Black adults who have a low level of mistrust toward medical professionals may be more willing to seek mental health services than those with no medical mistrust, reports a study published today in Psychiatric Services. Above a certain threshold, however, more medical mistrust was linked with less mental health care seeking.
“This finding suggests that a certain degree of wariness may have a counterintuitive positive effect in terms of promoting mental health care,” wrote Aderonke Bamgbose Pederson, M.D., of Harvard Medical School, and colleagues. “Patients with high levels of trust may not feel the need to seek mental health services, because they feel their clinicians will make decisions on their behalf and will tell them whether such services are needed.”
Pederson and colleagues conducted an online survey of 1,043 Black adults living in the United States. Participants completed the Group-Based Medical Mistrust Scale, which includes eight questions about negative feelings toward doctors and health care workers (mistrust) and four questions asking whether respondents receive the same care as other ethnicities (trust); all answers were on a five-point scale. Participants were also asked how likely they would be—on a seven-point scale—to seek help from a mental health professional for personal or emotional problems or for suicidal ideation.
After adjusting for sociodemographic factors such as age, education level, and citizenship status, the researchers found that among Black adults with an average mistrust score of three or less, each unit increase of medical mistrust was associated with a 55% increased likelihood of seeking help for a personal or emotional problem and a 44% increased likelihood of seeking help for suicidal ideation. Above a score of three, each unit increase of medical mistrust decreased the likelihood of mental health care seeking by 25% for both issues. A similar pattern was seen for the trust-related questions, wherein adults with the highest medical trust scores reported a lower likelihood of mental health care seeking.
“In light of our findings, acknowledging and addressing medical mistrust may have more benefit in improving health-seeking behavior, and perhaps health outcomes, than would eliminating mistrust,” Pederson and colleagues wrote. “In addition, an approach that prioritizes institutional reform might avoid placing the burden of overcoming mistrust on the population that has experienced systemic marginalization.”
For more information, see the Psychiatric News article “From Competence to Humility: Advancing Culturally Responsive Mental Health Care.”
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