Mental Health Literacy among the Palestinian-Arab Minority in Israel and Its Correlates with Mental Health Service Use

Abstract

Background. Mental health literacy (MHL) has been proposed as a factor in facilitating the utilization of mental health services. This study examined MHL among the Palestinian-Arab minority in Israel, based on Jorm’s six-dimension framework, and the contribution of each MHL dimension to mental health service use. Methods. A cross-sectional study consisting of a convenience sample of 214 Palestinian-Arabs (Mage = 36.40 ± 10.77 years, 68.2% female), who completed measures of MHL, psychological distress, mental health service use, and sociodemographic characteristics. The differences between participants who reported using mental health services (30.38%) and those who did not were examined using t- and χ2 tests. Binary logistic regression analysis was conducted to identify service use determinants. Results. Participants reported moderate or high levels on all MHL dimensions. Compared to those who did not report mental health service use, those who did had significantly ( p < 0.001 ) higher MHL levels on three dimensions: knowledge of professional help available, knowledge of where to seek information, and attitudes that promote recognition or appropriate help-seeking behavior. The regression analysis indicated that the main determinants of mental health service use were psychological distress (OR = 1.70, 95% CI: 1.44–2.01), knowledge of where to seek information (OR = 1.16, 95% CI: 1.02–1.32), and attitudes that promote recognition or appropriate help-seeking behavior (OR = 1.08, 95% CI: 1.02–1.14). Practice implications. This study underlines MHL’s crucial role and indicates that it is not only objective characteristics or psychological distress that determine service use among Palestinian-Arabs in Israel. Rather, individuals’ knowledge of where to seek information and attitudes promoting recognition or help-seeking behavior are also important determinants. Interventions targeting these two MHL dimensions may help increase mental health service use among this population.

Mental Health Underutilization by Palestinian-Arabs in Israel: Stigma-Related, Attitudinal, and Instrumental Barriers

“…However, our findings are in line with previous studies that showed that attitudes and perceptions are related to health outcomes including help-seeking and treatment adherence ( Abo-Rass et al., 2020b ; Andrade et al, 2014 ; Baines & Wittkowski, 2013 ; Mojtabai et al, 2016 ; Ten Have et al, 2010 ). They are also consistent with a recent study conducted in the Arab minority in Israel, which found that attitudes that promote mental help-seeking behavior are positively related to the utilization of mental health services ( Abo-Rass & Abu-Kaf, 2023 ).…”

“…First, most of our participants were female, with an education level higher than average in Arab society in Israel ( Central Bureau of Statistics, 2017 ). According to the literature, gender and education are significantly associated with mental health service use, with female and better-educated individuals both reporting higher utilization of mental health services ( Abo-Rass & Abu-Kaf, 2023 ; Campo-Arias et al, 2020 ). Second, the process of sociocultural change in Arab society in Israel has been shown to positively affect mental health literacy, prevailing attitudes to mental illness, treatment, and stigma ( Al-Krenawi, 2019 ), and this may therefore have also positively affected the perceptions of barriers to mental health services.…”

“…Nevertheless, at least in Israel, researchers have indicated that despite this unique sociocultural context, traditional beliefs of local Arabs are changing, including in the mental health field ( Abo-Rass et al, 2020a ). For example, a study conducted recently on Arabs in Israel found that they reported moderate-to-high levels of mental health literacy, whereas specific dimensions of mental health literacy (knowledge of where to seek information and attitudes that promote recognition or appropriate help-seeking behavior) are significant determinants of mental health service use in this population ( Abo-Rass & Abu-Kaf, 2023 ).…”

Mental health literacy as a barrier and facilitator for service use: Qualitative inquiry among Palestinian Bedouins in Israel

“…Recently, a study based on Jorm's (2000) framework was conducted among the Palestinian-Arab minority in Israel and found that, contrary to expectations, participants reported moderate-high MHL levels, higher than other ethnic/racial minorities or other Arab populations worldwide. This study also showed that the three dimensions of knowledge about available professional help, knowledge of where to seek information, and attitudes promoting recognition or help-seeking for disorders were positively and significantly related to service use (Abo-Rass & Abu-Kaf, 2023). However, this study was focused mainly on Palestinian-Arabs from central and northern Israel and did not include the subgroup of Palestinian Bedouins in the south.…”

“…Socially, people coping with mental illness are stigmatized, and the entire subject is taboo. The literature describes these attitudes as barriers to using mental health services, but also points to a positive change following the sociocultural changes of Palestinian-Arab society as a whole (Abo-Rass & Abu-Kaf, 2023; Abo-Rass et al, 2020; Abu-Asbah et al, 2014; Al-Krenawi, 2019).…”