Disrupting the Cycle of Medical Distrust Between Caregivers and the Health Care System For Persons Living With Serious Mental Illness: What Does Misinformation Have To Do With It? - Article 5 - 2022

Oct 15, 2026

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Article 5 (2022) in the Journal of Applied Research on Children examines how serious mental illness challenges communication of treatment preferences during crises, particularly for people facing stigma, uncertainty, and systemic barriers. In the United States, it highlights pathways from first-responder decisions and legal encounters to compounded distrust in care. The article focuses on caregivers as proxy decision makers and argues that fragmented access to health information enables a cycle of misinformation exchange among providers and families, raising concerns for transitional youth.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Introduction

Communication challenges during mental health crises

Caregiver experiences and proxy decision-making

Misinformation exchange and systemic barriers

Journal of Applied Research on Children: Informing Policy for Children at Risk Volume 13 Issue 2 Healthcare Misinformation and Child, Family, and Community Health Article 5 2022 Disrupting the Cycle of Medical Distrust Between Caregivers and the Health Care System For Persons Living With Serious Mental Illness: What Does Misinformation Have To Do With It? Virginia A. Brown University of Texas at Austin, Dell Medical School, [virginia.brown@austin.utexas.edu](virginia.brown@austin.utexas.edu) Christine Thomas University of Texas at Austin, Dell Medical School, [christine.saenz@austin.utexas.edu](christine.saenz@austin.utexas.edu) Follow this and additional works at: [https://digitalcommons.library.tmc.edu/childrenatrisk](https://digitalcommons.library.tmc.edu/childrenatrisk) Recommended Citation Brown, Virginia A. and Thomas, Christine (2022) "Disrupting the Cycle of Medical Distrust Between Caregivers and the Health Care System For Persons Living With Serious Mental Illness: What Does Misinformation Have To Do With It?," Journal of Applied Research on Children: Informing Policy for Children at Risk: Vol. 13: Iss. 2, Article 5. DOI: [https://doi.org/10.58464/2155-5834.1522](https://doi.org/10.58464/2155-5834.1522) Available at: [https://digitalcommons.library.tmc.edu/childrenatrisk/vol13/iss2/5](https://digitalcommons.library.tmc.edu/childrenatrisk/vol13/iss2/5) The Journal of Applied Research on Children is brought to you for free and open access by CHILDREN AT RISK at DigitalCommons@The Texas Medical Center. It has a "cc by-nc-nd" Creative Commons license" (Attribution NonCommercial No Derivatives) For more information, please [contact](contact digitalcommons@exch.library.tmc.edu)[ digitalcommons@exch.library.tmc.edu](contact digitalcommons@exch.library.tmc.edu) Disrupting the Cycle of Medical Distrust Between Caregivers and the Health Care System For Persons Living With Serious Mental Illness: What Does Misinformation Have To Do With It? Acknowledgements We want thank the following individuals for their expertise and assistance throughout all aspects of our study and writing process: Billy Table, Oshyn Sky, Phillip Schnarrs and Nazan Aksan. This article is available in Journal of Applied Research on Children: Informing Policy for Children at Risk: [https://digitalcommons.library.tmc.edu/childrenatrisk/vol13/iss2/5](https://digitalcommons.library.tmc.edu/childrenatrisk/vol13/iss2/5) Disrupting the Cycle of Medical Distrust Between Caregivers and the Health Care System For Persons Living With Serious Mental Illness: What Does Misinformation Have To Do With It? Persons living with a serious mental illness (SMI), which can include affective disorders, psychotic disorders, bipolar disorders, and major depressive disorders1 face significant challenges in communicating their preferences for treatment during a mental health crisis. SMI is defined as; a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. The burden of mental illnesses is particularly concentrated among those who experience disability due to SMI.2 In the United States, there were an estimated 14.1 million persons aged 18 or older who live with SMI.2 Moreover, young adults aged “18-25 years had the highest prevalence of SMI” compared to their older counterparts.2 Annually, for the 5 .5% of all persons living with SMI, the National Alliance for Mental Health reported that, in 2021, approximately “2 million times a year, people with serious mental illness are booked into jail”.3 Added to this are the decisions made by first responders regarding who is hospitalized or jailed. When arrest is the decision a cascade of criminal justice interactions including coercion and/or involuntary commitment can occur leading to alienating individuals with SMIs from seeking care, and compounding patient

FAQs

What communication difficulties does the article identify for people living with serious mental illness during crises?

It describes significant challenges in communicating treatment preferences when a mental health crisis occurs, alongside functional impairment that limits major life activities.

How do first-responder decisions contribute to medical distrust?

When arrest is the decision, the article explains a cascade of criminal justice interactions, including coercion and/or involuntary commitment, which can alienate individuals from seeking care and intensify distrust of providers.

What role do caregivers play, and why does limited access to health information matter?

Caregivers often serve as proxy decision makers, but difficulties reviewing fragmented information across institutions can restrict their involvement. The article also notes that caregiver access to health records is not automatic and requires authorization during emergencies.

Oct 15, 2026

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