Abstract
Background: In healthcare, occupational stress is a major problem, especially in settings with little resources and in rural areas. These stresses are exacerbated in Eastern Cape, South Africa, by heavy patient loads, staff shortages, and poor infrastructure. Despite the availability of mental health services, healthcare providers continue to underuse them, largely due to stigma, time restraints, and a lack of awareness.
Aim: The aim of this study is to explore the relationship between occupational stress and the utilization of mental health services among healthcare providers in two selected community health centers in the Eastern cape, South Africa.
Methods: A quantitative, cross-sectional research study design was employed, using a self-administered structured questionnaire distributed to a census population of 126 respondents, 64 from Qumbu Community Health Centre (CHC) and 62 from Mhlakulo CHC, who were permanent staff members of both CHCs. Out of the 126 respondents, 107 questionnaires were deemed valid for analysis. Data were analyzed using IMB SPSS (v29.0). Descriptive statistics summarized prevalence and patterns, while inferential test (chi-square and binary linear regression) assessed associations between stress levels, demographic variables, and mental health service utilization.
Results: Moderate to high occupational stress was reported by 89.6% of participants from Qumbu and Mhlakulo CHCs. Workload (74.5%) and lack of resources (73.6%) were the most common stressors in both CHCs. Trauma (55.8%) and pediatric units (51.0%) were identified as high-pressure areas. Almost half (48.6%) had taken stress related sick leave, yet only 28% accessed mental health services, predominantly counselling. A significant association was found between having a stress-related diagnosis and service use (p<0.001). Reported barriers included lack of time (77.4%), limited awareness (50.9%), and confidentiality concerns (38.7%). Most participants were female (84.1%), 100% African/Black, and middle-aged (35-54 years). Nurses comprised the largest staff category (86%), while doctors, pharmacists, pharmacist assistants, dentists, and radiographers formed smaller proportions. Most had less than 20 years of experience, worked both shifts, and averaged less than 12 hours per day.
Conclusion: The study highlights a critical gap between the high prevalence of occupational stress and the low uptake of available mental health services among health center staff. Findings across objectives show that stress is widespread, linked to workload and resource shortages, and often results in absenteeism, while service