Introduction: The COVID -19 pandemic significantly impacted the mental health and wellbeing of healthcare workers worldwide. This study examined the prevalence and predictors of self -reported mental health problems, specifically depression, anxiety, stress, and burnout among government healthcare professionals in Brunei Darussalam during the second and subsequent waves of the pandemic. Materials and Methods : A cross -sectional online survey was distributed to all government healthcare workers employed by the Ministry of Health in Brunei Darussalam. The survey collected sociodemographic information and applied two validated tools: the Depression Anxiety Stress Scale 21 -item version (DASS -21) to assess the depression, anxiety, and stress, and the Oldenburg Burnout Inventory (OLBI) to measure burnout. Results : Of 1,759 invited healthcare workers, 704 responded (response rate 40.0%). The prevalence of common mental health problems and burnout were 32.4% and 71.7%, respectively. Older age was protective against common mental health problems. Performing clinical duties outside one's training scope, and direct involvement in managing COVID -19 patients were significant predictors of common mental health problems. Expatriate staff had significantly lower odds of burnout compared to Bruneian nationals. Shift work and additional administrative duties independently predicted burnout. A history of mental health problems and difficulty accessing mental health support were strongly associated with both outcomes. Conclusions : This study identified a substantial burden of depression, anxiety, stress, and burnout among government healthcare professionals in Brunei Darussalam, with distinct vulnerable subgroups. These findings highlight the need for targeted mental health interventions, improved access to support services, and systemic workplace strategies to safeguard the wellbeing of the healthcare workforce. The Brunei International Medical Journal (BIMJ) is a peer -reviewed official publication of the Ministry of Health and Universiti Brunei Darussalam, under the auspices of the Clinical Research Unit, Ministry of Health, Brunei Darussalam. The BIMJ publishes articles ranging from original research papers, review articl es, medical practice papers, special reports, audits, case reports, images of interest, education and technical/innovation papers, editorials, commentaries, and letters to the Editor. Topics of interest include all subjects related to clinical practice and research in all branches of medicine, both basic and clinical, including topics related to allied health care fields. The BIMJ welcome s manuscripts from contributors but usually solicits review articles and special reports. Proposals for review papers can be sent directly to the Managing Editor. Please refer to the contact inf ormation of the Editorial Office. DISCLAIMER: All articles published, including editorials and letters, represent the opinions of the contributors and do not reflect the o fficial views or policies of the Clinical Research Unit, the Ministry of Health, or the institutions with which the contributors are affiliated, unless clearly stated. The appearance of advertisements does not constitute an endorsement by the Clinical Research Unit or the Ministry of Health, Brunei Darussalam. Furthermore, the publisher cannot accept responsibility for the c orrectness or accuracy of the advertisers' text, claims, or any bimjonline@gmail.com www.bimjonline.com Author Details: 1 Psychiatry Services, Ministry of Health, Brunei Darussalam 2 Dorset Healthcare University NHS Foundation Trust, United Kingdom 3 Community Psychology Division, Ministry of Health, Brunei Darussalam 4 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam 5 Department of Forensic Psychiatry, NHS Forth Valley, United Kingdom 6 Primary Health Care, Ministry of Health, Brunei Darussalam 25 Mikhail SOLIMAN1,2*, Fauziyyah MANAP3, Nur Syahirah CHUA3, Rina RAHMAD3, Hjh Rozailah RAHMAN3, Hanif ABDUL RAHMAN4, Najib NAIBI6, Kartini TUDIN1, Hilda HO1,5

Introduction: The COVID -19 pandemic significantly impacted the mental health and wellbeing of healthcare workers worldwide. This study examined the prevalence and predictors of self -reported mental health problems, specifically depression, anxiety, stress, and burnout among government healthcare professionals in Brunei Darussalam during the second and subsequent waves of the pandemic. Materials and Methods : A cross -sectional online survey was distributed to all government healthcare workers employed by the Ministry of Health in Brunei Darussalam. The survey collected sociodemographic information and applied two validated tools: the Depression Anxiety Stress Scale 21 -item version (DASS -21) to assess the depression, anxiety, and stress, and the Oldenburg Burnout Inventory (OLBI) to measure burnout. Results : Of 1,759 invited healthcare workers, 704 responded (response rate 40.0%). The prevalence of common mental health problems and burnout were 32.4% and 71.7%, respectively. Older age was protective against common mental health problems. Performing clinical duties outside one's training scope, and direct involvement in managing COVID -19 patients were significant predictors of common mental health problems. Expatriate staff had significantly lower odds of burnout compared to Bruneian nationals. Shift work and additional administrative duties independently predicted burnout. A history of mental health problems and difficulty accessing mental health support were strongly associated with both outcomes. Conclusions : This study identified a substantial burden of depression, anxiety, stress, and burnout among government healthcare professionals in Brunei Darussalam, with distinct vulnerable subgroups. These findings highlight the need for targeted mental health interventions, improved access to support services, and systemic workplace strategies to safeguard the wellbeing of the healthcare workforce. The Brunei International Medical Journal (BIMJ) is a peer -reviewed official publication of the Ministry of Health and Universiti Brunei Darussalam, under the auspices of the Clinical Research Unit, Ministry of Health, Brunei Darussalam. The BIMJ publishes articles ranging from original research papers, review articl es, medical practice papers, special reports, audits, case reports, images of interest, education and technical/innovation papers, editorials, commentaries, and letters to the Editor. Topics of interest include all subjects related to clinical practice and research in all branches of medicine, both basic and clinical, including topics related to allied health care fields. The BIMJ welcome s manuscripts from contributors but usually solicits review articles and special reports. Proposals for review papers can be sent directly to the Managing Editor. Please refer to the contact inf ormation of the Editorial Office. DISCLAIMER: All articles published, including editorials and letters, represent the opinions of the contributors and do not reflect the o fficial views or policies of the Clinical Research Unit, the Ministry of Health, or the institutions with which the contributors are affiliated, unless clearly stated. The appearance of advertisements does not constitute an endorsement by the Clinical Research Unit or the Ministry of Health, Brunei Darussalam. Furthermore, the publisher cannot accept responsibility for the c orrectness or accuracy of the advertisers' text, claims, or any bimjonline@gmail.com www.bimjonline.com Author Details: 1 Psychiatry Services, Ministry of Health, Brunei Darussalam 2 Dorset Healthcare University NHS Foundation Trust, United Kingdom 3 Community Psychology Division, Ministry of Health, Brunei Darussalam 4 PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam 5 Department of Forensic Psychiatry, NHS Forth Valley, United Kingdom 6 Primary Health Care, Ministry of Health, Brunei Darussalam 25 Mikhail SOLIMAN1,2*, Fauziyyah MANAP3, Nur Syahirah CHUA3, Rina RAHMAD3, Hjh Rozailah RAHMAN3, Hanif ABDUL RAHMAN4, Najib NAIBI6, Kartini TUDIN1, Hilda HO1,5

Introduction:: Deliberate self-harm (DSH) is a common presentation to hospital emergency departments and general wards in Brunei. Patients who present with DSH are usually referred for a psychiatric assessment. Methods:: This study describes the demographic, social and clinical characteristics of patients who were referred to psychiatric services after an acute incident of DSH. An evaluation of the DSH methods used and situational factors was conducted. Outcomes included medical or surgical treatment, hospital and psychiatric admissions. Results:: 99 patients were referred between 1st October 2018 and 1st September 2020. 65 (65.7%) were female. The mean age was 26.6 years. The most common method of DSH was overdose of medication, followed by self-cutting. Females were significantly more likely to overdose than males. The most common situational factors were relationship and financial problems. Previous psychiatric history and chronic medical conditions were equally prevalent in about a quarter of participants. Most participants did not require a psychiatric admission. Conclusions: Female gender, young age, unemployment, recent history of DSH, previous psychiatric history, chronic medical conditions, relationship and financial problems, were identified as risk factors for DSH. The majority of people presenting with DSH required medical intervention, however only a small proportion required psychiatric admission. Although the majority of DSH incidents were unplanned, providing interventions for these high-risk groups may be helpful.