PRESS RELEASE: Yale study reveals worryingly high levels of depression, anxiety and suicidal thoughts among seafarers

Press Release

19 November 2019. For immediate release

Yale study reveals worryingly high levels of depression, anxiety and suicidal thoughts among seafarers

A new study by Yale University has identified potentially dangerous levels of depression, anxiety and suicide risk among the world’s seafarers. Commissioned by the ITF Seafarers’ Trust charity, this authoritative and comprehensive survey of the state of seafarers’ mental health exposes risks and proposes actions that can be taken to address the problem.

The study drew on a sample of 1,572 seafarers who were representative of serving seafarers across the world, of different ranks, on different vessels, with different flags. It found that within the previous two weeks of completing the survey a quarter of them had suffered depression, 17 percent had experienced anxiety and 20 percent had contemplated suicide or self-harm.

The Seafarer Mental Health Study for the first time also found a link between depression, anxiety and suicidal ideation (thoughts) and a greater likelihood of injury and illness on board.

The survey identified the following factors as being associated with the feelings of depression, anxiety and suicidal thoughts:

  • Lack of adequate training
  • An uncaring work environment
  • Exposure to violence or threats of violence
  • Co-existing medical conditions (including cardiac disease and sleep disorders)
  • Low job satisfaction
  • Ill heath

The significance of the link to violence and bullying at work had not been previously drawn so clearly. Seafarers from the Philippines and Eastern Europe were four times as likely to report having experienced or witnessed violence as those from Western Europe.

Dave Heindel, Chair of the Seafarers’ Trust, stated: “The more we talk about mental health, the more we reduce the stigma associated with it. This report really helps us to understand the contributing factors and provides a basis for demanding some fundamental changes in the way the shipping industry operates. This morning the report’s lead author, Dr Lefkowitz, personally briefed the ITF Seafarers’ Committee on the findings of this far-reaching and important study. It was a sobering occasion; the gravity of his team’s discoveries is evident. They should be taken as a call to action by everyone in the shipping industry. For our part, the ITF and the representatives of its worldwide maritime union affiliates gathered here today have pledged to share these findings as widely as possible in order to draw attention to this until now hidden problem – as well as to use them to lobby the industry for system changes to the working environment onboard ships.”

Katie Higginbottom, Head of the Seafarers’ Trust, commented: “The lives of seafarers are known to be tough. This study shows them to be generally healthy and resilient but subject to massive pressures that are, for the most part, manageable. This issue of violence on board is, however, very disturbing and warrants further investigation. ”

Having examined the extent of the problems, the study includes a number of recommendations for maritime training institutes, companies, employers, P&I clubs and trade unions, including:

  • Enhance support for cadets, ensure proper training and make improvements to complaints procedures
  • De-stigmatise mental health within company culture
  • Recognise and address the need for interventions to address workplace violence, including by: defining and measuring violence in the seafaring workplace; involving key stakeholders to identify sources and strategies to reduce workplace violence; and by supporting research in intervention evaluation, with dissemination of results to governing bodies, registries, unions, and shipping companies.

The study’s authors were Dr Rafael Y Lefkowitz, MD MPH and Martin D Slade, MPH, from Yale University’s respected Occupational and Environmental Medicine Program. They utilised demographic, occupational, and work-environmental questions, along with ones assessing injuries and illness events, and mental health outcomes (symptoms of depression and anxiety). The final survey was the result of feedback gathered from seafarers over three months of ship visits.  The survey was then actively promoted for three months, during which time it attracted 1,894 participants, from which a representative cohort of 1,572 seafarers was selected.

The ITF Seafarers’ Trust is a UK-registered charity that funds programmes to advance the health and wellbeing of maritime workers. For more details visit



JPEG of the report’s front cover

For further information please contact:

Katie Higginbottom, Head of the ITF Seafarers’ Trust. Email: Tel: +44(0)7909806647

Executive summary, ITF Seafarers’ Trust & Yale University Seafarer Mental Health Study

This report describes findings from the seafarer survey of injury, illness, and mental health risk factors in international seafarers, sponsored by the ITF/Seafarers’ Trust.  The goal of the study was to determine rates and factors associated with mental health conditions in seafarers, and identify opportunities for preventive interventions.  The final study population included 1572 seafarers representing many regions of origin and vessel types. For the purposes of the study, seafarers with a PHQ-9 score of 10 or greater were considered seafarers with depression, and seafarers with a GAD-7 score of 10 or greater, seafarers with anxiety.  Seafarers with suicidal ideation were defined as those responding “several days,” “more than half the days,” or “nearly every day” to the question, “Over the past 2 weeks, how often have you been bothered by thoughts that you would be better off dead, or of hurting yourself in some way?”  The main findings are listed below, with recommendations narrated at the end of the full report.

Key findings included:

  • 25% of seafarers completing a patient health questionnaire had scores suggesting depression (significantly higher than other working and general populations).
  • 17% of seafarers completing a generalised anxiety disorder questionnaire were defined as seafarers with anxiety.
  • 20% of seafarers surveyed had suicidal ideation, either several days (12.5%), more than half the days (5%) or nearly every day (2%) over the two weeks prior to taking the survey.
  • Incorporating all demographic, occupational, and work environmental factors, final determinants of seafarer depression, anxiety, and suicidal ideation included work environmental factors (non-caring company culture, violence at work), job satisfaction, and self-rated health (the strongest predictor of anxiety and depression).
  • The most significant factor associated with workplace violence was seafarer region of origin. Seafarers from the Philippines and Eastern Europe were most likely to report exposures to workplace violence.
  • Depression, anxiety, and suicidal ideation were associated with increased likelihood of injury and illness while working on board the vessel.
  • Seafarer depression, anxiety, and suicidal ideation were associated with increased likelihood of planning to leave work as a seafarer in the next 6 months.
  • Periods in work/life cycle associated with high-risk of mental health issues included, most notably, during extension of a voyage.

While comparative data is limited, this analysis suggests that seafarers have higher rates of depression than other working populations, emphasizing the need for appropriate mental health policies and management strategies in this isolated, vulnerable, and globally essential workforce.  The study also importantly identifies potential opportunities to reduce depression and anxiety risks in seafarers, which may also reduce risks of injury and illness, and improve retention.  While limitations include that the data is self-reported data at one point in time, this study is a significant step towards understanding risk factors of seafarer mental health conditions.


The full report can be downloaded at

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