Medical Mistrust in Perinatal Mental Health : Harvard Review of Psychiatry

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Perspectives

Medical Mistrust in Perinatal Mental Health

Conteh, Nkechi MBBS, MPH; Gagliardi, Jane MD, MHS; McGahee, Shunda MD; Molina, Rose MD, MPH; Clark, Crystal T. MD; Clare, Camille A. MD, MPH

Author Information

From Harvard Medical School (Drs. Conteh, Molina, and McGahee); Department of Psychiatry, Massachusetts General Hospital, Boston, MA (Dr. Conteh); Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC (Dr. Gagliardi); Beth Israel Lahey Health Behavioral Services, Danvers, MA (Dr. McGahee); Department of Obstetrics, Gynecology and Reproductive Biology, Beth Israel Deaconess Medical Center, Boston, MA (Dr. Molina); Department of Psychiatry and Asher Center (Dr. Clark), and Department of Obstetrics and Gynecology (Dr. Clark), Northwestern Feinberg School of Medicine; Department of Obstetrics and Gynecology, SUNY Downstate Health Sciences University (Dr. Clare).

Original manuscript received 27 December 2021; revised manuscript received 21 April 2022, accepted for publication 25 May 2022.

Correspondence: Nkechi Conteh MBBS, MPH, Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114. Email: [email protected]

Harvard Review of Psychiatry 30(4):p 238-247, 7/8 2022. | DOI: 10.1097/HRP.0000000000000345

Abstract

Despite the advancement of telemedicine and recent innovations in treatment, minoritized women continue to bear a disproportionate burden of pregnancy-related psychiatric conditions and complications, which the pandemic has further exacerbated. Research demonstrates that medical mistrust and systemic racism play central roles in the underutilization of services by racially and ethnically diverse women during pregnancy and postpartum. To effectively address these disparities, it is imperative to understand the drivers of medical mistrust in perinatal health care systems. This Perspectives article describes the historical context of medical mistrust in psychiatric and obstetric health systems and offers solutions to mitigate mistrust and the impact of systemic racism on perinatal care.

© 2022 President and Fellows of Harvard College

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