The hidden mental health burden of corruption in healthcare: Findings from a scoping review and key informant interviews

Corruption in healthcare is a pervasive global challenge that undermines equity, efficiency, and trust in health systems. Whilst its economic and governance impacts are well documented, the psychological consequences for patients, providers, and those involved in anti-corruption reform remain under-explored. Understanding these mental health effects is critical for designing anti-corruption strategies that safeguard wellbeing and strengthen health systems. An exploratory mixed-methods study was conducted to map an emerging evidence base. A scoping review of 25 peer-reviewed and grey literature sources was complemented by four key informant interviews, which were used to interpret and contextualise the review findings. Findings were synthesised into a conceptual framework mapping pathways between corruption and mental health outcomes. Corruption was reported to be associated with psychological distress among patients, providers, and anti-corruption actors. This included stress, anxiety, depressive symptoms, and moral injury. At a community level, corruption eroded trust and collective agency, whilst institutional effects included normalisation of unethical practices. Structural determinants were found to perpetuate corruption's harms. Anti-corruption efforts produced mixed outcomes: reform targeting high-level officials improved public mental health modestly, whereas punitive measures against frontline workers exacerbated fear and demoralisation in the workforce. Protective factors such as moral agency, and robust reporting systems were found to buffer harm but were context dependent. Policy recommendations are made for practice, research and capacity building. These include framing corruption as a public mental health issue, strengthening whistleblower protections, commissioning further research, and adapting reform to local political economy and social norms. These findings indicate that corruption is a plausible but under-recognised social determinant of mental health requiring further research. Integrating mental health considerations into anti-corruption policy and health system reforms is essential to mitigate harm and strengthen resilience.