​The underwater world is a hostile environment to humans, requiring the use of advanced life-support equipment to survive in it. Diving – whether for work or pleasure – is therefore a safety-critical activity, where optimal human performance is necessary to successfully manage risks to divers’ health and safety.

In the diving context, optimal human performance is contingent on:
(1) Appropriate cognitive, emotional, and behavioural self-regulation, where
(2) Effective self-regulation is underpinned by intact neuropsychological functioning; and
(3) The capacity to master the skills necessary for safe diving experiences regardless of mode of diving (e.g. leisure or commercial).

Against this background of personal safety, determinations regarding a person’s competency to dive in the context of psychological or mental health, becomes pertinent. Such determinations are not always simple, for a number of reasons. Firstly, there are very few absolute contra-indicators: psychological performance and mental health lies on a continuum, and it is therefore difficult to identify specific cut-off points that would guide clinical decision making. Psychological competency-to-dive is thus mostly decided on a case by case basis. Secondly, the assessment of psychological competency-to-dive needs to consider multiple factors, making it a potentially complex process, further accompanied by the challenges associated with psychological assessment generally. These factors are multi-layered, encompassing intra-personal, inter-personal, and environmental intersections.

This document has been developed by a group of clinical psychologists working in the field of mental health support to professional divers. At the heart of this work is the assessment of divers in order to determine their psychological-competency-to-dive (PCtD), both in the military and civilian diving spheres. To this effect, PCtD determinations are conceptually and practically underpinned by an occupational health model which prioritises the consideration of a diver’s capacity to engage in and follow safe diving practice(s). The approach of this document is therefore oriented by those intersecting professional, ethical, and legal frameworks which specifically guide the conduct and practice of clinical psychologists in South Africa, and generally how clinical psychologists as well as other aligned or interested health (i.e. medical doctors) and diving (i.e. Diving Supervisors) professionals could approach prospective PCtD considerations. The aim of developing this document is to prime readers to those considerations regarding PCtD by sharing our clinical and professional experiences. This is done in the hope that this document may be of use to others who are engaged in similar activities, and to encourage further debate in the field of diving psychology and other allied disciplines to enhance understanding of the topic.