Challenges and Solutions of Building Trust in Mental Health Services: Hearing the Voices of Iranian Medical Students Through Community Participation Publisher Pubmed



Hedayati F ; Sayarifard A ; Sajadi HS ; Eghbal AH ; Rahiminejad F
Source: BMC Psychiatry Published:2026

Abstract

Background and objectives: Despite the prevalence of mental disorders, the treatment rate remains low due to various barriers, including trust issues. Trust impacts the patient-provider relationship and the utilization of mental health services. This study aims to identify challenges to trust in mental healthcare services for students at a medical sciences university and identify solutions to enhance trust through active community involvement in research. Methods: Using a Community-Based Participatory approach and content analysis, we engaged 25 stakeholders, including students, mental health providers, and parents at Tehran University of Medical Sciences. They engaged in a steering committee, semi-structured interviews, and one focus group. Nineteen interviews and one focus group were analyzed using MAXQDA 20 software. Results: Trust challenges were related to four categories: conceptual and societal frames of mental disorder, contextual and informational determinants, dynamics in therapeutic encounters, and structural and environmental determinants. These categories included 14 subcategories related to confidentiality, professionalism, ethics, patient contribution, stigma, past negative experiences, lack of mental health literacy, access, and service delivery issues. The most prominent solutions to these challenges include confidentiality maintenance, increasing mental health literacy, reducing stigma, implementing regulatory measures, and promoting professional behavior among healthcare providers. Conclusion: Trust in mental healthcare services is complex and shaped by previous experiences, professionalism, mental health literacy, and systemic barriers. This collaborative study provides insights and practical solutions by understanding and addressing the challenges of trust in the university setting. Trial registration: Clinical trial number is not applicable. © The Author(s) 2026.