Mental health
Governing: Table A-VI/4-2 'medical conditions and emergencies' and 'alcohol and drug abuse'; RCUK First Aid Guidelines 2025, suicidal thoughts; REG Yacht Code Annex J1.
The yacht context
The pressures are familiar: long seasons, 16-hour charter days, little privacy, a hierarchy you cannot get away from, relationships ending by text, social media, alcohol culture ashore, and the insecurity of an industry where people can be let go at the next port. None of that is a diagnosis. But the PMC holder is often the person crew come to, and should know how to respond.
REG Yacht Code Annex J1 says health protection is not limited to treating illness and includes health promotion and education. That covers mental health.
Recognising a problem
| Warning signs | |
|---|---|
| Behaviour | Withdrawal, irritability, not eating, drinking more, poor performance, uncharacteristic mistakes |
| Talk | Hopelessness, being a burden, 'no way out', saying goodbyes |
| Actions | Giving things away, reckless behaviour, standing alone at the rail |
| Physical | Poor sleep, exhaustion, weight change |
Suicidal thoughts: the RCUK 2025 approach
- Ask if they are alright, how they feel and why.
- Ask directly whether they have suicidal thoughts. Asking does not plant the idea; it opens the conversation.
- Assess the risk: have they talked about it or made plans?
- Listen, without judgement.
- Concrete threats or plans: tell them you are going to get help, and do. At sea: keep them safe, do not leave them alone, remove obvious means, inform the master, call TMAS through the Coastguard.
- No immediate warning signs: keep listening and encourage professional support.
Acute disturbance
Psychosis, severe agitation or intoxication can put the person and others at risk. Priorities are safety, a calm environment, excluding physical causes (low blood sugar, head injury, infection, alcohol withdrawal), and TMAS advice. Restraint and sedation are last resorts, on medical advice, recorded in detail.
Alcohol and drugs
Table A-VI/4-2 lists alcohol and drug abuse. Treat an intoxicated casualty medically first: airway, recovery position, supervision, blood sugar, head injury. Alcohol withdrawal a day or two after joining can cause shaking, confusion and seizures. The disciplinary question comes later and belongs to the master.
Confidentiality
Medical information is confidential. Share what the master needs to know to keep the person and the vessel safe, and explain to the patient that you will. Safety overrides confidentiality when there is risk to life.
Prevention
- rest-hour compliance (see HELM - Operational Level);
- a cabin culture that does not punish people for speaking up;
- time ashore and contact with home;
- HoDs who notice when someone changes.
WARNING — Do not manage it alone A crew member at risk of suicide is a medical emergency. Call TMAS, involve the master, and plan for landing the person to proper care.
TIP — After an incident A serious accident, death or rescue affects the whole crew. Brief, check in with individuals over the following days, and watch the people who say they are fine.