The Moderating Effects of Colleagueship on the Relationship Between Mental Health and Perceived Stigma Among Chinese Firefighters

Objective: To date, few studies have examined the relationship among mental health symptom severity, colleagueship, and perceived stigma, especially in Chinese firefighters. This study aims to investigate the association between posttraumatic stress symptoms (PTSS), depressive symptoms, and perceived stigma, taking colleagueship as a moderator. Method: This cross-sectional study included a total of 1,328 Chinese firefighters. These subjects completed electronic questionnaires from July 1 to August 31, 2021. Multivariate linear regression analyses were performed to assess the relationship between mental health symptoms and perceived stigma and the possible moderating effect of colleagueship on the above relationship. Results: After adjusting for possible confounders, both PTSS (beta = 0.088, 95% CI [0.013, 0.163]) and depressive symptoms (beta= 0.252 [0.177, 0.327]) were positively associated with stigma about seeking mental health care. Additionally, colleagueship and its dimensions, such as face (beta = 0.090 [0.024, 0.156]), instrumentality (beta = 0.234 [0.178, 0.291]), and emotion (beta=-0.091 [-0.163, 0.020]), had significant associations with perceived stigma. Moreover, the association between mental health symptoms and stigma was significantly moderated by colleagueship. Conclusions: Mental health symptom severity is positively associated with perceived stigma, and colleagueship enhanced this relationship. The present findings suggest that anti-stigma campaigns should focus on stigma related to colleagueship in the background of Chinese culture and highlight the need to establish confidential assistance programs and mental health awareness programs.