Hearing “Mayday, Mayday!” always gets the adrenaline pumping. Every day, Coast Guard command centers receive distress calls and spring into action. Response crews are dispatched, and lives are saved. Many decide to join the Coast Guard to receive world-class rescue training, to work with shipmates dedicated to the mission, and to have the opportunity to save lives. But what happens when a rescue mission is unsuccessful?
Unresolved searches result in decisions to suspend searching and often include next-of-kin (NOK) notifications, with families briefed in detail and told the Coast Guard did everything it could to save their missing loved ones. This is traumatic for the victims’ family and friends, but it also affects the Coast Guard men and women involved. The Coast Guard has long recognized that on-scene responders can be deeply affected by search-and-rescue (SAR) missions. However, there has been far less discussion about the effect unsuccessful missions have on operations center watchstanders and the command-and-control personnel who manage and close out these missions.
In addition, the long-term burdens on Coast Guardsmen who make the decisions to suspend searches and initiate NOK notifications are not well studied. There is considerable medical literature on the effects of cumulative stress among civilian first responders that reveals the trauma they endure and its impact on their well-being. While the Coast Guard has made progress addressing possible workforce stress following traumatic incidents, it should establish more awareness training about both short- and long-term stress associated with SAR operations.
The Medical Literature
According to the Coast Guard’s Office of Auxiliary and Boating Safety’s 2021 Recreational Boating Statistics, there were 5.5 deaths per 100,000 registered recreational vessels.1 While Coast Guard safety polices have reduced the number of deaths in the maritime environment over the past decades, fatalities still happen. Whether a Coast Guard member is involved with a single mission that results in a death or hundreds of fatalities over decades of service, the negative psychological impact he or she experiences can be profound.
Stress from a single, particularly disturbing mission may be easier to recognize than the cumulative stress from years of conducting and managing search-and-rescue missions. Notably, the results of the 2017 National Institutes of Health study Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance suggests that rates of traumatic stress “are comparable among Coast Guard personnel serving at Boat Stations to those of larger military services after combat deployment.”2 The study admits that the full impact of this stress is unknown and further study is required. The Ruderman Family Foundation’s White Paper on Mental Health and Suicide of First Responders found that first responders suffer from depression and posttraumatic stress disorder at a rate up to five times higher than non-frontline response workers in the general public.3 These and other studies strongly suggest not only that Coast Guard SAR managers have a higher probability of job-related mental anguish, but also that the majority are not likely to ask for help when they do suffer.
Current Service Training and Response
Since 1999, the Coast Guard has had a robust critical incident stress response (CISR) program that includes both preincident training and postincident support.4 As part of the CISR program, the Assistant Commandant for Human Resources (CG-1) staff, Coast Guard chaplains, and unit volunteers generate an effective critical incident stress management (CISM) team to help Coast Guard members cope with postincident stress before it becomes long-term trauma—“psychological first aid to minimize the harmful effects of job stress, particularly in crisis or emergency situations.”5 Most of the operational workforce has become familiar with the CISM process and other training, including Psychological First Aid and Applied Suicide Intervention Skills Training (ASIST), but no system is in place to deal with the cumulative effect of multiple traumatic incidents over many years.
Coast Guard leaders do recognize the problem of long-term cumulative stress. Rear Admiral Dana Thomas, the Coast Guard’s Director of Health, Safety, and Work-life (CG-11) and chief medical officer, cites research from Dr. Bessel van der Kolk that identifies the subconscious phenomena of cumulative stress as causing “invisible wounds.” The terminology recognizes people may be physically and psychologically harmed when exposed to emotionally charged missions, human tragedy, and traumatic events—especially over time.6 Dr. Nicola Davies is a health and behavioral psychologist who specializes in post-trauma intervention techniques. In “The Trauma of Search and Rescue,” she explains that “during the recovery stage, people start coming to terms with what has happened. . . . However, flashbacks, fears, anxiety and unusual behavior can be experienced by an individual anywhere from a week after the incident to 25 or more years later.”7
Coast Guard members routinely have 40- to 60-hour work weeks, move every three years from one demanding tour to another, work missions with minimal sleep, and may not be affected until years later as they throttle back in preparation for retirement. Psychologists specializing in grief acknowledge that people need time to process human tragedy, but most search-and-rescue managers do not, or cannot, find the time to properly “digest” cases that end with a loss of life.
Ways to Improve
Early in my career, most Coast Guard service members viewed health and wellness primarily through a fitness lens. If one’s body mass index was good, then one’s health was good. Experience taught me that mental wellness also can affect a member’s physical health. Therefore, the Commandant’s workforce priority of delivering point-of-need healthcare and family services must include an expanded effort to address long-term stress that affects the Coast Guard’s workforce.
To better address the challenge of cumulative mental stress, the Coast Guard should enhance the existing CISR program, splitting it into a two-pronged effort—one reactive and one proactive. The reactive prong is the current CISM program, which makes members aware that events can cause latent feelings of depression or anxiety and describes support programs in place to help. At the enterprise level, however, the service must strengthen its proactive awareness campaign and target service members in response-management jobs, as well as non-response personnel who augment these missions, such as translators.
Training should be incorporated into annual evaluation/standardization mechanisms in each first-responder community. This training also should be incorporated into the relevant A and C schools, commanding officer/executive officer courses, Leadership Development Center curriculum, and officer-in-charge colleges. In addition, predeployment training, such as that supporting the humanitarian mission of migrant interdiction operations, should prepare operators and mission-support personnel for theater-specific operational stress to which they might be exposed. During migrant interdiction operations, young men and women are faced with traumatic situations. The negative effects of such events may not manifest until later, however, and this must be a recurring theme in awareness training.
Leaders are also integral to forward-looking awareness. The Uniformed Services University Center for the Study of Traumatic Stress summarized numerous studies and offers training and practices that commands should employ to help members cope with operational stress. These include training on expected trauma exposure during missions and the normal physical and mental reactions to that exposure, training members to monitor themselves and others for adverse reactions, employing trained facilitators to lead group discussions to enhance peer support, educating members on mental health resources and encouraging their use, and promoting effective communication about mission progress.8
During the past two years, the Coast Guard piloted an operational stress control program, expanding it in 2023. This training provides members with greater capability to assess their overall well-being and allows leaders to better understand the stress level of their units and take steps toward early identification of individual and unit needs. Leaders should encourage their operators and mission-support personnel to reach out about what they have experienced and highlight that mental health management is a critical component of operational readiness.
This essay is part of my personal recovery following yet another heartbreaking NOK notification to a grieving family. While sharing with peers the many challenges of command, I realized I am not alone in feeling despair about passing such tragic news. It is endemic in this business.
Coast Guard men and women selflessly place themselves in harm’s way with the sole goal of saving lives. Even though they conduct missions with tactical precision, sometimes they are unable to locate the missing person in the water. They are well trained for the operational risks associated with weather, equipment failures, and crew dynamics. They must also be trained to recognize mental health stress that can occur from performing these missions, both in the near and long terms. The service owes it to them, and its leaders owe it to themselves.
1. U.S. Department of Homeland Security, Coast Guard Office of Auxiliary and Boating Safety, Commandant Publication P16754.35, 2021: Recreational Boating Statistics (Washington, DC: 16 June 2022): 6.
2. Richard J. Servatius et al., “Stress-Related Mental Health Symptoms in Coast Guard: Incidence, Vulnerability, and Neurocognitive Performance,” Frontiers in Psychology 8 (September 2017).
3. Miriam Heyman et al., “The Ruderman White Paper on Mental Health and Suicide of First Responders,” The Ruderman Family Foundation, April 2018, 19.
4. U.S. Coast Guard, Commandant Instruction 1754.3A: Critical incident Stress Management (Washington, DC: Headquarters, U.S. Coast Guard, 18 July 2011).
5. U.S. Coast Guard, Critical incident Stress Management, 2.
6. Bessel Van der Kolk, The Body Keeps Score: Brain, Mind and Body in the Healing of Trauma (New York: Penguin Books, September 2014).
7. Nicola Davies, “The Mental Trauma of Search and Rescue,” FrontLine Magazine, 15 March 2015.
8. Uniformed Services University, Department of Psychiatry, Center for the Study of Traumatic Stress, “Helping Military Personnel Who Experience Work-Related Trauma Exposure: Recommendations for Military Leaders,” www.cstsonline.org/assets/media/documents/CSTS_FS_Helping_Mil_Pers_Who_Experience_WorkRelated_Trauma_Exposure.pdf.
