A Community-based Cross-sectional Study of a Tiered Mental Health Support Model for Frontline Workers in Andhra Pradesh during the COVID-19 Pandemic.

The COVID-19 pandemic caused significant psychological stress among frontline workers. To address this, our institute, in collaboration with UNICEF, established a Psycho-Social Counselling (PSC) system in Andhra Pradesh to provide timely mental health support and promote well-being. The study aimed to assess the prevalence of psychological stress among frontline workers during COVID-19 pandemic using a structured mental health screening model and to conduct capacity-building programmes for prevention of psychosocial problems among healthcare workers. A community-based cross-sectional study using a locally adapted and validated Mental Health Screening Questionnaire (MHSQ) was conducted among frontline workers. Participants scoring ≥6 underwent detailed evaluation. Counselling helpline services and statewide mental health awareness sessions were conducted to support coping strategies among frontline workers. Among 8,219 participants, 1,468 (17.86%) had high-risk MHSQ scores (≥6). Of these, 673 (45.8%) underwent detailed evaluation; 455 (5.53%) received counselling and 218 (2.65%) required psychiatric management. Anxiety (45%) and insomnia (42%) were most common, followed by depression (12%) and substance use disorders (2%). Approximately 4,500 healthcare workers also received offline training. The PSC model demonstrated the feasibility of a structured, multi-tier approach for early identification and timely psychosocial support during public health emergencies.