just been through a serious breakup.

In this scenario, traits can help determine level of functioning. If this seafarer is resilient, he may still have an adequate level of functioning despite experiencing symptoms of a mental health crisis, in which case he should pass the PEME. However, if he’s a person of low resilience, an evaluator may conclude that his stress, depression and inability to cope are trait-based, rendering him unfit for duty. 

This is where it is crucial for the PEME assessor to appreciate the complexity of individuals and the intricate relationship between environmental factors, individual traits, experiences and support networks, and to not simply make out-of-context conclusions based on a current snapshot of feelings and behaviours. 

When conducting a fit-for-duty evaluation on someone experiencing mental health issues, such as anxiety, sleep deprivation and panic attacks, we are looking at states; when we conduct personality and aptitude tests prior to employment, we are assessing traits. At VIKAND, we believe PEMEs need to integrate both, and to understand in detail whether a seafarer is being failed for state or trait reasons.

Maritime Depends on its Workforce

From cruise lines to cargo ships, maritime operations depend on a high-performing crew. Vessels need to be a safe and productive environment regulated by data-driven medical examinations and fit-for-duty evaluations for everyone onboard. However, as our understanding of mental health evolves, it’s important to distinguish between manageable states and unmanageable traits, or else we risk losing viable talent.

VIKAND’s Mental Wellness division is here to support vessel operators in the process of evaluating candidates and developing systems to maintain good mental health among crew members. Visit our Mental Health page today to learn more about our approach and capabilities.