Background: Healthcare workers are increasingly exposed to occupational stressors that predispose them to poor mental wellbeing and burnout, particularly in resource-constrained public health settings. Understanding staff mental wellness needs is essential for informing effective institutional wellness interventions.

Objective: This study assessed the prevalence of work-related stress and burnout, coping mechanisms, utilization of mental health services, and staff perceptions regarding the need for a structured wellness program at Machakos County Referral Hospital.

Methods: A descriptive cross-sectional study was conducted among 182 clinical and non-clinical staff members. Data were collected using a structured self-administered questionnaire covering demographic characteristics, stress frequency, mental wellbeing, burnout experience, coping strategies, organizational support, awareness and utilization of mental health services, and preferred wellness interventions. Descriptive statistics and chi-square tests were used for data analysis.

Results: Work-related stress was highly prevalent, with 91.2% of respondents reporting feeling stressed at least sometimes. Burnout was nearly universal, reported by 93.4% of participants. Only 7.1% rated their mental wellbeing as excellent, while 20.3% rated it as poor or very poor. High workload, lack of support, and lack of recognition were the most cited contributors to burnout. Gender, age, employment type, job role, and years of service were not significantly associated with burnout (p > 0.05). Coping strategies were predominantly informal, including talking to colleagues, rest, and prayer, while professional mental health service utilization was low (15.4%), mainly due to confidentiality concerns and fear of stigma. Despite moderate awareness of available services (65.9%), utilization remained limited. A strong majority (92.9%) expressed the need for a structured staff wellness program, with stress management workshops and recreational activities being the most preferred interventions.

Conclusion: There is a high burden of stress and burnout among staff at Machakos County Referral Hospital, coupled with low utilization of formal mental health services. Staff demonstrate strong readiness for structured wellness interventions. Institutional investment in comprehensive, confidential, and accessible staff wellness programs is urgently required to promote workforce wellbeing and sustain quality healthcare delivery.