In the demanding and high-pressure world of healthcare, mental health challenges among professionals often go unnoticed or unaddressed, partly due to self-imposed barriers. A groundbreaking multicenter study published in BMC Psychiatry sheds light on one such barrier: self-stigma surrounding the act of seeking professional psychological help among healthcare workers at high risk for depression and anxiety. This research, conducted in Hunan Province, China, offers vital insights into the psychological landscape affecting these frontline heroes, highlighting the complex interplay of factors that sustain the reluctance to seek mental health support despite clear needs.
Health care workers (HCWs) frequently operate under strenuous conditions that exacerbate their susceptibility to mental health disorders like depression and anxiety. Paradoxically, these individuals -- expected to be providers of care -- often internalize stigma that discourages them from accessing psychological support. Self-stigma, the internalization of societal prejudices about mental health, can severely impede their willingness to pursue therapy or counseling. The present study focuses on quantifying this self-stigma and identifying the underlying factors that exacerbate or mitigate it among those flagged as high-risk based on standardized screening tools.
The methodology involved a comprehensive survey distributed to 1,224 healthcare workers across 12 hospitals in the Hunan Province from late 2022 through early 2023. Using convenience sampling, the researchers collated biological, psychological, and social data through validated instruments, including the Self-stigma of Seeking Help Scale, Perceived Social Support Scale, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, Generalized Anxiety Disorder-7 (GAD-7) scale, and the General Self-Efficacy Scale-Schwarzer. Importantly, HCWs scoring 10 or above on the PHQ-9 and GAD-7 were identified as being at a heightened risk for depression and anxiety, respectively.
From the initial cohort, 384 valid responses meeting the criteria of high risk were analyzed. The median total score of self-stigma related to seeking professional help was moderately elevated, suggesting a significant internal barrier among this vulnerable group. Intriguingly, sleep duration, levels of social support, and severity of depressive and anxiety symptoms emerged as significant predictors influencing the degree of self-stigma experienced by these healthcare workers. This multifactorial insight underscores the nuanced and interdependent nature of psychological impediments in a real-world clinical context.
The relationship between inadequate sleep and psychological distress among HCWs is well-documented, but this study links sleep deficiency directly to self-stigmatizing attitudes. Sleep deprivation arguably aggravates cognitive and emotional processing, thereby magnifying negative self-appraisals and diminishing the perceived need -- or ability -- to seek help. This finding calls for systemic interventions aimed at improving work schedules and rest opportunities for healthcare staff as a conduit for reducing stigma and facilitating help-seeking behaviors.
Social support, a critical buffer against mental health deterioration, was inversely associated with self-stigma levels. HCWs perceiving higher social support demonstrated lower self-stigma, implying that robust interpersonal connections serve as protective factors. This further illustrates that stigma is not merely an individual psychological barrier but is deeply embedded in social networks and institutional cultures. Cultivating supportive work environments can thus play a pivotal role in destigmatizing psychological help-seeking among healthcare personnel.
Depressive and anxiety symptoms themselves were positively correlated with self-stigma, revealing a distressing cycle where increased symptom burden intensifies shame and fear of judgment. This vicious circle not only delays treatment but also exacerbates morbidity and potentially leads to diminished patient care quality. Understanding this interplay is crucial for designing mental health programs that simultaneously address symptom management and the psychological barriers to accessing care.
The study's sophisticated statistical analyses, including generalized linear modeling, allowed the disentanglement of these factors, confirming their independent and collective roles. Such quantitative rigor provides a robust platform for healthcare administrators and policymakers aiming to tailor interventions that transcend generic wellness programs, focusing instead on targeted stigma reduction and mental health promotion strategies specifically tailored for high-risk HCWs.
Importantly, while this research is concentrated on a Chinese population, the implications are global. Health care systems worldwide confront similar challenges with mental health stigma among practitioners. The universal nature of these findings offers a call to action for international healthcare leaders to recognize and systematically combat self-stigma to enhance workforce resilience during and beyond the current era of public health crises.
This study importantly bridges a gap in mental health research by not only exploring symptom prevalence but emphasizing the psychological barriers that continue to hinder help-seeking behaviors. It highlights that interventions must extend beyond awareness campaigns to foster inclusive, stigma-free cultures within medical communities. This could involve peer support programs, confidential counseling options, and systemic changes accommodating HCWs' mental well-being as integral to healthcare excellence.
Furthermore, the research spotlights the need for longitudinal studies to observe the evolving dynamics of self-stigma in relation to workplace stressors and changing societal attitudes toward mental health. Future investigations might focus on intervention efficacy, tailored therapies, and cross-cultural comparisons to build a comprehensive understanding of self-stigma mechanisms over time.
In essence, the study offers a compelling narrative intertwining the psychological, social, and systemic factors that promote or hinder mental health care among those who tend to others in times of need. By illuminating the self-stigma phenomenon among high-risk healthcare workers, this research paves the way for informed, evidence-based policy development aimed at safeguarding the mental health of healthcare professionals, ultimately improving patient outcomes and healthcare system sustainability.
As healthcare systems continue grappling with the aftermath of successive pandemics and growing workload demands, addressing the mental health crisis with an emphasis on dismantling self-stigma is paramount. This study's insights serve as an urgent reminder that protecting caregivers' well-being is not just a compassionate imperative but a necessary condition for functional and resilient health services worldwide.
Subject of Research: Self-stigma related to seeking professional psychological help among high-risk healthcare workers for depression and anxiety.
Article Title: Self-stigma of seeking professional psychological help and its influencing factors among high-risk health care workers for depression and anxiety: a multicenter cross-sectional study
Article References:
Huang, R., Lei, B., Liu, Y. et al. Self-stigma of seeking professional psychological help and its influencing factors among high-risk health care workers for depression and anxiety: a multicenter cross-sectional study. BMC Psychiatry 25, 533 (2025). https://doi.org/10.1186/s12888-025-07019-4