Pederson Aderonke Bamgbose, Azman Ayla, Stephens Jasmin Brooks, Hawkins Devan
Massachusetts General Brigham-Harvard University.
University of Washington.
Res Sq. 2025 Jul 15:rs.3.rs-6959283. doi: 10.21203/rs.3.rs-6959283/v1.
Major depressive disorders are ranked third in the global burden of disease by the World Health Organization. The association between mistrust in Black adults and its effect on health service utilization is well established. However, research on mistrust and specific utilization of mental health services is limited. This study examines role of medical mistrust and depressive symptoms on mental health service utilization.
We conducted an online cross-sectional survey among Black adults ( = 1042) using the Group-Based Medical Mistrust Scale, the General Help-Seeking Questionnaire, and the Patient Health Questionaire-9. Gamma regression models were used to assess the relationship between medical mistrust and its association with willingness to use mental health services. We added depressive symptoms to the model to assess whether depressive symptoms may mediate the primary association.
Black adults with moderate levels of mistrust reported increasing levels of willingness to seek help (RR = 1.40; 95%CI 1.28, 1.53; p < 0.001 and RR = 1.50; 95%CI 1.38, 1.64; p < 0.001), whereas Black adults at the highest level of mistrust were less likely to seek help from a mental health professional (RR = 1.23; 95%CI = 1.13, 1.34; p < 0.001). The inclusion of depressive symptoms in the model resulted in a 9.5% average decrease in willingness to seek help from a mental health professional.
Depressive symptoms may have a mediating effect on medical mistrust and its association with willingness to seek mental health services for Black adults. Interventions designed to increase service utilization and engagement should consider the role of medical mistrust and the role of depressive symptoms.
世界卫生组织将重度抑郁症列为全球疾病负担的第三位。黑人成年人中的不信任感及其对医疗服务利用的影响之间的关联已得到充分证实。然而，关于不信任感与心理健康服务的具体利用情况的研究有限。本研究考察了医疗不信任感和抑郁症状在心理健康服务利用中的作用。
我们使用基于群体的医疗不信任量表、一般求助问卷和患者健康问卷-9对1042名黑人成年人进行了在线横断面调查。使用伽马回归模型评估医疗不信任感及其与使用心理健康服务意愿之间的关系。我们将抑郁症状添加到模型中，以评估抑郁症状是否可能介导主要关联。
中度不信任水平的黑人成年人寻求帮助的意愿有所增加（风险比=1.40；95%置信区间1.28，1.53；p<0.001；风险比=1.50；95%置信区间1.38，1.64；p<0.001），而不信任感最高水平的黑人成年人向心理健康专业人员寻求帮助的可能性较小（风险比=1.23；95%置信区间=1.13，1.34；p<0.001）。在模型中纳入抑郁症状后，向心理健康专业人员寻求帮助的意愿平均下降了9.5%。
抑郁症状可能对黑人成年人的医疗不信任感及其与寻求心理健康服务意愿之间的关联具有中介作用。旨在提高服务利用率和参与度的干预措施应考虑医疗不信任感的作用以及抑郁症状的作用。
