As the understanding of mental illness has shifted from interpretations rooted in moral deficiency or demonic influence to a medical condition amenable to scientific treatment (1), the role of psychiatrists has transitioned from marginalization to becoming a crucial component of societal stability. Despite this progress, psychiatric healthcare professionals remain disproportionately affected by workplace violence (2). Evidence on mental health among clinicians further shows that psychiatrists experience higher rates of depression than many other medical specialists (3). In China, nearly one-fifth of psychiatrists report an intention to leave the profession (4). In addition, they face a constellation of challenges, including burnout (5) and persistent professional stigma (6–8), all of which exert sustained negative effects on their professional lives. Therefore, exploring the current state of decent work among psychiatrists and the factors associated with it not only contributes to understanding their position in modern society but also offers a theoretical basis for supporting their rights.

The International Labor Organization (ILO) formally introduced the concept of “decent work” in 1999, defining it as employment that ensures freedom, equity, security, and dignity for all workers (9). Although early research in healthcare settings has examined decent work among psychiatric nurses, considerably less attention has been given to psychiatrists, whose professional environment differs substantially from that of other medical groups. In China, psychiatrists face pronounced occupational stressors, including elevated rates of workplace violence and burnout (10, 11). Therefore, ensuring decent work for psychiatrists is therefore not only essential for respecting and protecting their individual rights but also a necessary component of the sustainable development of the mental health sector.

The importance of self-control for individual well-being and career success has received considerable scholarly attention. Self-control, defined as the capacity to inhibit impulses and act in accordance with social norms, has been linked to behavioral problems and antisocial tendencies when insufficient (12). In occupations that place high demands on self-control, such as the service sector, the inability to meet these demands can result in burnout and emotional exhaustion (13). Individuals with stronger self-control are also more likely to engage in organizational citizenship behaviors that benefit both their colleagues and the broader organization (14). Psychiatrists work in environments characterized by high levels of emotional pressure, complex clinician–patient interactions, and continuous advances in medical knowledge. These challenges often generate feelings of overload and diminished control (15, 16). Thus, strengthening self-control among psychiatrists may therefore help them regulate their emotions and behaviors more effectively, promoting better adaptation to the rapidly evolving healthcare environment.

Career adaptability refers to the psychological resources and self-regulatory capacities individuals draw upon when responding to current and anticipated career tasks, challenges, transitions, and major life events (17). It is regarded as a flexible psychological resource that enables individuals to navigate career-related changes and supports continuous professional development (18). Prior research has shown that career adaptability directly contributes to higher levels of work engagement among healthcare professionals and is associated with a stronger orientation toward happiness (19). It has also been linked to turnover intentions, suggesting that individuals with higher adaptability are less likely to consider leaving their jobs (20). Furthermore, a meta-analysis demonstrated that career adaptability is significantly related to a range of psychological and dispositional variables, including cognitive ability, self-esteem, core self-evaluation, proactive personality, future orientation, hope, and optimism (21). However, existing research on career adaptability has primarily focused on populations such as university students (22), employees in organizational settings (23), and nurses (24). Studies examining career adaptability among psychiatrists remain limited, highlighting a need for further investigation within this professional group.

The Psychology of Working Theory (PWT) offers a theoretical basis for examining how self-control and career adaptability relate to perceptions of decent work. PWT positions decent work at the center of its framework and explains how individuals obtain work experiences that meet basic survival needs, social connection needs, and self-determination needs. The theory proposes that economic constraints and marginalization influence work volition and career adaptability, and these constructs are associated with the attainment of decent work (25). From a functional perspective, self-control represents a foundational psychological capacity that enables the effective enactment of career adaptability (17). Within the PWT framework, career adaptability is conceptualized as a key mechanism through which individuals navigate structural constraints to achieve decent work. In occupations characterized by high emotional demands and uncertainty, individuals with higher levels of self-control are better able to sustain goal-directed occupational behavior and regulate emotional responses to role conflict and complex work requirements, thereby facilitating the development and mobilization of career adaptability (26, 27). In turn, individuals with greater career adaptability are more capable of managing occupational stressors, coordinating external constraints with personal career goals, and maintaining functional and sustainable work performance, which enhances their perceptions of work quality and decency (28). Accordingly, we propose that self-control indirectly influences perceptions of decent work through its support of career adaptability, with career adaptability serving as a mediating mechanism in this relationship.

In psychiatric clinical practice, perceptions of decent work are shaped by various structural factors such as workload, institutional regulations, and clinical risk, many of which are difficult for individuals to change in the short term. The PWT emphasizes the role of psychological processes and identifies career adaptability as a key mechanism through which individuals construct experiences of decent work under structural constraints (29). As a psychological resource, self-control does not directly alter external conditions but enables individuals to regulate attention, emotional responses, and behavior in stressful situations (30). This regulatory capacity serves as a foundation for adaptive career behaviors and is closely related to career adaptability (17, 31). Career adaptability reflects the extent to which individuals mobilize internal resources to respond to external constraints by demonstrating concern for the future, maintaining behavioral control, exploring opportunities, and building confidence, which contributes to the development of subjective perceptions of decent work (32).

In summary, existing literature and theoretical perspectives suggest that self-control and career adaptability are important personal resources associated with decent work. However, empirical studies exploring these associations among psychiatrists remain limited. Guided by the PWT framework, this study examines the relationships among self-control, career adaptability, and perceptions of decent work among psychiatrists. This research provides theoretical insights into psychiatrists’ work experiences in high-pressure and complex clinical environments and offers practical implications for enhancing their professional well-being and supporting the sustainability of mental health service systems.

In this study, several sociodemographic and psychological factors were associated with psychiatrists’ perceptions of decent work. Professional title and monthly income showed significant relationships with decent work, indicating that individuals with higher professional status and higher earnings tend to report a more favorable perception of their work conditions. Psychological variables also played an important role. Both self-control and career adaptability were positively related to perceptions of decent work. Moreover, self-control demonstrated both direct and indirect associations with decent work through career adaptability. This pattern suggests that individuals with higher self-control may develop stronger career adaptability, which in turn contributes to a higher perception of decent work. In sum, career adaptability serves as a meaningful explanatory mechanism linking self-control to psychiatrists’ evaluations of the quality and dignity of their work.

The associations between professional title, income level, and perceptions of decent work align with patterns documented in prior research and extend the understanding of decent work within the psychiatric workforce. Senior physicians generally possess greater clinical experience and domain-specific expertise, which enables them to make informed long-term decisions, manage complex diagnostic and therapeutic challenges, and exercise higher levels of autonomy and authority. These factors enhance their professional standing and the recognition they receive (38). It is noteworthy that after career adaptability was included in the model, the association between professional title and perceptions of decent work was no longer statistically significant. This finding suggests that the initial differences observed between resident physicians and attending physicians may, to some extent, be attributable to underlying psychological resources rather than professional rank alone. In China, psychiatrists across different professional titles are often exposed to similarly high levels of workload, sustained emotional labor, elevated clinical risk, and stringent institutional constraints (39, 40). Under such conditions, individual differences in career adaptability may play a more proximal role than hierarchical status in shaping psychiatrists’ subjective perceptions of work quality, dignity, and decency. Similarly, higher monthly income was strongly linked to a greater sense of decent work, consistent with findings from research conducted in nursing (41). Economic remuneration plays a central role in shaping whether individuals feel fairly rewarded for their contributions. Evidence from China indicates that low wages are among the top three contributors to job dissatisfaction among psychiatrists (42). The literature further highlights that income is closely related to perceptions of fairness and the capacity to maintain a reasonable standard of living, both of which are integral components of decent work (25). Professional status and adequate financial compensation are also key determinants of job satisfaction among healthcare professionals, suggesting that improvements in decent work conditions may simultaneously enhance psychiatrists’ job satisfaction and retention (10).

Moreover, the findings of this study indicate that self-control constitutes an important factor associated with psychiatrists’ perceptions of decent work. Self-control is closely associated with intrinsic motivation and effective self-regulation strategies and has been conceptualized as a psychological resource that supports sustained task performance (43). In psychiatric practice, clinicians routinely encounter emotionally charged and cognitively demanding situations. Self-control requirements such as emotion regulation and distraction management form a substantial part of their daily work. Previous research has shown that when self-control demands accumulate or are poorly managed, they are associated with higher stress levels and reduced well-being among clinicians (44, 45). These findings indicate that greater emphasis should be placed on the role of self-control within the mental health workforce. Developing targeted interventions that enhance self-regulatory skills may enable psychiatrists to navigate professional development more effectively and mitigate stress-related challenges inherent in their clinical work.

This study also indicates that career adaptability is closely associated with psychiatrists’ perceptions of decent work, a finding consistent with prior research in the teaching profession (46). Career adaptability is conceptualized as a self-regulatory resource; individuals with higher levels of adaptability tend to experience fewer negative outcomes, which contributes to reduced stress and higher job satisfaction. (47). In contrast, lower career adaptability has been associated with a reduced likelihood of engaging in decent work (48). For psychiatrists, who frequently encounter complex clinical demands and emotionally intensive practice environments, career adaptability functions as an important psychological resource that supports well-being and a sense of professional fulfillment.

Finally, the results of this study show that career adaptability mediates the relationship between self-control and decent work, lending further support to the PWT. Self-control is critical in professional contexts because it enables individuals to regulate their behaviors and emotions effectively It helps professionals respond thoughtfully to challenging situations, avoid impulsive reactions, and remain focused on long-term objectives rather than short-term distractions (49, 50). This capacity facilitates continuous improvement, goal attainment, and sustained career development. Enhanced career adaptability, in turn, positively shapes individuals’ perceptions of decent work by aligning their work experiences with personal values and long-term career goals (51). Moreover, the mediation effect was moderate in size (β = 0.245), indicating that career adaptability plays an important role in the process through which self-control is reflected in psychiatrists’ perceptions of decent work. Given the emotional demands and cognitive complexity inherent in psychiatric practice, individuals who are able to regulate their emotions and behaviors effectively may be better positioned to develop adaptive strategies that support more positive work experiences. In this context, career adaptability functions as a meaningful psychological resource rather than a peripheral factor and contributes to how psychiatrists understand the quality, dignity, and sustainability of their professional work. Therefore, managers play a pivotal role in cultivating environments that support the development of self-control and career adaptability. Such efforts may contribute to strengthening psychiatrists’ perceptions of decent work and enhancing their overall professional well-being.

Finally, the results of this study indicate that career adaptability mediates the relationship between self-control and perceptions of decent work, which is consistent with our proposed hypothesis (25). While prior research has primarily conceptualized career adaptability as a psychological resource that directly facilitates access to decent work (32), the present findings further suggest that the effective enactment of career adaptability is closely linked to individuals’ capacity for self-control. Self-control enables individuals to maintain stable behavioral engagement and regulate emotional responses in work contexts characterized by high emotional demands and substantial uncertainty, thereby providing the necessary conditions for the development and activation of career adaptability (49). The mediating effect of career adaptability was of moderate magnitude (β = 0.245), indicating that it plays a meaningful role in the pathway through which self-control relates to psychiatrists’ perceptions of decent work. Career adaptability has been widely recognized as a key psychological resource supporting career sustainability, subjective well-being, and experiences of decent work (28, 41). Under conditions of high emotional labor, clinical uncertainty, and structural constraints faced by psychiatrists, career adaptability not only facilitates sustained occupational engagement and goal-directed behavior but also helps buffer occupational stress, reduce the risk of burnout, and enhance perceptions of work meaning and dignity (28, 52). Accordingly, managers who promote the development of self-control and career adaptability are better positioned to enhance psychiatrists’ perceptions of decent work and support their sustained professional well-being.

In conclusion, this study offers important insights into factors associated with psychiatrists’ perceptions of decent work in China. The results highlight the contribution of sociodemographic characteristics, such as income and professional title, as well as psychological attributes, including self-control and career adaptability. These findings provide direction for efforts aimed at improving the working conditions of psychiatrists and support the long-term sustainability of mental health services.