Common mental disorders among Arab-Israelis: findings from the Israel National Health Survey

OBJECTIVES: Psychiatric epidemiological data on Arab populations are generally scanty. This community-based survey, a component of the World Health Organization's 27-country study, explored the prevalence rates of anxiety and mood disorders, emotional distress and help-seeking practices among Arab-Israelis, and compared them with those found among Jewish-Israelis.

METHODS: Close to 5,000 non-institutionalized individuals were interviewed with the WHO/Composite International Diagnostic Interview (CIDI) to determine the prevalence rates of selected psychiatric diagnoses, and with the 12-item General Health Questionnaire (GHQ) to measure emotional distress. The schedule included other items, e.g., socio-demographic variables and help-seeking practices.

RESULTS: Arab-Israelis, in contrast to Jewish-Israelis, had higher mean GHQ-12 scores and lower self-appraisal of mental health. Twelve-month prevalence rates for any anxiety or affective disorder were not significantly higher among Arab-Israelis. Among respondents with diagnosed disorders, rates of help-seeking from specialized health services were lower among Arab-Israelis than among Jewish-Israelis. Intention to consult was elicited from both groups when the disorders were accompanied by higher distress scores.

CONCLUSIONS: Despite major health gains, the social stresses impacting the Arab-Israeli minority may explain both the higher emotional distress and lower self-appraisal of mental health. However, no impact was observed of social causation factors on the rates of common mental disorders in the Arab-Israeli group. Cultural factors, including the definition of disorders and stigma and a lesser availability of culturally-tailored services, could account for the marked treatment gap.