Although research has shown that moral distress harms mental health in diverse populations, information on potential moderators of such associations is scarce. In a sample of sub-Saharan African nurses, we examined the link between moral distress and depressive symptoms. We explored for whom and when such relationships may hold with regard to gender, age, and work experience. Participants consisted of 398 nurses drawn from a tertiary healthcare institution in southeastern Nigeria. Data were collected using the Moral Distress Questionnaire (MDQ) for clinical nurses, and the Center for Epidemiological Studies Depression Scale Revised (CEDS-R). Hayes regression-based macro results for the moderation effects indicated that the association of high moral distress with increased depressive symptoms was robust for women but not significant for men. Although older age and higher years of nursing experience were associated with reduced symptoms of depression, nurses’ age and years of work experience did not moderate the relationship between moral distress and depressive symptoms. To promote mental well-being and preserve the integrity of nurses, gender-based differentials in how morals contribute depressive symptoms should be considered in policy and practice.

Suicide remains a critical global mental health challenge, disproportionately affecting low- and middle-income countries where access to formal mental health services is limited. In such contexts, including sub-Saharan Africa, individuals in crisis often turn first to faith leaders. Clergy frequently encounter suicidal crises and serve as initial points of contact, yet there is little empirical evidence on their comfort or competence in responding to such crises. Our study examined clergy’s self-reported comfort and competence in handling suicidal crises, thereby addressing a critical gap in understanding clergy’s readiness for frontline suicide prevention in Nigeria. Participants were 253 Catholic clergy (all Black men; ages 27–72, M = 44.58, SD = 9.95) who completed a questionnaire form during monthly recollections and annual retreats for priests in eight Nigerian dioceses between June and October 2024. All participants reported having intervened in cases of suicidal thoughts or attempts. An ordinal logistic regression was applied for the data analysis. Findings indicated that roughly 40% felt comfortable or very comfortable and about 50% felt competent or very competent during the interventions. Findings showed that clergy who felt more comfortable were 2.34 times more likely to feel competent, after adjusting for age, years of experience in priestly work, additional academic qualification, annual number of individuals with suicidal thoughts requesting assistance, annual number of individuals with a suicide attempt requesting assistance, and annual number of suicide-related funerals. Results highlight the need for mandatory, structured suicide prevention training to strengthen clergy capacity in Nigeria and other low- and middle-income countries.