The Multifactor Institutional Mistrust Scale: Do Black Americans Hold Beliefs of Mistrust Toward Mainstream Institutions That Serve as a Barrier to Seeking Mental Health Treatment?

Abstract

Previous research has shown that Black Americans tend to have lower utilization rates of mental health services than White Americans, despite higher persistence and severity of mental health disorders in the Black community. Past researchers have attributed this behavior to many structural and psychological barriers, such as finances, stigma, lack of culturally competent care, stereotype threat, etc. The current study presents a framework in which the group-based development of mistrust toward mainstream institutions particularly those involving medicine, public safety, and education serves as a barrier to mental health help-seeking behaviors in the Black community. Developing a cross-sectional institutional mistrust scale called the Multifactor Institutional Mistrust Scale (MIMS), the study found that the three subscales were reliable measures of mistrust but were weak predictors of help-seeking behaviors. Further analysis revealed a significant link between mistrust in medical, public safety, and education contexts, empirically establishing the construct of institutional mistrust. Black Americans were found to have higher institutional mistrust scores than White Americans. Still, mistrust scores of White Americans were significant predictors of mental health help-seeking behaviors while that of Black Americans were not. Potential explanations for this are discussed, namely the possibility that fear of authority in such contexts influences help-seeking behaviors.