Medical Mistrust and Willingness to Use Mental Health Services Among a Cohort of Black Adults.

OBJECTIVE

Black adults experience depression that is more severe than that of their White counterparts, yet they are less likely to receive treatment from a mental health professional. This study aimed to examine the relationships between medical mistrust or trust and the willingness to seek mental health care.

METHODS

The authors conducted an online cross-sectional survey of 1,043 Black adults in the United States. The primary variables of interest were medical mistrust (measured via the 12-item Group-Based Medical Mistrust Scale; GBMMS) and a single item, derived from the General Help-Seeking Questionnaire, that assessed willingness to seek mental health care. The authors hypothesized that mistrust would have a negative correlation with willingness to seek help from a mental health professional. To estimate the association between level of mistrust and willingness to seek care, gamma regression models were fitted with a log link, and the analyses were adjusted for age, ethnic identity or origin, education, insurance status, personal income, citizenship status, and length of time in the United States.

RESULTS

At low levels of medical mistrust (GBMMS scores ≤3), an increase in mistrust was significantly associated with an increase in the probability of seeking mental health care (rate ratio [RR]=1.55, p<0.001). At high levels of medical mistrust (GBMMS scores >3), an increase in mistrust was associated with a decrease in care seeking (RR=0.74, p<0.001). Similar patterns were observed for medical trust.

CONCLUSIONS

At low levels of medical mistrust among Black adults, each unit increase in mistrust was counterintuitively associated with an increase in willingness to seek care from a mental health professional.