Navigating mental health needs at sea: Perspectives from the Canadian maritime community during the COVID-19 pandemic.

Seafarers play a vital yet often underrecognized role in sustaining global trade, facing unique mental health challenges, that was further exacerbated by the COVID-19 pandemic. Existing literature underscores elevated risks of anxiety, depression, and suicide among seafarers, heightened by isolation, extended contracts, and diminished shore leave. This is the first qualitative study exploring seafarer mental health needs and support use in Canadian waters. Guided by the research question-What are the mental health needs of seafarers operating in Canadian waters during the COVID-19 pandemic, and what were the barriers that prevented them from accessing support?-this study sought to identify how several socio-ecological factors shape seafarers' mental health needs and use of support. Thirteen interviews (eleven seafarers and two key informants) were conducted between February and October 2022. A hybrid thematic framework approach was adopted: an initial inductive thematic analysis generated data-driven codes, which were subsequently organized through framework analysis by deductively mapping them onto the domains of the Socio-Ecological Model. Interpretation was complemented by Ungar's social-ecological resilience perspective to interpret how individuals "navigate" available resources and "negotiate" for mental health support. Findings reveal that pandemic-driven mobility restrictions-such as denial of shore leave and repatriation challenges-intensified the pre-existing stressors of seafaring life. Inadequate onboard connectivity, reports of workplace harassment, and limited coordination among authorities, employers, and welfare organizations further constrained mental health support access. Port-based welfare centres, ship inspectors, and collaborative interventions demonstrated a potential to mitigate psychosocial risks. The pandemic spotlighted systematic gaps in the mental health supports available to seafarers in Canadian waters. Addressing these gaps requires multi-level strategies that link onboard, port-based, and policy-level supports. Adapting Mental Health First Aid and Stepped Care 2.0 to maritime settings, coupled with stronger interagency collaboration, can enhance timely, context-specific mental health care.