Navigating Trauma at Sea: A Systematic Review of Risk Factors and Interventions for Psychological Trauma Among Seafarers

Traumatic experiences at sea are not uncommon and may arise from events such as piracy, war, accidents or deaths, as well as from harsh working conditions and social confinement. Although occupational stressors at sea and their potential traumatic and mental health impacts have been recognised, there has been limited systematic categorisation of these stressors, as well as insufficient research on interventions to address seafarers’ traumatic experiences. The study conducted a systematic literature review of the causes, impacts, and interventions related to psychological trauma among seafarers. The review aimed to (1) examine the risk associated with psychological trauma among seafarers, and (2) critically assess the existing interventions designed to address or mitigate psychological trauma at sea. Twenty-eight studies were included in the review. Seafarers are exposed to a range of traumatic events, particularly piracy, occupational incidents, violence, and, recently, COVID-19-related stressors. Other potentially traumatic experiences, such as exposure to armed conflict and seafarer abandonment, have received comparatively little research attention. Such stressors are associated with PTSD symptoms, depression, anxiety, sleep disturbances, and occupational disturbances. Trauma support was reported to be limited, including low rates of help-seeking and scarce follow-up care. Interventions include crisis response, psychological support, psychoeducation, family involvement, and resilience-based approaches, although evidence on effectiveness is sparse. Psychological trauma is an under-recognised occupational health issue in seafaring, arising from both acute and chronic stressors. The findings highlight the need for trauma-informed maritime health frameworks, improved access to psychological support, and effective prevention, intervention, and recovery strategies.