Lack of Trust in the Health-Care System After Losing a Child to Suicide
A Nationwide Population Survey
Abstract
Abstract.Background: Lack of trust in the health-care system after losing a child to suicide may prevent bereaved parents from seeking professional treatment when needed, thus diminishing their chances of recovery. Aims: This is the first large study to aim at evaluating the incidence of lack of trust in the health-care system and associated variables in suicide-bereaved parents. Method: This nationwide population-based survey included 569 parents who lost a child to suicide 2-5 years earlier and a matched comparison group of 326 nonbereaved parents. Using a study-specific questionnaire, we asked bereaved and nonbereaved parents if they trusted the health-care system and measured psychological and background variables. Results: Prevalence of lack of trust in the health-care system differed between the bereaved (46.5%) and the nonbereaved parents (18.3%), giving a relative risk of 2.5 (95% CI = 2.0-3.3). After multivariable modeling, high scores of depression, living in big cities, and being single were identified as variables associated with lack of trust in suicide-bereaved parents. Conclusion: Suicide-bereaved parents show lack of trust in the health-care system. We present possible effect modifiers that may be considered in professional interventions aiming at influencing suicide-bereaved parents' level of trust.
References
(2010). What has trust in the health-care system got to do with psychological distress? Analyses from the national Swedish survey of public health. International Journal for Quality in Health Care, 22, 250-258. 10.1093/intqhc/mzq024
(2006). Distrust of the health care system and self-reported health in the United States. Journal of General Internal Medicine, 21, 292-297. 10.1111/j.1525-1497.2006.00396.x
(2013). Parents bereaved by offspring suicide: A population-based longitudinal case-control study. JAMA Psychiatry, 70(2), 158-67. 10.1001/jamapsychiatry.2013.275
(2012). Vulnerable families' use of services: Getting what they need. Australian Social Work, 65, 571-585. 10.1080/0312407X.2012.689308
(2014). EPA guidance on building trust in mental health services. European Psychiatry, 29, 83-100. 10.1016/j.eurpsy.2014.01.001
(2003). Trust and the development of health care as a social institution. Social Science & Medicine (1982), 56, 1453-68. 10.1016/S0277-9536(02)00142-9
(2006). Trust in health care: Theoretical perspectives and research needs. Journal of Health Organization and Management, 20, 359-375. 10.1108/14777260610701768
(2001). Trust in physicians and medical institutions: What is it, can it be measured, and does it matter? The Milbank Quarterly, 79, 613-639. 10.1111/1468-0009.00223
(2006). Towards better measurements in bereavement research: Order of questions and assessed psychological morbidity. Palliative Medicine, 20, 11-16. 10.1191/0269216306pm1098oa
(2013). Comparison of health confidence in rural, suburban and urban areas in the UK and the USA: A secondary analysis. BMJ Open, 3. 10.1136/bmjopen-2013-002640
(2003). Helping people bereaved by suicide. BMJ (Clinical Research Ed.), 327(7408), 177-178. 10.1136/bmj.327.7408.177
(2004). Talking about death with children who have severe malignant disease. New England Journal of Medicine. 10.1056/NEJMoa040366
(2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606-613. 10.1046/j.1525-1497.2001.016009606.x
(2007). Social capital, institutional (vertical) trust and smoking: A study of daily smoking and smoking cessation among ever smokers. Scandinavian Journal of Public Health, 35, 460-467. 10.1080/14034940701246090
(2002). Contact with mental health and primary care providers before suicide: A review of the evidence. The American Journal of Psychiatry, 159(6), 909-916.
(2006). Green space, urbanity, and health: How strong is the relation? Journal of Epidemiology and Community Health, 60, 587-592. 10.1136/jech.2005.043125
(2013). Jumping through hoops - the cost of compliance on sole parents. Child & Family Social Work, 18(2), 159-167. 10.1111/j.1365-2206.2011.00817.x
(1996). The impact of managed care on patients' trust in medical care and their physicians. JAMA, 275(21), 1693-1697. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8637148
MICE (Version 2.13.2) [Computer software]. Vienna, Austria: R Development Core Team.
(2009). How good is trust?: Measuring trust and its role for the progress of societies. OECD Statistics Working Papers, 38. 10.1787/220633873086
(2003). The prevalence of PTSD following the violent death of a child and predictors of change 5 years later. Journal of Traumatic Stress, 16(1), 17-25. 10.1023/A:1022003126168
(2014). The ethics of doing nothing. Suicide-bereavement and research: Ethical and methodological considerations. Psychological Medicine, 44(16), 3409-3420. 10.1017/S0033291713001670
(2013). Psychological morbidity among suicide-bereaved and non-bereaved parents: A nationwide population survey. BMJ Open, 3(8), e003108. 10.1136/bmjopen-2013-003108
(2013). Preparatory studies to a population-based survey of suicide-bereaved parents in sweden. Crisis, 34(3), 200-210. 10.1027/0227-5910/a000175
(1993). Maternal grief after sudden infant death syndrome. Journal of Developmental and Behavioral Pediatrics, 14, 156-162.
(2007). Is the prevalence of psychiatric disorders associated with urbanization? Social Psychiatry and Psychiatric Epidemiology, 42, 984-989. 10.1007/s00127-007-0256-2
(2010). The current status of urban-rural differences in psychiatric disorders. Acta Psychiatrica Scandinavica. 10.1111/j.1600-0447.2009.01438.x
(2013). Events prior to completed suicide: Perspectives of family survivors. Issues in Mental Health Nursing, 34, 309-316. 10.3109/01612840.2012.751639
(2002). Suicide survivors' perceptions of the treating clinician. Suicide and Life-Threatening Behavior, 32, 158-166.
(2009). Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine, 6(8), e1000121. 10.1371/journal.pmed.1000121
(2002). Suicide risk in relation to family history of completed suicide and psychiatric disorders: a nested case-control study based on longitudinal registers. The Lancet, 360(9340), 1126-1130. Retrieved from http://www.sciencedirect.com/science/article/pii/S0140673602111974
(2009). Long-term outcomes for mothers who have or have not held their stillborn baby. Midwifery, 25, 422-429. 10.1016/j.midw.2007.03.005
(2006). A hierarchical step-model for causation of bias-evaluating cancer treatment with epidemiological methods. Acta Oncologica (Stockholm, Sweden), 45, 421-429. 10.1080/02841860600649293
(2012). Suicide bereavement and complicated grief. Dialogues in Clinical Neuroscience, 14(2), 177-186.
(2003). Lone mothers, social exclusion and depression. Psychological Medicine, 33, 715-722. 10.1017/S0033291703007347
(2011). Multivariate imputation by chained equations. Journal of Statistical Software, 45, 1-67. 10.1177/0962280206074463
(2008). How should variable selection be performed with multiply imputed data? Statistics in Medicine, 27, 3227-3246. 10.1002/sim.3177
(2011). Effect of health care system distrust on breast and cervical cancer screening in Philadelphia, Pennsylvania. American Journal of Public Health, 101, 1297-1305. doi:10.2105/AJPH.2010.300061
