Challenges and Opportunities to Maximize Mental Health among Shipboard Sailors: A Qualitative Study

Abstract

Recent reports show U.S. sailors have the highest rates of self-reported psychological health symptoms of any service, perhaps in part due to the unique challenges of serving in a shipboard environment. Resources are available to maximize the psychological health of sailors while at sea, though no empirical research is available regarding sailors’ perspectives on what strategies, services, and programs they find most helpful and accessible. To address this knowledge gap, thirteen focus groups were conducted with sailors from two different ships (n = 86) to determine how they manage stress and maximize psychological health while underway. Content analysis of focus group transcripts conducted by two independent reviewers identified themes within three content areas: strategies and resources to manage stress and maximize psychological health; challenges to accessing supportive services and resources; and opportunities to improve psychological health. Five themes emerged for managing stress underway, the most common of which was engaging in physical fitness. Others included participating in organized social events, general comradery and social support, seeking help from medical, and communicating with Chaplains. Social and logistical barriers to seeking psychological healthcare were identified, including stigma, fear of adverse career repercussions, and too few providers/long wait times. Suggestions for improving psychological health at sea included improving sleep health, changes to workload and scheduling, increased shipboard providers trained in psychological healthcare, and increased social support. Specific interventions that may benefit shipboard sailors are sleep health education, improvements to berthing areas, adoption of circadian watchbills, telemedicine, and an increased number of social events aboard ships.