Stress and fatigue are a fact of life for men and women working at sea. The typical symptoms of stress are insomnia, loss of mental concentration, anxiety, substance abuse, extreme anger and frustration, family conflict, and physical illnesses such as heart disease, migraine headaches, stomach problems, and back problems (ICSW 2009). Risk factors causing stress on board are demands of the job; the level of control seafarers have over their work; the support received from management and colleagues; relationships at work; the seafarers’ role in the organization, and change and how it is managed.