Addressing Medical Mistrust in In-Patient Psychiatric African American (AA) Patients

Abstract Background: Medical Mistrust (MM) is associated with patient dissatisfaction, treatment nonadherence, and poor health outcomes. In the United States, MM is prevalent in African American patients in In-Patient Psychiatric settings. Caregiver training and education on MM and cultural sensitivity can help identify mistrust and provide strategies to increase trust and reduce mistrust. Purpose: The aim of this project was to implement an educational tool to improve caregiver awareness about knowledge of MM. By doing so, it was the goal to enhance cultural sensitivity skills and patient-centeredness in the African American population at the adult psychiatric unit in Northwest hospital, Maryland. Ultimately, the goal was to minimize mistrust and enhance trust between caregivers and their patients. Methods: Literature review was conducted which provided evidence-based information. An educational material was designed from the available literature and was presented to psychiatric caregivers. A pretest-posttest questionnaire design was used to evaluate the impact of the evidence-based educational intervention on caregivers in this setting. Most importantly, the questionnaires were for informative purposes- about the positive effect of the educational intervention. Intervention: An educational intervention about MM and strategies to decrease it in African American patients with mental disorders was delivered via zoom and a cloud link. A pre and post-test questionnaire (Medical mistrust caregiver survey) comprising three sections was used to detect changes in the caregivers’ awareness and knowledge about MM and strategies to improve caregiver-patient trust before and after the educational intervention. Results: The project participants were 34 psychiatric caregivers. An analysis of the data results showed a slight improvement in the awareness and knowledge of MM among the participants. There was an overall increase in the post questionnaire correct responses. The percentage of correct answers in part of the pre questionnaire was 82.0 %; it increased to 86.6 % in the post questionnaire. The importance of this educational session as shown in the results is that it created an awareness about MM and minimization strategies on AA patients in the in-patient psychiatric unit. Conclusion: There was a slight increase in caregiver awareness and knowledge about MM and practices that help improve caregiver-patient trust. Therefore, implementing an educational session about MM on AA patients to psychiatric caregivers raises an awareness of MM and reduces distrust with caregivers and their patients. However, more sensitization and strategies will help to reduce distrust with caregivers and their patients. Keywords: Medical mistrust, psychiatry, education, knowledge, awareness, cultural sensitivit