Barriers to Mental Health Service Use among Palestinian-Arab Women in Israel: Psychological Distress as Moderator

Background: Many studies indicate that ethnic minority women, including women from the disadvantaged Palestinian-Arab minority in Israel, experience higher rates of psychological distress but are less likely to use mental health services. This study examined psychological distress and its role as a moderator in the relationship between mental health service use and stigma-related, attitudinal, and instrumental barriers. Method: Cross-sectional study of 146 Palestinian-Arab women who completed measures of psychological distress, mental health service use, the Barriers to Care Evaluation scale, and sociodemographic characteristics. Results: Participants who did not utilize mental health services reported higher levels of all barrier types compared to participants who reported previous use, but lower levels of psychological distress. Psychological distress was a significant moderator only in the relationship between attitudinal barriers and mental health service use. Conclusions: This study highlights the role of psychological distress in the relationship between barriers to and utilization of mental health services, helping professionals and policymakers increase mental health service use among Palestinian-Arab women in Israel and other vulnerable women elsewhere.