How Can Healthcare Organizations Earn Trust with Marginalized Communities?

Reaching underserved communities requires more than just accessible and effective care — it hinges on building trust, a panel of experts emphasized at the Behavioral Health Tech conference in Phoenix on Wednesday. 

“We need to build trust and relationship with a community that has been marginalized, underserved, mistreated, abused, misdiagnosed for 400 plus years,” said Ryan Mundy, founder and CEO of Alkeme Health and moderator of the panel. “And so there’s a lot of work that needs to be done just to repair the relationship and build trust.”

How can healthcare organizations build this trust? It’s important to be clear on what the organization can and cannot do, according to Bukata Hayes, chief equity officer and vice president of racial & health equity at BlueCross BlueShield Minnesota.

“One of the things about trust is we haven’t laid our cards on the table. We have said, ‘Hey, we’re coming to help you’ — sort of that savior mentality — ‘and here’s how it’s going to look.’ Instead of saying, ‘We are in a system. That system has certain things we can and can’t do. Here’s what we can do within that system.’ I find that if you approach folks and provide those data points, that information, that perspective, and they understand that you are trying to work towards an ultimate end, I find that that builds a little bit of trust,” Hayes said.

He added that it’s vital to acknowledge the history and the fact that the system has built on the exploitation of marginalized groups. Otherwise, “trust is never built if you never acknowledge the harm.”

In addition, asking questions is another way to build trust, according to Joseph Perekupka, CEO of Freespira. The company offers a digital therapeutic treatment for panic disorder, panic attacks and post-traumatic stress disorder to help regulate breathing. It also provides check-ins with a coach.

“How we’re building trust is we’re asking very specific questions,” Perekupka said. “Every patient that goes through our program is paired up with a care coach that guides them through 28 days. They’re not practicing medicine. They’re really their partner on this journey. But through that, there is trust that’s built because they feel like they have somebody that’s helping guide them. … We’re getting information from each of the patients that go through that so we can build a better patient experience. … We’re training our team so the minute an individual reaches out and engages with anybody from Freespira, they are armed with up-to-date information to say, ‘Great, you’re a veteran, here’s what we heard from other veterans that went through this program.’”

It’s important to understand what the patient really wants as well, said Ayo Gathing, regional vice president and chief medical officer of Humana Healthy Horizons. She is also a board-certified child, adolescent and adult psychiatrist.

“What are you looking for? How can I help you? How can I be a partner? How can we collaborate? What do we want to do together? It can’t always be what I think they need,” she said. “I know the research and data. It has to be a collaborative partnership. And that’s where the trust starts. … Tell me what you need, and let me see if I can help you with that. And then I will tell you what I see and what I think. And let’s see if we can meet somewhere in the middle and start this journey long-term.”

Another panelist — Nisha Desai, co-founder and COO of Anise Health — noted that lack of trust often comes from patients not feeling seen and heard. Anise Health offers culturally-responsive digital mental health care for Asian Americans.

“I think therapeutic alliance is a very important measure when it comes to culturally-responsive care, making sure people feel seen and heard by the providers,” she said. “We’re thinking constantly of ways in which we can improve that therapeutic alliance, by equipping our providers with the right information so that the patients feel seen and heard. In the intake process, … we’re thinking about the whole person. We’re thinking about their religious background, their gender, their sexual orientation, their language, their generational status, all the different things that make someone who they are that might be critical to acknowledge in the process of delivering care.”

Editor’s note: The conference covered the reporter’s accommodations.

Photo: LoveTheWind, Getty Images