The frontline healthcare workers and police staffs were always the major force that fighted the COVID-19 epidemic. Increasing attention has been paid on the mental health issues of frontline warriors during the global public health emergency [5, 13]. However, the security personnel especially prison police who also actively engaged in preventing and controlling this epidemic were largely neglected. To the best of our knowledge, this study was firstly conducted to evaluate mental health status of frontline prison police in China during the COVID-19 epidemic, and to identify factors that influence psychological distress.
A total of 981 frontline prison police participated in the cross-sectional Web-based survey, which was considered large enough to draw definite inferences. The current study found that a 33.43% prevalence of psychological health issues among the police who prevented the COVID-19 epidemic from spreading to prison. The findings obtained in the study were higher than those obtained among healthcare professionals and the general population (21.3% − 33.0%) [15, 24, 25]. There was no any data and previous research evaluating the mental health of prison police, resulting in a impossible comparison with the prevalence findings during other periods. However, respondents with prison police during the prevention and control of the COVID-19 epidemic reported significantly higher levels of psychological problems than those with Chinese adults surveyed in 2019 (3.6% − 5.0%) [26]. These results reflected that frontline prison police reached a level of mental health problems, which could not be ignored and required further evaluation.
The 12-item General Health Questionnaire (GHQ-12) was an effective instrument for screening mental disorders, and has been widely used in Chinese community samples [17, 20]. The three-factor model of GHQ-12 proposed by Worsley and Gribbin (1977) [22], including anxiety and depression, social dysfunction, and loss of confidence, was verified to give the best fit [23]. Psychological factors analysis showed that frontline prison police mainly experiencd mental health issues associated with anxiety and depression, and issues related to these symptoms were unhappy and depressed, lost sleep over worry and constantly under strain. These findings were consistent with several researches, which suggested that anxiety, depression, sleep issues [27], and stress [28] were the most common psychological problems caused by COVID-19 epidemic. Excessive anxiety might lead to several harmful consequences including lower quality of life [29], suicidal ideation and attempts [30], physical chronic conditions [31] and relationship complications [32]. Many emotional and physical health problems, as well as decreasion of the ability to function at work and home, could be elicited by depression [33, 34]. It implied that psychological intervention should be carried out for frontline prison police early to help alleviate their psychological symptoms.
Despite it was necessary to evaluate the prevalence of psychological symptoms in frontline prison police, the further analysis for identifying risk and protective factors contributing to mental health issues was more importantly. Data from the present study showed that male frontline prison police was more likely to suffer from mental health problems compared with female prison police. This contrasted with findings in the general population [35], healthcare workers [36], and police personnel [13] during the COVID-19 epidemic. Reason for the finding was attributed to men might take more responsibility leading to psychological distress symptoms [37]. The participants with work in closed jail recently were about 2.203 times (OR = 2.203) more likely to have mental health problems than that with home quarantine and preparation, which might be because a person in a closed environment could develop psychological problems [38]. Our results suggested that more night shifts have increased the risk of mental health problems in frontline prison police. Consistent with earlier study, more night shifts could cause sleep disturbances, and burnout and mental disorder among employees [39]. The frontline prison police with tendency of mental health problems smoked significantly more and were therefore at greater risk [40]. Moreover, participants who were poor physical condition and chronic or serious illness history had a higher risk of psychological issues. It might indicate that mental health defense of this prison police subgroup with weak physical function has been negatively affected.
Previous studies have confirmed that healthy diets and exercise regularly could promote mental health for the adult population [41, 42]. Our data proved that regular diet and more physical exercise were protective factors for mental health among frontline prison police, and the incidence of psychological problems were 0.779 and 0.702 times that of the opposite. The present study also revealed that comunication with family members was another protective factor associated with mental health of the prison police during the prevention and control of the COVID-19 epidemic. This might be due to the fact that providing emotional support from family and friends and maintaining contact were positive treatment to protect mental health [43].
Since the early phase of COVID-19 epidemic control, the prison authorities in China have been constantly implemented psychological interventions, including published the mental health handbook for prison police, established psychological assistance hotlines, and assigned mental health professionals to provide timely psychiatric help. These measures have efficiently alleviated the psychological problems of frontline prison police, thereby reducing the rate of work errors. As the normalization of epidemic prevention and control will continue for a long time, this study may provide practical guidance for the development of a psychological support strategy. According to the current findings, the targeted interventions should be performed to relieve mental health problems among frontline prison police. First, prison authorities should formulate and implement a viable strategy to adjust duty hours to the optimization, and provide solid logistical support to guarantee prison police' quality of life with sleep, diet and exercise, so that their physical and mental health problems can be reduced. Second, the mental health of frontline prison police should be dynamically monitored to provide appropriate information on treatment and psychological intervention for affected people, and supply continuity of regular mental health care services among the whole population. Third, the prison police should maintain a good living habits to promote mental health, and learn to use emotion regulation strategies for reducing psychological stress. Fourth, the authorities need to emphasize the role of family support during this epidemic, increase opportunities for frontline prison police to communicate with family members, so as to avoid their psychological disorders caused by closed information between each other. Fifth, our government and relevant authorities should strengthen the psychological evaluation, online psychological counseling, psychological crisis prevention and intervention of frontline prison police during epidemic control and in the future.
There have been several limitations in present study, which were as follows: (1) our respondents were all from China, which might not fully represent the mental health status of frontline prison police around the world. (2) Given the particularity and complexity of COVID-19 epidemic prevention and control, we have conducted an online survey using snowball sampling approach, which the participants were limited to using smartphones or computers with network link service. Moreover, the prison police on duties might be overworked, leading to the consequence that many shared links were not responded. (3) The mental health problems of frontline prison police might have been biased due to recall and selection bias in self-reports on the individual’s physical and mental health. (4) This study have employed cross-sectional design, so only association analyses allowed and causal inferences could not be made, and it only revealed the psychological status of frontline prison police during a certain period of epidemic control. Future research should adopt longitudinal design to evaluate the long-term psychological implications of the epidemic through exploring multiple time points.