INT-HR-4.1.2

Mental Health Onboard: Noticing, Listening, Signposting

A HOD is not a clinician, and the job is to notice changes, listen without fixing, be honest about the limits of confidentiality, and signpost professional help such as a doctor, an employee assistance programme or ISWAN. Never diagnose, never treat, and escalate immediately where there is any risk to life.

Your second stewardess has stopped eating with the crew. She is doing her job, but she has gone quiet, she is not sleeping, and last week she cried in the laundry and said it was nothing. You are not a clinician and you never will be. You are, however, the person closest to her — and what you do next matters.

What You Are, and Are Not

You are not a doctor, a therapist or a counsellor. You must not diagnose, must not label, and must not attempt to treat. What you are is someone who can notice, listen, keep her safe, and route her to real help. That is a genuinely valuable role and it is enough.

What You Might Notice

Area Possible signs
Mood Persistent low mood, tearfulness, hopelessness, flatness, irritability
Anxiety Constant worry, panic symptoms, avoidance, dread before service
Withdrawal Leaving the mess, not calling home, isolating in the cabin
Function Standards dropping, lateness, forgetting, uncharacteristic errors
Physical Sleep and appetite changes, unexplained illness, weight change
Substances Drinking more, drinking alone, using alcohol to sleep
Burnout Exhaustion that rest does not fix, cynicism, feeling ineffective

These are observations, not diagnoses. Many have other explanations. The right response to any of them is the same: a conversation, and a route to professional help.

Having the Conversation

  • Choose privacy and time. Not five minutes before service.
  • Open with what you have seen, gently and without labels. I have noticed you have been quiet and you have not been eating with us. How are you doing, really?
  • Ask twice. The first I am fine is often reflex.
  • Listen. Do not fix. Silence is fine. You do not need an answer for her.
  • Take it seriously. Do not minimise, do not compare, do not tell her others have it worse.
  • Ask what would help, rather than deciding for her.
  • Be honest about confidentiality. See below.
  • Signpost, clearly. The yacht doctor or telemedicine service, an employee assistance programme if the yacht has one, her own GP, and seafarer welfare services such as ISWAN, which runs a free, confidential, multilingual helpline for seafarers and their families.

What Not to Do

  • Do not diagnose or name a condition.
  • Do not give clinical, treatment or medication advice.
  • Do not suggest coping methods involving physical discomfort or endurance.
  • Do not promise secrecy you cannot keep.
  • Do not gossip, not even framed as concern.
  • Do not treat it as a performance problem.
  • Do not leave someone you are genuinely worried about alone.

Confidentiality and Its Limits

Say it up front: I will keep this between us as far as I can — but if I think you are at risk, or someone else is, I will have to involve the Captain, and I will tell you before I do it. If there is any indication of risk to life, that is an immediate Captain and medical escalation. This is not a betrayal; it is what safety requires.

Onboard Notes

  • Ask early, ask badly, but ask. A clumsy question beats a polite silence.
  • Know before you need it: the yacht EAP, the telemedicine provider, and the ISWAN helpline.
  • Look after yourself too. HODs absorb everyone else and often have nobody absorbing them.
  • General professional guidance only. This is not clinical advice; professional help should always be sought.

Practice questions

5 questions
recallcore

recall · core

What is the HOD role in relation to a crew member mental health, and what is explicitly outside it?

recallcore

recall · core

Name signposting routes a HOD should know before they are needed.

scenariocore

scenario · core

Your second stew has stopped eating with the crew, is not sleeping, and cried in the laundry saying it was nothing. How do you approach her?

scenariostretch

scenario · stretch

A crew member asks you to promise that what she is about to tell you stays between the two of you. What do you say?

oralstretch

oral · stretch

Why is it dangerous to treat a mental health issue as a performance problem?

Independent study. xplor is not an IAMI- or PYA-accredited GUEST training provider. This course covers the ground assessed in GUEST Unit 30; it awards no GUEST unit, certificate or Certificate of Competency and does not count toward one. It is not legal or clinical advice.

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