Troubled waters: An overview of seafarer mental health

The sea has a long association with poor mental health. In 1815, based on numbers in “lunatic asylums” (as they were then known), naval physician Gilbert Blane estimated that sailors experienced severe mental illness at seven times the rate of the general population1. Ancient and modern literature speaks of the sea’s ability to reveal hidden characteristics, while the extreme conditions would attract people on the margins2. In modern times, conditions at sea have improved, from physical safety to living standards to the reduction of the chance of a wreck. Yet despite this, contemporary seafarers still suffer from poor mental health outcomes at disproportionally high rates. It is important to therefore look into why mental health issues are so prevalent among sailors and what can be done to mitigate this.

Poor mental health in seafarers has a variety of causes. The sea is a challenging work environment, where people are isolated for weeks, often months, away from loved ones and thus support networks. They may miss out on important life events of their families, further driving home the loneliness3. Work days are long, often stressful, with disturbed sleep being common due to night shifts or watches4. Crews may not be from the same culture or speak the same language, which in worst case scenarios leads to bullying that is impossible to escape due to the confines of the ship5. On top of this, the ship environment itself is noisy, full of vibration and motion, which is not conducive to good health.

All of these are predictive risk factors for poor mental health among general populations, but as sailors experience them simultaneously, often for weeks or months on end, it is no wonder problems begin to develop. Furthermore, sailors frequently go through dangerous areas of the world, where piracy may be an issue. They may also pushed to the brink by inadequate staffing or financial insecurity, both of which may exacerbate mental health6. Many non-rated seafarers are employed on contracts of less than a year7. This kind of instability is fertile ground for anxiety.

As a result of all these factors, a variety of mental health issues crop up among seafarers. Stress is by far the most common, both physical and mental, in one study, stress was reported by around 65% of the respondents, rising to 86% among nautical officers8. This can progress further into burnout, or manifest in mental illnesses such as depression and anxiety. As many as 25% of sailors surveyed, for the Seafarer’s Trust Mental Health Report in 2019, suffered from depression while 17% suffered from anxiety9. It should be noted that all age groups of seafarers are equally affected, both young people and veteran sailors alike10.

A seafarer with no remedy for these issues may turn to unhealthy coping mechanisms such as substance abuse, with research showing that the same stressors that led to poor mental health also lead to addiction11. This not only makes these issues worse in the long run but can become a safety risk. Even if they are perfectly sober, poor mental health contributes to less care taken to prevent accidents, either through apathy or stress making it difficult to focus. It has been found that seafarers with anxiety or depression were found to be more likely to report injury12. In the most severe cases, sailors may die, either from the health issues associated with prolonged stress, or by their own hand.

What makes these all the worse is the pervasive stigma about mental health among seafarers. The profession is still overwhelmingly male, as demonstrated by the many surveys on this topic which had an average 90% male participation rate. Men in general are more reluctant to talk about their mental health, but in the maritime industry, which is seen as a place of toughness and resilience13, this may be exacerbated. Nobody wishes to seem weak. Other sailors can rarely detect a problem, and even if they do notice, or the sufferer opens up, they are often not equipped to properly help14. Language barriers can also inhibit a seafarer’s ability to speak about their problems. Most critically, sailors are economically incentivised to not disclose their issues, as failing a medical exam, including the psychological aspect, would mean they could not work and thus provide for themselves and their families15. They thus keep silent out of fear.

There have been many initiatives to try to address and tackle the problem of poor mental health among sailors. The first part is what can be done for the afflicted seafarer on an individual level. Crews can be given training on busting mental health myths, breaking the stigma, and what to do to help tackle mental health, including supporting each other through a crisis. A buddy system has been suggested as helpful, where older sailors could mentor younger ones and encourage better relations among the crew16. Chaplain support could also help by giving sailors a neutral third party to talk through problems with17. Sailors may also be given access to resources such as helplines or online support that they can access to manage their mental health. The difficulty of this is there is no one-size-fits-all approach. Mental health intervention may be for a medical problem, but can be influenced by culture and religion18, as well as personality.

Tackling the cause of poor mental health should not just fall solely on the sailor, however. The ship’s operators and ship owners should also create policies that foster better mental health. When surveyed, sailors stated that the top things to help make life on board happier, were better working conditions such as more sleep, permanent contracts and larger crews, as well as internet access to stay in touch with loved ones19. Employers should therefore have clear policies on the topic of mental health and how to handle it, but also on tackling harassment and bullying, and the amount of work and pressure their workers are put under20. These would be more effective in the long term than just focusing on what the individual can do21. Mental health is too complex and important to be left to just the seafarers afflicted: the whole industry needs to tackle it to truly be effective. It has been suggested that the focus on mental health should be as much as physical safety, given that it can impact safety almost as much22. Saner crews lead to safer crews, leading to better outcomes for people and business alike. It is time to acknowledge that.

Abila, Sanley Salvacion, and Iris Lavalle Acejo. “Mental Health of Filipino Seafarers and its Implications for Seafarers’ Education.” International Maritime Health, vol. 72, no. 3, 2021, pp. 183–192. https://doi.org/10.5603/IMH.2021.0035.  

Beck, Catherine. “Patronage and Insanity: Tolerance, Reputation and Mental Disorder in the British Navy 1740–1820.” Historical Research, vol. 94, no. 263, 1 Feb. 2021, pp. 73–95, https://doi.org/10.1093/hisres/htaa038.

Brooks, Samantha K, and Neil Greenberg. “Mental Health and Psychological Wellbeing of Maritime Personnel: A Systematic Review.” BMC Psychology, vol. 10,1 139 , 30 May 2022, https://doi.org/10.1186/s40359-022-00850-4.

Compton, Nic. Off the Deep End: A History of Madness at Sea. Alard Coles Nautical, Bloomsbury, 2018.

Editorial Team. “American Club: How to Manage Seafarers’ Mental Health Challenges.” Seafarers, SAFETY4SEA, 15 Nov. 2023, https://safety4sea.com/american-club-how-to-manage-seafarers-mental-health-challenges/.

Ellison, Kurt. “Lost at Sea: Seafarers and Mental Health.” Currents: A Student Blog, School of Marine and Environmental Affairs, https://smea.uw.edu/currents/lost-at-sea-seafarers-and-mental-health/. Accessed 21 Feb. 2026.

Handling a Mental Health Crisis or Emergency and Spotting Suicidal Behaviour in Seafarers . International Chamber of Shipping, Sept. 2021, www.ics-shipping.org/resource/handling-a-mental-health-crisis-or-emergency-and-spotting-suicidal-behaviour-in-seafarers.

“Improving Safety Climate by Tackling Mental Health.” Lloyd’s Register Foundation, 18 Jan. 2021, www.lrfoundation.org.uk/news/improving-safety-climate-by-tackling-mental-health.

Iversen, Robert T B. “The Mental Health of Seafarers.” International Maritime Health, vol. 63,2 (2012): 78-89, https://journals.viamedica.pl/international_maritime_health/article/view/26143.

Kizilsaç, Bayram Barış, et al.  “Revealing the Relationship Between Substance Abuse and Prevalence of Anxiety in Maritime Workers.” Eurasian Academy of Sciences Social Sciences Journal, 52 (2024): 98-107.

Lefkowitz, Rafael Y., and Martin D. Slade. Seafarer Mental Health Study. Seafarer’s Trust, Oct. 2019, www.seafarerstrust.org/sites/default/files/node/publications/files/ST_MentalHealthReport_Final_Digital-1.pdf.

“Mental Health and Seafarers: It’s Time to Talk.” Gard’s Insights, Gard, Gard AS. 23 Oct. 2019, https://gard.no/en/insights/mental-health-seafarers-it-s-time-to-talk/.

Nittari, Giulio, et al. “Factors Affecting Mental Health of Seafarers On Board Merchant Ships: A Systematic Review" Reviews on Environmental Health, vol. 39, no. 1, 2024, pp. 151-160. https://doi.org/10.1515/reveh-2021-0070. 

Oldenburg, Marcus, et al. “Burnout Syndrome in Seafarers in the Merchant Marine Service.” International Archives of Occupational and Environmental Health, vol. 86, no. 4, Springer Science and Business Media LLC, May 2013, pp. 407–416, https://doi.org/10.1007/s00420-012-0771-7 .

Oldenburg, Marcus, and Hans-Joachim Jensen. “Stress and Strain among Seafarers Related to the Occupational Groups.” International Journal of Environmental Research and Public Health, vol. 16, no. 7, MDPI AG, Mar. 2019, p. 1153, https://doi.org/10.3390/ijerph16071153.

“Prioritizing Seafarers’ Mental Health: A Maritime Imperative.” Virtue Marine, 1 Mar. 2025, www.virtuemarine.nl/post/understanding-the-mental-health-struggles-of-seafarers.

Robertson, Jen. “Mental Health and Modern Seafaring.” National Museums Liverpool, www.liverpoolmuseums.org.uk/stories/mental-health-and-modern-seafaring. Accessed 21 Feb. 2026.

Robertson, Jen. “Sailing the Stormy Seas of Mental Health.” National Museums Liverpool, www.liverpoolmuseums.org.uk/stories/sailing-stormy-seas-of-mental-health. Accessed 22 Feb. 2026.

Sampson, Helen, and Neil Ellis. Seafarers’ Mental Health and Wellbeing. IOSH Research Committee, 2019, https://iosh.com/media/n0gpp31w/iosh-research-seafarers-mental-health-wellbeing-full-report.pdf. Accessed 22 Feb. 2026.

“Seafarer Happiness Index (SHI) Report – Caring for Seafarers’ Mental Well-Being.” SRS E-Bulletin, www.mpa.gov.sg/staticfile/Cwp/assets/SRS/Issue21/case-studies/seafarers.html. Accessed 22 Feb. 2026.

Şenbursa, Nihan, et al. “Understanding Seafarers’ Physical and Mental Health.” Journal of International Maritime Safety Environmental Affairs and Shipping, vol. 8, no. 4, Informa UK Limited, Oct. 2024, https://doi.org/10.1080/25725084.2024.2421708.

Svetina, Matija et al. “Factors impacting seafarers' mental health and career intentions.” Inquiry: A Journal of Medical Care Organization, Provision and Financing, vol. 61 (2024): 469580241229617, https://doi.org/10.1177/00469580241229617. 

Vaughan, Caitlin. “Mental Health of Seafarers: What has the Industry Done to Tackle This? What Else is Needed?” International Seafarers’ Welfare & Assistance Network, 6 Aug. 2024, www.iswan.org.uk/news/mental-health-of-seafarers-what-has-the-industry-done-to-tackle-this-what-else-is-needed/.