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Israel Journal of Health Policy Research
Published in: Israel Journal of Health Policy Research 1/2019

Open Access 01-12-2019 | Original research article

Barriers to help-seeking in Israeli Arab minority adolescents with mental health problems: results from the Galilee study

Authors: Raida Daeem, Ivonne Mansbach-Kleinfeld, Ilana Farbstein, Alan Apter, Rasha Elias, Anneke Ifrah, Gabriel Chodick, Silvana Fennig

Published in: Israel Journal of Health Policy Research | Issue 1/2019

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Abstract

Background

The Galilee Study assessed mental health service needs among Israeli Muslim and Druze adolescents and their mothers. Studies show that mothers of adolescents belonging to the Arab minority have much lower help-seeking rates than Jewish mothers. This paper examines mothers’ structural and cultural barriers to help-seeking.

Methods

All 9th grade students living in 5 towns representative of Muslim and Druze localities in northern Israel, were eligible for the study and 1639 (69.3%) obtained parental agreement and participated. Emotional or behavioral problem were assessed in the classroom using the Strengths and Difficulties Questionnaire. A total of 704 adolescent-mother dyads participated in the follow-up, and were interviewed at home, using the Development and Well Being Assessment inventory, the Composite Barriers to Help-Seeking Questionnaire, the General Health Questionnaire − 12, the Subjective Feelings of Discrimination Index and socio-demographic questions. Pearson χ2 test and multivariate binary logistic regressions were performed to analyze mothers’ consultation rates by risk factors. Exploratory factor analysis was performed to identify underlying factors and assess construct validity of the Composite Barriers to Help-Seeking Questionnaire, and also mean scores and standard deviations for the distinct scales were calculated.

Results

More mothers of adolescents with a mental disorder than those without a mental disorder consulted a professional or school source (39.7% vs. 20.5%; χ2 = 45.636; p = < 0.001). The most important barriers to help-seeking were those related to “Accessibility”, followed by barriers related to the belief that “Treatment is detrimental” and to the possibility of “Reprisal by authorities”. Barriers related to “Stigma” and “Distrust of professionals” had the lowest means scores. Differences by ethnicity/religion were found.

Conclusions

Structural barriers related to lack of access, were considered the main obstacle to help-seeking in this Israeli Arab minority population. Cultural barriers such as stigma were considered of secondary importance. Structural barriers could be reduced by increasing the number of accessible public mental health clinics in the minority localities, a responsibility of the Ministry of Health and the HMOs. Information campaigns and psychoeducation for parents would help reduce other barriers to mental health treatment.
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Metadata
Title
Barriers to help-seeking in Israeli Arab minority adolescents with mental health problems: results from the Galilee study
Authors
Raida Daeem
Ivonne Mansbach-Kleinfeld
Ilana Farbstein
Alan Apter
Rasha Elias
Anneke Ifrah
Gabriel Chodick
Silvana Fennig
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Israel Journal of Health Policy Research / Issue 1/2019
Electronic ISSN: 2045-4015
DOI
https://doi.org/10.1186/s13584-019-0315-7

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