On the night of 28 September 1994, the M/S Estonia, a passenger ferry travelling from Tallinn to Stockholm, sank in the Baltic Sea. The incident resulted in significant loss of life; of the 989 crew and passengers aboard, only 137 survived, making it one of the deadliest maritime disasters in modern history.

Sara Hedrenius, published author and Senior Advisor in Mental Health and Psychosocial Support at the Swedish Red Cross, was one of the survivors, and the memories of that fateful night remain clear in her memory. Severe weather conditions, with high waves and strong winds, made the mass rescue operation (MRO) more difficult.

“A loud bang was the first indication that something was wrong. I remember making my way up and out onto the deck. Once there, I felt uncertain about what to do, so I clung to the highest point I could reach, the railing. Looking down at the black water below felt utterly surreal.

“When the ship capsized, we climbed over the railing and stood on the vessel’s side. The moon was shining, and I had never been so scared in my entire life – my heart was pounding, and I felt sick.

“When the captain signalled, we knew it was time to leave the ship. There was nothing to hold on to, nothing to keep us afloat, so we moved toward the water and let a wave sweep us into the sea,” says Sara.

The time between the first banging heard and the moment the ship finally sank was approximately one hour. Surviving a disaster of this magnitude comes with long-term effects. Sara, who was 20 years old then, could not fully grasp what had happened.

Support from fellow survivors played a key role in validating her memories and understanding her reactions. “It was helpful to see that other survivors struggled with similar reactions and thoughts. It made it easier to understand that my responses were a result of what I had been through, not a sign that I had fundamentally changed as a person.”

Trauma therapy provided practical tools for managing the psychological impact and helped her move forward.

The Estonia disaster led her to focus on crisis response and mental health support. “My studies in psychology and psychotraumatology eventually guided me to work with the Red Cross, specialising in disaster and crisis management.”

Maritime disasters can highlight gaps in rescue operations. She interviewed several rescue swimmers afterwards and learned that equipment failures hindered efforts that night.

“Torbjörn Olsen, one of the rescue swimmers that night, developed a new product after the disaster to make helicopter hoists safer. Tragic events can sometimes lead to innovations in safety procedures, such as Torbjörn’s helicopter hoist technology,” she adds.

Following the Estonia disaster, changes were implemented, including adopting neon-green rescue suits and helmets for swimmers. The disaster raised awareness of the importance of structured crisis support for maritime personnel.

Maritime disasters impact survivors differently based on several factors. One crucial aspect is whether the accident was caused by human error or intentional actions, which can lead to more significant psychological injuries.

Survivors' personal experiences during the event, such as feeling their lives were in danger and the length of the period of uncertainty, also play an important role in their recovery. A major challenge is the transition from immediate crisis support to long-term care, as follow-up assistance is often neglected, leaving individuals without the support they need.

She believes having a basic understanding of human reactions and needs is helpful. Organisations must be prepared to provide Psychological First Aid. This reduces stress, provides reassurance, fosters connection, and enhances feelings of control during chaotic situations. Assessing needs and offering practical support are essential for recovery.

Sara will be the opening speaker at the upcoming G6 MRO conference organised by the IMRF in Sweden this June. Her message to the SAR community emphasises the importance of crisis support and the need to integrate it within organisations.

She believes that learning the basics of crisis management is essential, as it helps individuals recognise what they may need during difficult situations and how they can support friends or colleagues – especially since knowing how to respond isn't always straightforward.

She says organisations and responders have to be prepared for the mental and emotional toll of MROs on both survivors and rescue personnel.

Preparedness requires thorough training exercises that include mental health considerations. Post-disaster evaluations should incorporate feedback from both survivors and personnel.

Insights from those directly affected contribute to meaningful operational improvements, ensuring that future responses are more effective.

“Despite growing awareness, stigma around mental health persists. Encouraging open discussions and normalising psychological support within SAR communities can help address this issue. Keep the conversation going and share experiences with one another. This will help your organisation grow, improve, and stay engaged in continuous learning.

“Adopting evidence-based international guidelines ensures consistency in post-rescue care. Additionally, research and data collection contribute to refining intervention strategies for both survivors and rescuers,” Sara adds.

The role of SAR teams extends beyond rescue operations. Providing proper support during and after missions strengthens both individual resilience and organisational effectiveness.

“Mental health considerations should be a core aspect of emergency response strategies, ensuring that both survivors and rescuers are better prepared for future challenges,” Sara concludes.

Come and join us in Sweden

Join us for the IMRF G6 Conference in Sweden, a premier event bringing together global maritime search and rescue (SAR) experts. Don’t miss insightful discussions, a live SAR exercise, and networking with industry leaders. Register now to be a part of this significant gathering and help shape the future of maritime SAR.