Reference Guide
Psychological First Aid
A practical, humane framework for responding to crew members in distress. Not therapy — a professional, supportive first response.
What is Psychological First Aid?
Psychological First Aid (PFA) is a humane, supportive response to fellow human beings who are suffering and may need support. It is not therapy, counseling, or psychological treatment.
PFA involves three core actions: Observe signs of distress, Listen with calm and empathy, and Link the person to appropriate support. It can be provided by any officer or crew member — no psychological training is required.
NOT Therapy
PFA does not diagnose, treat, or analyze psychological conditions.
NOT Counseling
PFA does not require a therapeutic relationship or professional license.
IS Human Support
PFA is practical, respectful, and immediately actionable by any officer.
Step 1
Observe
Observation is the first step of PFA. Before approaching a crew member, observe their behavior, emotional state, and physical presentation for signs of distress.
Signs to Watch For
Poor or disrupted sleep
Crew member appears fatigued beyond normal watch schedule
Social isolation
Avoiding shared meals, common areas, or crew interaction
Irritability or short temper
Unusual emotional reactivity to minor situations
Visible emotional distress
Tearfulness, visible anxiety, or emotional flatness
Poor concentration
Difficulty focusing on tasks or making decisions
Withdrawal from duties
Declining performance or avoidance of responsibilities
Step 2
Listen
Listening in PFA means creating a safe space where the crew member feels heard and not judged. Approach calmly, speak gently, and focus on understanding — not solving.
Calm Approach
Choose a private location. Approach without urgency or alarm.
Active Listening
Make eye contact, nod, and acknowledge what is being shared.
Emotional Validation
Acknowledge feelings without judgment: "That sounds really difficult."
Respectful Communication
Use the crew member's name. Speak at their level, not above.
Example Script
Step 3
Link
Linking connects the crew member to appropriate support based on their level of need. PFA providers do not need to solve everything — their role is to connect people to the right resource.
Officer Support
For general welfare concerns and monitoring
Welfare Support
Seafarer welfare organizations and chaplains
Medical Support
Ship's medical officer for physical or mental health assessment
Company Process
HR, DPA, or formal company welfare channels
Family Contact
Facilitating communication with family when possible
Follow-Up
Scheduling a check-in to monitor progress
Red Flags — When to Escalate Immediately
The following signs indicate a situation beyond PFA scope and require immediate escalation to the medical officer and Master.
Immediate Action:
Do not leave the crew member alone. Notify the medical officer immediately, then notify the Master. Document everything.
Do's and Don'ts
Do
- Approach calmly and privately
- Listen without interrupting
- Validate feelings without judgment
- Use the crew member's name
- Ask open-ended questions
- Offer practical support (water, a quiet space)
- Follow up after initial contact
- Document your observations and actions
- Escalate when red flags are present
Don't
- Force the crew member to talk
- Minimize or dismiss their feelings
- Make promises you cannot keep
- Share their situation with other crew without need
- Offer advice or solutions immediately
- Express shock, judgment, or disbelief
- Leave someone in acute distress alone
- Attempt therapy or psychological treatment
- Ignore red flags to avoid confrontation
Escalation Indicators
Use this guide to determine the appropriate level of response. When in doubt, escalate.
Officer Level
When
General welfare concern, mild distress, routine monitoring
Action
Conduct supportive conversation, document, follow up
Chief Mate / Master
When
Recurring pattern, moderate distress, unresolved concern after officer intervention
Action
Formal notification, escalated documentation, welfare plan
Medical Officer
When
Physical symptoms, inability to function, self-harm concern, substance use
Action
Immediate medical assessment and fitness-for-duty evaluation
Master + DPA
When
Suicidal ideation, assault, serious harassment, psychiatric emergency
Action
Immediate formal escalation, DPA notification, possible repatriation
Ready to apply PFA?
Explore the full module library for situation-specific guidance.