Exploring associations between trust in doctors and the likelihood of accessing healthcare for anxiety, depression and menstrual problems

Background

Anxiety, depression and menstrual problems are conditions that significantly impact an individual’s health and wellbeing yet, barriers to healthcare can prevent access to appropriate medical care. Trust in doctors is a notable factor as previous studies have shown that it affects engagement with healthcare services and has declined in recent years.

Methods

Using the Avon Longitudinal Study of Parents and Children, we investigated associations between trust in doctors and healthcare access at two timepoints, for anxiety, depression (mothers and partners) and menstrual problems (mothers only).

Results

Mothers reporting greater trust in doctors were more likely to access care for anxiety (n=1849, adjusted odds ratio (AOR) 1.11, 95% confidence interval (95% CI) 1.08-1.14), depression (n=2411, AOR 1.10, 95% CI 1.07-1.12), and menstrual problems (n=1723, AOR 1.04 95% CI 1.01-1.06). If mothers and partners endorsed “the doctor is always helpful”, they were more likely to access care for depression (mothers: n=2005, AOR 1.30, 95% CI 1.16-1.46; partners: n=580, AOR 1.46, 95% CI 1.05-2.03) and for anxiety (mothers: n=1892, AOR 1.35, 95% CI 1.19 to 1.54; partners: n=734, AOR 1.40, 95% CI 1.02-1.91).

Implications

This study supports association between trust in doctors and healthcare access for anxiety, depression and menstrual problems, particularly amongst mothers. This contributes to previous literature that suggests that trust remains an important factor in understanding treatment gaps, and that researchers and clinicians must work to improve public trust in healthcare systems.

Lay Summary

The number of people experiencing anxiety, depression and menstrual problems is rising. All three conditions can dramatically affect an individual’s quality of life however, many people report feeling unable to seek out professional help. Known as the treatment gap, the difference between those who require medical care and those who receive it, is driven by several factors, highlighting the need to understand the factors that determine whether people access healthcare. Trust in doctors is a notable factor, as previous studies have shown that it affects healthcare access and has declined in recent years. As such, this study seeks to understand whether there is a relationship between trust in doctors and healthcare access for anxiety, depression and menstrual problems.

This study used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), using data from two different timepoints, to assess this relationship amongst mothers and their partners. We investigated this relationship in mothers for anxiety, depression and menstrual problems and in partners for anxiety and depression only.

Results from this study suggest that this relationship was evident in mothers for all three conditions, when their children were 21 months old. There was also some evidence of the relationship between trust in doctors and healthcare access for anxiety and depression, when their child was 6 years old. Partners also showed some evidence of this relationship for anxiety and depression when their child was 6 years old. This work contributes to previous research showing that trust in doctors may be an important factor in determining whether people access healthcare for these conditions and suggests that researchers and doctors should work to improve public trust in healthcare systems.