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Effect of Workplace Mental Health Assessment on Psychological Distress Detection among Healthcare Workers in Nigeria

Abstract

Psychological distress is an important occupational and public health concern among healthcare workers in Nigeria. Healthcare workers may experience demanding workloads, long working hours, staff shortages, occupational stress, exposure to critically ill patients, emotional strain, workplace violence, inadequate resources, and other challenging working conditions that may contribute to anxiety, depressive symptoms, burnout-related distress, sleep difficulties, and other psychological problems. Despite these challenges, psychological distress may remain undetected because of stigma, fear of professional consequences, limited workplace mental health services, inadequate mental health awareness, concerns about confidentiality, and shortages of trained mental health personnel. Workplace mental health assessment provides an opportunity to identify healthcare workers experiencing psychological distress through structured mental health questionnaires, confidential assessments, occupational health services, counselling programmes, and referral systems. Early detection may facilitate counselling, psychosocial support, professional mental healthcare, workplace adjustments, stress-management interventions, and timely referral where necessary. Against this background, this study investigates the effect of workplace mental health assessment on psychological distress detection among healthcare workers in Nigeria. The study will be anchored on the Health Belief Model, Job Demand-Control Model, and Social Ecological Model. The Health Belief Model explains how healthcare workers' perceptions of susceptibility to psychological distress, perceived severity, perceived benefits of mental health assessment, perceived barriers, and cues to action may influence participation in workplace mental health assessment. The Job Demand-Control Model emphasizes the relationship between workplace demands, such as heavy workloads and time pressure, and workers' control over their work, explaining how occupational conditions may contribute to psychological distress. The Social Ecological Model emphasizes the influence of individual, interpersonal, organizational, community, and broader social factors on healthcare workers' mental health and help-seeking behaviour. Collectively, these theoretical perspectives provide a suitable framework for explaining how workplace mental health assessment may influence psychological distress detection among healthcare workers in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise healthcare workers aged 18 years and above employed in selected public and private healthcare facilities across Nigeria, including doctors, nurses, midwives, pharmacists, laboratory scientists, community health practitioners, medical laboratory personnel, and other eligible healthcare professionals. A multistage sampling technique will be used to select states, healthcare facilities, departments, units, and eligible healthcare workers. Workplace mental health assessment will be measured using indicators such as availability of workplace mental health assessment programmes, assessment coverage, frequency of assessments, use of validated psychological assessment tools, assessment of anxiety and depressive symptoms, evaluation of occupational stress, availability of confidential assessment services, trained mental health personnel, counselling services, employee assistance programmes, mental health education, workplace psychosocial support, and referral arrangements. Psychological distress detection will be assessed using indicators such as identified symptoms of anxiety, depressive symptoms, persistent stress, emotional exhaustion, sleep difficulties, psychological distress scores, healthcare workers requiring further professional evaluation, newly identified psychological distress, referrals for counselling or mental healthcare, and confirmed psychological conditions where appropriate. Data will be collected using structured questionnaires, validated psychological assessment instruments, occupational health records, workplace counselling records, employee assistance programme records, and referral registers. Descriptive statistics will be used to summarize healthcare workers' characteristics, occupational factors, mental health assessment coverage, psychological distress indicators, and patterns of distress detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of workplace mental health assessment on psychological distress detection. Where appropriate, psychological distress detection rates before and after implementation of workplace mental health assessment programmes may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that workplace mental health assessment has a significant positive effect on psychological distress detection among healthcare workers in Nigeria. Healthcare workers who participate in workplace mental health assessment are expected to have a higher likelihood of previously unrecognized psychological distress being identified than workers without access to such assessment. Routine assessment may facilitate early recognition of anxiety, depressive symptoms, occupational stress, sleep difficulties, emotional distress, and other psychological problems. Early detection may provide opportunities for confidential counselling, psychosocial support, professional mental healthcare, workplace adjustments, stress-management interventions, and timely referral. Providing assessment within healthcare workplaces may reduce some barriers associated with seeking mental healthcare independently and may encourage workers who are reluctant to disclose psychological difficulties to access support. Workplace mental health education may also improve awareness of psychological distress and reduce stigma associated with seeking mental healthcare. Conversely, inadequate confidentiality, fear of professional consequences, shortage of trained mental health personnel, limited workplace mental health services, high workloads, low participation, and weak referral and follow-up systems may reduce the effectiveness of workplace mental health assessment. The study therefore expects accessible, confidential, and appropriately implemented workplace mental health assessment to contribute significantly to improved detection and early management of psychological distress among healthcare workers in Nigeria. The study is expected to contribute to the literature on workplace mental health assessment, psychological distress detection, healthcare workers' mental health, occupational mental health, workplace well-being, psychosocial risks, employee health, mental health promotion, early detection, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Labour and Employment, state ministries of health, healthcare institutions, hospital administrators, occupational health practitioners, psychologists, psychiatrists, counsellors, healthcare professional associations, development partners, and policymakers regarding strategies for strengthening mental health support for healthcare workers. The study will also provide evidence-based recommendations for expanding confidential workplace mental health assessment programmes, increasing access to trained mental health professionals, strengthening counselling and referral systems, improving mental health education, reducing workplace stigma, implementing psychosocial support programmes, improving working conditions, and integrating mental health assessment into comprehensive occupational health and employee wellness programmes across healthcare facilities in Nigeria.

Keywords: Workplace mental health assessment, psychological distress detection, healthcare workers, occupational mental health, psychological well-being, workplace stress, mental health screening, psychosocial support, employee wellness, early detection, Nigeria, public health.