Protecting the Mental Health of Offshore Workers

good morning I'm Nicole Edwards with an nios office of research integration on behalf of Nash welcome to the second installment of the 2024 expanding research Partnerships webinar series the series theme is exploring worker safety and health in unique environments and challenging working conditions today's webinar will focus on protecting the mental health of offshore workers now it is my pleasure to introduce Dr Jessica stright deputy director of The naos Office of research integration thanks Nicole and thank you everyone for joining us for today's webinar we're very pleased to have this opportunity to bring together experts from

the occupational safety and health research Community who are going to provide critical insights into the successes challenges gaps and needs related to protecting and promoting the mental health of offshore workers it's my pleasure to kick off the Morning by introducing that distinguished panel of speakers first we have Dr Samantha case who has studied risk factors for injuries fatalities and vessel casualties and Commercial Fishing offshore seafood processing and Marine Transportation at Nash since 2014 just last week Sam transitioned from her role as a research epidemiologist at Nash to begin a new position as a scientific program

official in cdc's National Center for injury prevention and control and we certainly wish her all the best in this new Endeavor today we're very lucky to have Sam with us to share work she completed during her time with the naos center for maritime safety and health studies Dr Marissa Baker is assistant professor in the department of environmental and Occupational Health Sciences at the University of Washington School of Public Health she also serves as deputy director of the Northwest Center for occupational health and safety and today Marissa will discuss the results of research conducted during the

covid-19 pandemic to identify stressors and solutions related to the mental health of us Mariners Dr Julie Sorenson is the director of the Northeast Center for health and safety a program of the Basset Healthcare Network in coopertown New York Julie's research interests include qualitative research methods social marketing intervention development intervention dissemination and human behavior research she has been working with fisherman for over a decade on developing health safety interventions that respond to the unique needs of fishing communities and joining Julie is Dr Mandy Rome a research scientist at the Northeast Center for occupational health and safety

her research interests include qualitative research methods infectious disease transmission Dynamics intervention development and human Behavioral Health she has worked with fishermen for the last six years on developing health and safety programs to address their community's needs together Julie and Mandy will provide a global perspective on mental health and Commercial fisheries and discuss Mental Health Resources for the fishing industry and now we're ready to begin our webinar approximately 40 minutes of presentation from our speakers will be followed by an interactive question and answer session please put any questions that you have for the speakers in the

Q&A box at the bottom of your screen at any time during the webinar and without further delay I will invite Dr Sam case to our virtual post to get us started today Sam thanks Jessica hi everyone thanks so much for joining us today I'll be kicking us off with an introduction to work-related stressors in Maritime so first what is the relationship between work and mental health work is a social determinant of Health that can influence many aspects of Our Lives both positively and negatively it is an important protector of mental health work can provide a

livelihood sense of confidence purpose and achievement positive relationships and a sense of inclusion and belonging all of which are Amplified in a safe and healthy work environment but work can also negatively affect mental health and there are many different reasons for this some of which we'll talk through today uh but the mental health and behavioral health effects of work-related stressors are many and these effects include depression anxiety burnout fatigue and substance use and workplace stress and poor mental health outcomes have wide ranging effects that span Beyond individual workers chronic workplace stress can lead to lower

job satisfaction morale and productivity among workers as they may feel less energized and motivated can also harm retention efforts and lead to high turnover as workers strive to find better working conditions and finally it can lead to an increase in workplace incidents such as injuries because workers who are stressed or fatigued may be less likely to recognize and avoid hazards Maritime work environments are incredibly diverse taking place on the water as you might expect as well as Waterfront facilities Maritime jobs include vessel based work such as in Marine transportation and Commercial Fishing as well as

landbased work in ports and Marine terminals shipyards and seafood processing plants but today we're going to focus on the offshore segments of Maritime including commercial fishing and Marine Transportation briefly commercial fishing involves the harvesting of fish and shellfish from Wild stocks using a variety of vessels and gear such as wines Nets and traps Marine transportation is the movement of goods and people using a variety of watercraft such as fairies cruise ships container ships oil tankers towboats and more and as you can see from these images there's four just a small sample of four vessels um

of a variety of sizes and configurations um they also differ in how and where they operate vessels may have a single crew member on board to hundreds of crew consisting of captains mates deck hands Engineers cooks and more within each of these industries the operations and the organization of work can vary greatly but there are General work-related stressors shared by these workers that can affect their mental health and well-being and these stressors as you'll come to learn are often very interrelated so let's get into it first Maritime workers can experience or witness severe life-changing injuries

that can have profound effects on these workers psychological well-being workers are exposed to numerous physical ergonomic and chemical hazards such as noise vibration working with dangerous machinery and gear slippery walkways and ladders exposure to chemical cargos and lifting heavy objects just to name a few they can also work in extreme environmental conditions including wind waves and icing conditions and all of these can affect anything from slips trips and falls to vessel sinkings because of these hazards Maritime workers experience higher rates of fatalities and nonfatal injuries than workers in other jobs Studies have shown that Maritime

workers are concerned about their safety working on board vessels and perceive their work as unsafe at higher levels than workers in other jobs one study revealed that about 2third of mariners were stressed about ship safety and this was linked to physical and mental fatigue sleepiness and job dissatisfaction risk of injury and mental Health outcomes are also correlated among Maritime workers for instance a survey of mariners found that those with depression anxiety or suicidal ideation had increased likelihood of a work-related injury factors related to work organization can also have significant effects on a worker mental health

and well-being many maritime operations are characterized by round-the-clock 24/7 operations and this requires shift work and sometimes very long working hours this can vary depending on the vessel and operation type and the crew on board but often leads to less sleep than is desirable on Towing vessels for example watchkeeping schedules are often 6 hours on 6 hours off or 12 hours on 12 hours off in the fishing industry commercial fishermen may work for 16 to 20 hours a day during the peak Harvest times within a fishing season the work hours for maritime workers may result

in stress fatigue tension among the crew and impaired Human Performance non-standard work arrangements are also found in Maritime Industries such as contracts Mariners on temporary contracts have reported an increased prevalence of work stress depression and fatigue due to scheduling uncertainty and just an overall sense of job insecurity many commercial fishermen are independent contractors which can impact their access to safety and health protections and employment benefits such as healthc care coverage job control or the ability to make and influence decisions about work can mitigate stress caused by high demands at work but when demands are high

and control is low that translates to a high strain job and Maritime work is often characterized by high job demands and low job control Mariners have reported that their High Press work is a leading work-related stressor that has been linked to fatigue job dissatisfaction and intent to leave the industry many Mariners also report a lack of autonomy which has been associated with chronic fatigue and sleep issues low job control can be due to the hierarchical structures on vessels so for instance a captain holds the power and authority over the vessel and all the crew um

but this can also be due to external factors which we'll talk about in a moment offshore work is very unique because these workers live where they work at least temporarily and there are numerous stressors when we think about working and living on a vessel the time on board varies by operation workers may be on vessels for months at a time with limited Shore leave extended time at sea has been linked to job dissatisfaction among Mariners Studies have shown that for seaf farers mental health significantly decreased after a long voyage and led to symptoms like anxiety

and paranoia commercial fishermen have also reported feeling isolated and lonely even when they're working on a vessel with other crew members and this social isolation is a risk factor for depression you saw images earlier in this presentation of some of the vessels used in maritime operations and some are much smaller than others even on the largest vessels crew may feel restricted living on a vessel and this is only exacerbated on those smaller vessels where there are close living quarters a lack of personal space and limited Mobility social support is a protective factor for mental health

and well-being however when at se Communications with friends and family at home can be difficult that internet is gaining more traction in Maritime Industries but it's not ubiquitous internet access can be limited and even when it is available it can be costly to Maritime workers the isolation and the remoteness of this work as well as some monotonous and routine work can lead to feelings of boredom among crew and this can lead to stress as well as safety problems through lapses in attention and we've discussed how the quantity of sleep may be limited on vessels but

the quality of sleep is also impacted sleep disturbances can be caused by vessel motion vibrations noise and light poor sleep among Mariners has been linked to poor mental health outcomes including depression and emotional exhaustion as well as fatigue positive interpersonal relations among crew members lending to social support and cohesion can be a protective Factor against adverse psychological effects as we've kind of alluded to previously however Mariners have reported a range of negative interpersonal issues and workplace violence OSHA defines workplace violence as quote any act or threat of physical violence harassment intimidation or other threatening disruptive

behavior that occurs at the work site Mariners have reported multiple types of workplace violence including hazing bullying harassment assault sexual harassment and sexual assault and women in Maritime are disproportionately affected and have reported higher rates of harassment and sexual based violence regardless of gender these experiences can lead to increased stress anxiety depression and post-traumatic stress disorder or PTSD among crew members there are also stressors related to external factors like policy and economic concerns and these broader contexts influence maritime operations and impact workers sense of job control and decision-making Authority Maritime workers may feel stressed from

complex or unclear regulations for example the commercial fishing industry is governed in part by a fisheries management process which affects how where and when fishermen can work and fisherman has expressed that the increased complexity of these rules and regulations has significant impacts on their levels of work rated stress as another example earners who work in international shipping have reported stress related related to confusing International regulations pertaining to Shor Le unpredictable market prices the state of local and Global economies and the state of international trade can also affect stress in one study of mariners 90% of

participants indicated that global trade and economy concerns were a main source of work rated stress during the covid-19 pandemic as mentioned in the very beginning work provides a livelihood and a sense of Safety and Security and threats to this livelihood and income because of uncertainty about future work is a major stressor for maritime workers from climate change affecting the health of fish stocks to supply chain disruptions from external cources there are many factors at play that can impact whether these workers have sustainable reliable work into the future so now that we've reviewed some significant stressors

at a very high level um associated with offshore Maritime work what do we know about the mental health status of me of Maritime workers and given this really unique work environment what culturally appropriate interventions can help protect the well-being of Maritime workers uh Dr Baker Dr Baker Dr senson and Dr Rome will discuss the answers to these questions next and I've have some references in case anyone wants dig into any of these topics a little more and um as Jessica mentioned I was with the Nash Center for maritime safety and health studies and I've provided

contact information here um if you have questions or want to learn more thank you so much thanks Sam for orienting us all to the topic of the day by providing that overview of work-related stressors that are faced by Maritime workers um next up we'll hear about post-pandemic Mariner mental heal from Marissa Baker Marissa hi thank you um so I want to talk about some of the results from the US Mariner survey that I did with all of the great Partners who are highlighted here um this was during the first half of 2021 so right during

the height of the pandemic March 2021 was when vaccines became widely available just to kind of Orient ourselves to that time and the goal of this survey was to characterize mental health out Comes potential causes and barriers to accessing mental health care in US Mariners so the Mariners who transport Goods not um fishermen um and to prioritize interventions to improve Mariner well-being not only during covid-19 but beyond so in brief nearly 1600 Mariners responded and they tended to be white male between the ages of 25 and 64 this does reflect the um the industry as

a whole but of course it makes it harder for us to make inferences about some of the underrepresented groups Mariners self-reported to be in good physical health they like their jobs they like the people they work with I'll show some stats on that in a second but during the pandemic and um they did feel like they were lacking support both from the Shor side and um from their Crews and they could feel isolated when they were at Sea they also reported that their Sleep Quality and mental health Health decreased it got worse during the pandemic

as it did for all of us probably as well but just to start with the some big positive news um we asked the Mariners you know do you agree with these statements I like the people I work with and 91% of our respondents either agreed or strongly agreed that they like the people they work with when we asked if they like doing the things they do at work um 93% agreed or strongly agreed that they do and so this points to kind of what um Sam said around the positive aspects of work Mariners like their

job they like the people they work with um and so you know despite that we we still saw adverse mental health outcomes and here here are the mental health outcomes that we saw in this survey population so we used validated screeners to assess five different outcomes and those are listed along the xais depression anxiety suicidal ideation high stress and PTSD um and you can see the percentage of mariners that screened positive for these adverse mental health outcomes um you know about 21% um would screen positive for depression close to 10% for um had Suicidal Thoughts

in the previous two weeks and then if you look all the way on to the right more than half of the respondents to our survey um had at least one of these five outcomes now there could be a selection bias at play here right because the people who are more likely to take um a mental health survey maybe are folks who feel like they are struggling with their mental health but when I presented these results to the industry groups that I worked with this certainly set off some alarms these numbers were much higher than they

expected to see especially considering this is such a mentally fit occupation and an occupation that requires a high degree of mental Fitness um to be successful given the um hazards that Sam summarized for us um so we looked a little bit at what aspects of vessel life were related to the mental health outcomes in our survey you can see we have a paper detailing this in more detail um which I've linked below but um consistent with what Sam told us those who had longer afloat tours um tended to be that tended to be related to

adverse mental health outcomes um those who expressed that they had more worries about what was happening at home or were feeling more isolated um the frequent changes in protocols um that were happening during covid-19 result were related to adverse mental health outcomes um those who said they received limited communication from their company or their Union around mental health um those who said they could not access Mental Health Care both on either on on the vessel or off the vessel um those who felt a lack of support or community on the vessel um and the and

we really saw a you know a strong relationship between poor sleep and mental health outcomes um for a variety of different kind of um things that were that Mariners experienced we asked them how often they experienced these during um covid-19 and so what I present here are the percent of of respondents to our survey who indicated that they have these experiences either fairly often or very often and along the x-axis I have the different experiences with the percent um who responded so nearly half of our Mariners were denied Shore leave in Port and of course

this was part of a covid-19 protocol but it really did wear on their mental health um about a third felt isolated on board a vessel um about a third were also restricted in their ability to join or rejoin their family um and then um getting it kind of access to the home front 27.5% indicated they have inadequate cell phone service and more than that 36% indicated they have inadequate internet access on a vessel so this was a situation of folks who were denied Shore leave were at sea for longer periods of time unable to join

their family and also lacking access to cell phones or Internet to communicate with the home front um so I mentioned that paper that really kind of summarizes things for covid-19 but another you know I think it's important to also take these um findings and try to move them you know now that we're past the immediate threat of covid-19 and many of the rep Protocols are returning to normal aboard the vessels to kind of pull out some of the findings from the survey that could be timeless and also could inform um the industry postco um and

so in addition to the quantitative results that I presented we also had some qualitative um find um questions on the survey and so we did kind of a Content analysis to identify some themes um that could inform the industry moving forward and I'm going to highlight some of those um in my time today so the first is the need for better mental health communication to Mariners um 65% of our respondents reported that they received no communication or training on mental health during the pandemic from their employer and one of the Mariners told me Mental Health

Training the company sends out is not helpful at all is it does not pertain to Mariners in one of the trainings some of the tools they suggest to help with mental stress are talk to your family or go outside for a walk so what we found is that while most Mariners did not receive anything or reported they did not receive anything even those that did it might not have been appropriate um to the Mariner audience and these are the topics that Mariners indicated they would like to receive some training or communication on warning signs to

look for in crewm mates how to access mental health help the access and protections they have through their employer who to contact if they have needs while they are aboard and strategies to cope with stress were the top five um topics that Mariners were interested in learning more about um the second theme was related to protocol changes and unfair application of the protocols so in our um content analysis we learned some Mariners appreciated all the protections the masking quarantining things like that others hated it kind of like the general population but what was consistent is

that um the Mariners felt that the protocol changes they weren't getting a lot of communication around them it didn't seem like they were um justly applied either within the organization or between organizations and so that regardless of whether they found them helpful or harmful or annoying um they pretty much all agreed that the way they were rolled out was not supportive of mental health and one Mariner told me during my last trip we had an extended Port stay for maintenance and restricted to the ship for our safety despite crew members not being allowed to leave

our ship was overrun by contractors who could come and go as they please the company's preach safety and following the rules yet they allowed a person with a positive covid test to come aboard the ship the rules only apply to the companies when it is in their interests and our freedoms have been stripped from us out at sea for what seems like no reason things like this really wear on a Seaman's mental health this was actually one of the most common things that we heard um you know when Shor side people don't have to follow

the protocols or when stors could get on the vessels without following the protocols it um it did not please the Mariners who were kind of forced to to be following protocols um we also learned that barriers exist to accessing Mental Health Care especially for the Mariners who may need it the most nearly 70% of respondents to our survey said they would not be able to start or maintain Mental Health Care while aboard a vessel and you can imagine with lack of Internet lack of phone um you can imagine how why that might be challenging um

one Mariner told us mental healthc care is a literal joke on board there are no accommodations made while on board even when management explicitly states that Mental Health Care accommodations should and will be made it is made clear by senior officers that any request will be denied and seen as negative behavior so there's not only kind of the access issues due to um accessing a provider but there can also be kind of stressors um from those that they are working with on the vessels um to to feel like they're discour encouraged in accessing care so

we asked um the Mariners do you agree or disagree that vessel senior officers encourage the crew to get mental health help if needed um and for those Mariners who screened as not having depression 70% agreed that they are being encouraged to access mental health help but for those Mariners who screamed positive for depression less than half agreed that they are being encouraged to access mental Health held so this tells me that Mariners with depression are much less likely to feel supported by senior officers and these are in fact the Mariners who would need these this

help the most similar um we asked if do you agree that if you're feeling sad or stressed there is usually someone on The Vessel to talk to um among those Mariners who are not depressed my my things are off a little here um among those Mariners who are not depressed which is on the left left uh more than half agreed that there is someone on The Vessel to talk to 56% agreed among those Mariners who screened positive for depression only about a third agree that there is someone on The Vessel to talk to so again

Mariners with depression are much less likely to identify someone to talk to and as Sam told us social support is is an important kind of protective factor for um mental health and so um you know making sure that everyone has someone to to talk to especially those who might need it the most um and one Mariner said there is a stigma with asking for mental health help in the industry it is largely an attitude to forget your problems and work through it focus on your duties and forget how you feel there really are no resources

available for mental health for commercial Mariners at Sea it has made me seek short side employment and not want to return to Sea until a solution is reached sailing during covid was the only time in my life I've truly experienced hopelessness and here are the bar the most common barriers that were um given to me for accessing mental health care most common was lack of consistent internet and phone um but I also want to highlight that you know there were concerns about losing their US Coast Guard credential um and you know concerns around not having

privacy or just not wanting to spend the time when they have such limited off time this is the last theme I'm going to highlight for you all Mariners appreciate support and recognition from their employer and the public for the critical Services they provide and they feel like they were not they did not have this during covid they weren't um you know on the priority list for vaccinations like our healthcare workers were or you know military um and you know one Mariner told me that Mariners feel like numbers on a spreadsheet pushed around to get the

mission done not people with lives of their own we understand that it is a difficult time but a little Outreach from the Shor side office would go a long way so um some some more recognition moving forward and at times like these the maritime professionals know for sure that our country doesn't care about the risks we are taking and continue to take to get critical products so that the country can operate our Workforce isn't as large as most but we are treated like criminals in our own ports and have no access to vaccines although we

are forced to have repeated contact with people who have been exposed to co a lot of us do not need to be out here we do it for the honor involved in providing a critical service obviously we need better lobbyists so this is recognition not only from Shor side um but also from the country um and appreciating the work and service that they provided all of us to keep us safe during the pandemic so the recommendations I have um and these are kind of for moving into this um past the immediate threat of covid era

um to continue to increase screening for mental illness um because we did find that um the rates were higher than we expected appropriate and frequent training and communication around mental health and sleep hygiene I didn't talk about the latter but that was important in the survey as well um coming up with mental health care and Wellness Resources that can be accessed aboard a vessel sometimes without internet access or telephone increasing soal support on board half of the respondents said they don't have someone on The Vessel to talk to so whether this could be some kind

of mentorship program or someone on The Vessel who is kind of known as the the resource if you need someone to talk to I also want to emphasize that more supports are needed for women and younger Mariners both of these groups had higher rates of the five mental health outcomes as compared to the overall population and if we want to continue growing this um occupation which we need to um we do have to make sure that we are supporting um all Mariners and making sure that they can enter and stay in the field so I

will end with my disclosure slide this was funded by CDC nios via an IPA to myself um and the results here reflect my my view and not the view of others thanks Marissa so much for sharing the insights that you've gained by engaging with Mariners to learn more about their work experiences and their mental health concerns I'd now like to invite Julie son and Mandy Rome to our virtual Podium to deliver our last presentation for today which will cover mental health uh in commercial fisheries juliean and Mandy thanks for being with us today all right

thank you Jessica and thank you Marissa for that uh very informative presentation I think you'll probably see similar themes in our presentation today which as Jessica pointed out will focus on Mental Health in commercial fisheries and we'll be sharing our experiences uh working with fishermen in the Northeast and I'll be join joined by my colleague Dr Mandy Rome who will talk about a project that uh she led and several resources she's uh pulled together to support commercial fishermen and their mental health needs um I think just uh to give you a quick overview of our

15 minutes uh I'll talk a little bit about who we are the Northeast Center and give a quick overview of Northeast Fisheries um we'll give a bit of an overview on mental health concerns in Northeast fisheries and then a quick look at the literature globally um and then uh my colleague Dr Rome will talk about her man therapy campaign and then resources that we have uh offered uh or are uh sharing with fishermen on our website um so the Northeast Center uh for occupational health and safety we'll give a quick overview on who we are

and what we do um our mission at the Northeast Center is to enhance the health of a forestry and fishing workers and we do that by identifying priority health and safety issues uh we we work with these communities and stakeholders to develop uh prevention Solutions collectively so we co-create Solutions and we are one of 11 Regional Nash extramural a forestry and fishing fishing centers um a quick look at nor North Northeast us Fisheries um in our neck of the woods uh commercial Fisheries operations tends to be smaller businesses um many are one-man operations or they

may have just a few crew members and I will note that anecdotally we've observed an increase in Onan uh operations and there's a variety of reasons for that um which probably we don't have time to get into in this presentation um we do have some larger offshore fleets um but mostly these are smaller uh Fisheries operations and um as you can imagine uh commercial Fisheries are one of the most dangerous occupations second uh only to logging uh in relation to the rate of Occupational fatalities um fishermen more specifically are 38 times more likely to die

at work and there are many reasons for this um Falls overboard are the leading cause of death in the Northeast Lobster fishery which is Big fishery in our region vessel disasters are the biggest contributors nationally to indust to the commercial Fisheries industry death toll uh there are also accidents that are related to slips trips in Falls and that can be problematic when you're out at Sea um there are also onshore injuries that occur um and I think one of the thing that one of the things that we've been increasingly concerned about are the issues related

to Financial stressors regulation past trauma um social isolation being away from families uh many of the things that uh Dr casee has already mentioned um I will note that we did a study on uh sleep and health in several uh regions of the United States with commercial fisheries and found that regulation was one of the biggest reasons that they were losing sleep um another thing that we have noted is uh the issue of Nostalgia which is uh interesting term but it really relates to uh being at home but not being at but not feeling at

home because your home has changed so much and with rapid changes in the working Waterfront that seems to be an increasing concern for fishermen um and just a look at the literature a little bit um and how this topic is being covered uh by uh you know the research occupational safety and health research Community collectively will note that um you know despite the fact that Fishers are susceptible to a range of mental health issues that are linked to the nature of their work um and factors outside of work um it is uh it is interesting

to note that there are a few uh studies who have really looked specifically at mental health and uh interestingly uh this chart here shows uh studies that have been focused on various topics globally as well and you can see uh mental health uh is represented in these pie charts with the brown uh slice of the pie chart uh and you don't see a lot of brown there kind of reflecting the fact that uh there's um probably a lack of research in this area um I think the studies that have been conducted they have looked at

issues such as fishing access restrictions or large scale environmental destruction and the long-term ra ramifications for fishing families um and then uh you know in the literature there has been discussion of uh the rates of suicide in commercial fishing communities which are um uh unacceptably high I would say um we have roughly 48 deaths per 100,000 uh uh fishermen at in specifically for males um and uh we did a study uh actually the sleep study that I referred to where we did uh we provided Health assessments for fishermen and we used a clinical PTSD screener

and what we found is that the participants in our study if you if you just focus on the male members uh in our uh study sample their uh rates of PTSD were three times higher than what you You' see for the national average uh for men um so uh much much higher in the commercial fishing industry um I think uh what you know concerns that we have are that you know if there are that many fishermen who are struggling can they get access to Mental Health Care um and not surprisingly this is very difficult and

there are various reasons for this getting time off from work can be very difficult and when you take time off you lose lose uh money so uh not something that they enjoy doing or want to do because they need the money um they SK schedules are dictated by the weather and uh they will be the first to point out that they aren't good planners when it comes to their own health and another issue is that you know if you go to the doctors you want to make sure that that experience is a good experience or

you know fishermen may not return and there are some concerns about cultural competency in the provider Community do they know how to have conversations with fishermen about their health and are they aware of the limitations fishermen experience when it comes to taking care of their own health and then there's also the stigma of help seeking so given that background I will now turn things over to my colleague Dr Rome thanks Julie so I want to talk today about the man theapy campaign um that we did so we teamed up with the main host Fisherman's Association

um Monique kums is their uh director of community programs so she had come to us with this idea and uh we teamed up with man therapy um so they are a group that focuses on destigmatizing Mental Health seeking behavior and this is an approach that the fishing Community had recommended for us um so if anybody has seen the TV show Parks and Recreation um man therapy kind of takes that Vibe so they sort of have this iic take on tackling very serious issues so this is a way to sort of get those difficult conversations started

you know there are a lot of issues in seeking Mental Health Care uh stigma being a huge one for for not only fishermen but a lot of other people as well um and man therapy is Not Just For Men it is also for anyone that has a man in their life um so this is a great resource for Fisher's wives fishermen's children Fisher's parents whoever um is in their life so using local vernacular was really important we wanted to develop this Outreach material for fishermen and organizations that work with fishermen and so on but using

local vernacular was a really important part of this um I'm not going to go through this whole list don't worry but using uh language that connects with the population that you're trying to Target is really really important um it's going to grab their attention and it's going to help them relate to the content that you're trying to get across um you know it shows that it's made by somebody that understands their lifestyle so we wanted to make sure that these Outreach posters social media posts things like that all got their attention and spoke in a

language that they typically speak in so these are three of the posters man therapy has an incredibly talented team um we um mcfa and the NEC we had a few meetings with them to discuss um commercial fishing and what it means to be a commercial fishermen what their lifestyle is like and from those talks man therapy designed seven posters to destigmatize mental health seeking behavior and to get fishermen thinking and talking about this subject um speaking of using local vernacular this F first poster on the left get that mind of yours running on the flat

assc this is a phrase uh our fishermen here in the Northeast use a lot to describe a very calm ocean you know uh perfect fishing conditions you know the kind of day you want so we thought this was a great use of that um and something that would really grab their attention and get them sort of engaged in this material the second poster here the ocean keeps you mostly sayane man therapy can help with the rest this shows fishermen that there are resources for them and we'll get into those in just a little while and

the last one don't let your brain be the only equipment that you don't maintain um fishermen pay a lot of attention to their equipment it's really really hard it's really important for them to maintain their equipment make sure everything is running right um doing what it's supposed to do for safety reasons um so kind of saying you know you you maintain your equipment so well so do the same for yourself and we've got three more here there a few more examples so this middle one here um very much like a man therapy kind of taking

that that that humor aspect but still um tackling these serious issues so give your brain as much attention as you give your dinghy um we also have two more um a little more serious not quite as funny but therapy won't bring home more fish but at least you will bring home less baggage so just kind of you know no it's not going to change how you fish but it can still help you sort of thing and if you can take on the unforgiving North Atlantic you can take on what's north of your neck um so

north of your neck is a common phrase that fishermen use in the Northeast um and everybody knows the North Atlantic is incredibly unforgiving um so just sort of relating back to their job and their lifestyle so we did you know we had these posters done and we said okay how do we get them out you know we don't want to just share them once on social media and have them gone um Jessica I just sent you the link to our website if you wouldn't mind putting that in the chat for me so we decided to

house all of these on a website but we wanted to be able to kind of have these materials for um fishermen for organizations that help um fishermen with different things so we decided to create a website so that link went out in the chat um we wanted to make sure we could get everything out there um so we made this website where we can download people can download all of these posters whoever want them we named It lines of support tackling stress at C and our whole goal is to gather resources in an easily accessible

way to Aid fishermen and those working with living with um different uh with fishermen and get the resources that they need so like Marissa said in her talk one of her fishermen had said you know we have these Mental Health Resources we had this training but you know the takeaway was you know go for a walk go talk to your family which these are not feasible you can't do that when you're out at Sea um and a lot of General mental health information a lot of people say have you tried fishing so you know you're

not going to tell a commercial fisherman in that because they they have indeed tried fishing um so that's not that's not going to help them so we pulled together some resources we did try to pull out State specific resources so the coastal states that are re our uh organization covers we have in here so if they have fishery specific Mental Health Resources we made sure to point that out we also have some general Mental Health Resources um but like Julie was saying kind of that cultural competence there's I think this is a a nationwide problem

but there's High provider turnover so a lot of these Coastal states are getting mental health care providers from these landlock states that really don't understand the fishing lifestyle which can be frustrating for a fisherman kind of trying to get help from somebody that really can't understand what their lifestyle is so we also have some resources so we did several it iterations of this website so we have you know our facts the PTSD rates are a lot higher in commercial fishermen in our study than the national average um suicide rates are very high but what we

realized was hey wow this is really negative we need to have a positive spin on this so we made sure with all of our facts we had some accompanying link so you know hey we're talking about PTSD rates okay how can I prevent Trauma from becoming PTSD so it gives them another resource to go to and then um talking about suicide rates how can I help somebody that's in crisis or what do I do if I'm in crisis and then I'll flip it back to Julie I think she's going to talk about some other Fisheries

efforts that are taking part right now thanks Mandy um so yeah just a open invitation for anyone who wants to join uh our Behavioral Health and Commercial Fisheries quarterly call um you can email either myself or Dr Rome and we can add you to the list serve uh we have another one coming up in November and that will be with Casey chosewood from nios uh we're uh I'm also working with Dr Lincoln and Casey Elliott on an iish innovation exchange and for more information on that please visit the iish website um and Mandy I don't

know if you could uh just include that in the chat as well um uh Dr Lincoln and Casey Elliot uh are also working on a special issue for Journal of agromed there may be some uh more articles coming out on that uh or on mental health and that and then we have our fishing forward podcast series which can be accessed through Coastal Roots radio um or I'm sorry SoundCloud has been transferred to SoundCloud so if you're interested check it out there and then I also wanted to note that there was an article out in the

New York Times focusing on uh um uh the use of opioids and Fentanyl in the fishing industry and I think that is it for us well Mandy Julie thank you so much this is really has been a fantastic set of presentations on behalf of Nash I'd like to thank all four of our speakers once again for sharing their insights into mental health in the world of Maritime and offshore work uh this concludes the presentation portion of today's webinar