ArticleSocial psychiatry and psychiatric epidemiology2024
Trust of patients and families in mental healthcare providers and institutions: a cross-cultural study in Chennai, India, and Montreal, Canada.
Article in Social psychiatry and psychiatric epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 1 citations in OpenAlex.
- Health service utilization by people with psychosis during Peru's mental health reform and the COVID-19 pandemic: a population-based study.Lancet regional health. Americas · 2026Article
- Barriers, Facilitators, Attitudes, and Preferences Toward Digital Mental Health Interventions Among Patients with Severe Mental Illness and Their Caregivers: A Qualitative Exploration from a Low- and Middle-income Setting.Indian journal of psychological medicine · 2026Article
- Making early intervention for psychosis feasible in India: Lessons from two decades of SCARF's first episode psychosis program.Indian journal of psychiatry · 2025Article
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10 authors at 4 institutions in 4 countries.
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Abstract
purposeCross-cultural psychosis research has typically focused on a limited number of outcomes (generally symptom-related). It is unknown if the purported superior outcomes for psychosis in some low- and middle-income countries extend to fundamental treatment processes like trust. Addressing this gap, we studied two similar first-episode psychosis programs in Montreal, Canada, and Chennai, India. We hypothesized higher trust in healthcare institutions and providers among patients and families in Chennai at baseline and over follow-up.
methodsUpon treatment entry and at months 3, 12 and 24, trust in healthcare providers was measured using the Wake Forest Trust scale and trust in the healthcare and mental healthcare systems using two single items. Nonparametric tests were performed to compare trust levels across sites and mixed-effects linear regression models to investigate predictors of trust in healthcare providers.
resultsThe study included 333 patients (Montreal = 165, Chennai = 168) and 324 family members (Montreal = 128, Chennai = 168). Across all timepoints, Chennai patients and families had higher trust in healthcare providers and the healthcare and mental healthcare systems. The effect of site on trust in healthcare providers was significant after controlling for sociodemographic characteristics known to impact trust. Patients' trust in doctors increased over follow-up.
conclusionThis study uniquely focuses on trust as an outcome in psychosis, via a comparative longitudinal analysis of different trust dimensions and predictors, across two geographical settings. The consistent differences in trust levels between sites may be attributable to local cultural values and institutional structures and processes and underpin cross-cultural variations in treatment engagement and outcomes.
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