Pederson Aderonke Bamgbose, McLaughlin Claire, Hawkins Devan, Jain Felipe A, Anglin Deidre M, Yeung Albert, Tsai Alexander C
Depression Clinical and Research Program, Department of Psychiatry (Pederson, Jain, Yeung), and Center for Global Health (Tsai), Massachusetts General Hospital, Boston; Harvard Medical School (Pederson, Jain, Yeung, Tsai) and Harvard T.H. Chan School of Public Health (McLaughlin), Boston; School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston (Hawkins); Department of Psychology, City College of the City University of New York, New York City (Anglin).
Psychiatr Serv. 2025 Apr 1;76(4):318-325. doi: 10.1176/appi.ps.20240016. Epub 2025 Jan 17.
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.
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.
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.
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.
成年黑人经历的抑郁症比成年白人更严重，但他们接受心理健康专业人员治疗的可能性较小。本研究旨在探讨医疗不信任或信任与寻求心理健康护理意愿之间的关系。
作者对1043名美国成年黑人进行了一项在线横断面调查。主要关注变量为医疗不信任（通过12项基于群体的医疗不信任量表；GBMMS进行测量）以及从一般求助问卷中衍生出的一个单项，该单项评估寻求心理健康护理的意愿。作者假设不信任与向心理健康专业人员寻求帮助的意愿呈负相关。为了估计不信任程度与寻求护理意愿之间的关联，采用对数链接拟合伽马回归模型，并对年龄、种族身份或出身、教育程度、保险状况、个人收入、公民身份以及在美国的居住时长进行分析调整。
在医疗不信任程度较低（GBMMS得分≤3）时，不信任程度的增加与寻求心理健康护理的概率增加显著相关（率比[RR]=1.55，p<0.001）。在医疗不信任程度较高（GBMMS得分>3）时，不信任程度的增加与寻求护理的减少相关（RR=0.74，p<0.001）。医疗信任也观察到类似模式。
在成年黑人医疗不信任程度较低时，令人意想不到的是，不信任程度每增加一个单位，与向心理健康专业人员寻求护理的意愿增加相关。
