Beneath the Surface: Mental Health in Commercial Fisheries.

Commercial fishing is a dangerous occupation where injuries, stress, and traumatic events are common. This study determined probable Post-Traumatic Stress Disorder (PTSD) rates in a cohort of 142 commercial fishermen in the United States and assessed factors that influence PTSD outcomes and severity. Fishermen representing four fisheries were sampled: salmon gillnetters (Alaska), Dungeness crab (Oregon), scallopers and lobstermen (Massachusetts). Participants self-reported information on health, sleep, activity, and substance use through surveys, and responded to a brief PTSD screener (PC-PTSD-5) that assesses probable PTSD under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Positive PTSD screening rates in male fishermen were 12% (as compared to 10% for female fishermen), roughly three times the national average for US men (4%). Fishermen with self-reported depression, financial struggles, inability to control important things in their lives, difficulty going to (p = .0278) or staying (p = .038) asleep were significantly more likely to screen positive for PTSD. Factors influencing the severity of PTSD symptoms in those that have experienced a traumatic event included: financial insecurity, interpersonal concerns (family, crew), stress, and concern for safety on the vessel. Interestingly, sleep variables did not impact the severity of PTSD symptoms, only the outcome of probable PTSD. These results suggest the need to better understand the nature of traumatic events in fishing communities and to validate existing PTSD screening tools with fishermen to determine their accuracy in diagnosing PTSD in this population. Additionally, tailored behavioral health care for fishermen is essential to effective treatment and recovery from trauma.