+xPerhaps I've just been lucky, but I've yet to encounter any obvious cases of psychiatric distress offshore.
Here's a lengthy popular magazine article from November, 2018 that may be relevant:
"My Father's SOS—From the Middle of the Sea".
Hi Roger,
Probably the most famous psychiatric problem off-shore is Donald Crowhurst on a Golden Globe Race” google for details and I hear the book is good.
I do not think you are lucky: I believe that psychiatric problems offshore are rare, especially those of a “psychotic break” level. (Already mentioned are the medication induced variety.) Most people who suffer in this area know they are vulnerable (with some exceptions) and, with good judgement, do not put themselves in such a challenging environment. Those with well managed challenges (anxiety, depression, maybe even bi-polar), tend to do just fine and definitely benefit from a spouse or crewmate knowing of the issues and, if relying on medication, ensuring that it is taken regularly in the unusual sleep and work schedules of an off-shore passage-making vessel.
Far more common (and generally far more problematic and destructive) is what I call “character pathology” or what also might be called the excesses common in everyday life. The most common might be the man who is prone to angry outbursts when things go a bit pear shaped: The “Cap’t Bligh syndrome perhaps. Often this is seen on racing boats, but on cruising boats this anger can be directed at his spouse or crew. It is caused by the man not having good mechanisms for dealing with anxiety. And off-shore, in tight quarters with no relief in sight, this can lead to problems.
Another common occurrence is the Captain (again often a man) who must have everything “just so” and is not easy-going enough to allow for things to be “good enough”. Sometimes this slips into a rigid admonition to “do it my way”.
Then there is the micro-managing person who is always looking over the shoulder of others giving “advice” and instructions.
Many a cruise (and many a marriage) has foundered on these issues which may be tolerable when on land, but can be quite destructive in the confines of a boat at sea.
Random thoughts, Dick Stevenson, s/v Alchemy