Mental Health Challenges Among Medical Officers in Monaragala District Sri Lanka: Investigating Depression, Anxiety, Stress, and sleep quality

Background: Medical officers working in rural districts of Sri Lanka are exposed to significant occupational stressors that may adversely affect their mental health and sleep quality. Objectives: To determine the prevalence and severity of depression, anxiety, and stress among medical officers (MOs) in Monaragala District and to assess their association with sleep quality. We further hypothesized that higher psychological distress would be associated with poorer sleep quality and that female doctors would report greater distress than males. Design: Descriptive cross-sectional study. Setting: Government hospitals in Monaragala District, Sri Lanka. Participants: Sixty-eight medical officers who were actively engaged in clinical duties during the study period. Interventions: None. Primary and Secondary OutcomeMeasures: Primary outcomes were the prevalence and severity of depression, anxiety, and stress measured using the Depression Anxiety Stress Scale–21 (DASS-21). Secondary outcomes included sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI), associations between psychological distress and sleep quality, and gender differences in mental health outcomes. Results: Symptoms of anxiety were reported by 60% of participants, depressive symptoms by 48%, and stress symptoms by 42%. Moderate-to-extremely severe symptoms were observed in approximately one-third of participants for anxiety and depression. Poor sleep quality (PSQI >5) was identified in 52% of medical officers. Depression, anxiety, and stress scores were strongly intercorrelated (r > 0.70, p < 0.01). Psychological distress demonstrated moderate positive correlations with poor sleep quality (r = 0.31–0.44, p < 0.01). Female medical officers had significantly higher mean depression, anxiety, and stress scores compared to males (p < 0.05). Conclusions: Psychological distress and sleep disturbances are highly prevalent among medical officers in Monaragala District. Anxiety was the most common symptom domain. Poor sleep quality was significantly associated with higher levels of psychological distress. Female medical officers appear particularly vulnerable. These findings highlight the need for workplace-level mental health screening and targeted support interventions.