Abstract

Background: The COVID-19 outbreak in China has created multiple stressors that threaten individuals' mental health, especially among public health workers (PHW) who are devoted to COVID-19 control and prevention work. This study aimed to investigate the prevalence of mental help-seeking and associated factors among PHW using Andersen's Behavioral Model of Health Services Use (BMHSU).Methods: A cross-sectional survey was conducted among 9,475 PHW in five provinces across China between February 18 and March 1, 2020. The subsample data of those who reported probable mental health problems were analyzed for this report (n = 3,417). Logistic and hierarchical regression analyses were conducted to examine the associations of predisposing, enabling, need, and COVID-19 contextual factors with mental health help-seeking.Results: Only 12.7% of PHW reported professional mental help-seeking during the COVID-19 outbreak. PHW who were older, had more days of overnight work, received psychological training, perceived a higher level of support from the society, had depression and anxiety were more likely to report mental help-seeking (ORm range: 1.02–1.73, all p < 0.05) while those worked in Centers for Disease Control and Prevention were less likely to seek help (ORm = 0.57, p < 0.01). The belief that mental health issues were not the priority (64.4%), lack of time (56.4%), and shortage of psychologists (32.7%) were the most frequently endorsed reasons for not seeking help.Conclusions: The application of BMHSU confirmed associations between some factors and PHW's mental health help-seeking. Effective interventions are warranted to promote mental health help-seeking of PHW to ameliorate the negative impact of mental illness and facilitate personal recovery and routine work.

Highlights

  • The novel coronavirus disease (COVID-19) was declared a pandemic by the World Health Organization on March 12th, 2020 [1]

  • During the COVID19 outbreak period, a recent survey conducted in the epicenter Wuhan, China found that approximately 30% of front-line medical workers reported severe anxiety compared to general medical staff in another city (16%), where the epidemic was not serious [10]

  • In the present study, we examined the prevalence and associated factors of mental health help-seeking using the framework of Behavioral Model of Health Services Use (BMHSU) among public health workers (PHW) who reported mental health problems, including [1] predisposing factors; [2] COVID-19 control and prevention work-related contextual factors; [3] enabling factors; [4] need factors

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Summary

Introduction

The novel coronavirus disease (COVID-19) was declared a pandemic by the World Health Organization on March 12th, 2020 [1]. To minimize transmissions through interpersonal contacts, the Chinese government has taken a series of severe control measures, including public transportation regulations, early detection of cases, contact tracing, and strict quarantine [2] These aggressive public health interventions contributed enormously to containing the epidemic and involve the efforts of public health workers (PHW) across the country. During the COVID19 outbreak period, a recent survey conducted in the epicenter Wuhan, China found that approximately 30% of front-line medical workers reported severe anxiety compared to general medical staff in another city (16%), where the epidemic was not serious [10] Another survey of PHW across five provinces in China reported a high prevalence of depression (21.3%) and anxiety (19.0%) [11]. This study aimed to investigate the prevalence of mental help-seeking and associated factors among PHW using Andersen’s Behavioral Model of Health Services Use (BMHSU)

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