Mental Health

Mental health literacy among Arab-Palestinians in Israel and its association with socioeconomic characteristics and healthcare utilization.

TL;DR

Among Palestinian citizens of Israel, higher education and income were associated with greater mental health literacy at the bivariate level, and education, income, and first-aid MHL knowledge were significantly associated with mental health service use, while stigma and knowledge of helpers were not.

Key Findings

Higher socioeconomic status, measured by education and income, was significantly associated with greater mental health literacy at the bivariate level among Palestinian citizens of Israel.

  • Cross-sectional survey of n = 372 participants (Mage 36.88 ± 13.52 years, 68% female), based on the Australian National Survey of Mental Health Literacy and Stigma.
  • The associations were strongest for accurate disorder identification, knowledge of appropriate interventions, and lower levels of stigma.
  • Both SES indicators (education and income) showed this pattern.

Education was significantly associated with mental health service use in hierarchical logistic regression.

  • Reported OR = 3.62, 95% CI: 1.38-9.45.
  • The analysis was a hierarchical logistic regression including SES and MHL indices as predictors.

Income was significantly associated with mental health service use, with an odds ratio below 1.

  • Reported OR = 0.36, 95% CI: 0.13-0.99.
  • The confidence interval upper bound is close to 1, indicating a borderline association.

First-aid mental health literacy knowledge also contributed to explaining mental health service use.

  • Reported OR = 0.86, 95% CI: 0.75-0.99.
  • This was the only MHL component significantly associated with service use in the regression.

Stigma and knowledge of potential helpers were not significantly associated with mental health service utilization.

  • Other MHL indices, such as stigma and knowledge of potential helpers, showed no significant association in the regression.
  • This held even though lower stigma was associated with higher SES at the bivariate level.

The sample differed from the broader Palestinian citizen of Israel population in demographic composition.

  • The sample included more women, older people, and more people with higher education than the PCI population.
  • This limits representativeness of the findings.

The authors conclude that structural inequalities and cultural beliefs jointly shape mental health knowledge and behavior, and call for culturally sensitive, socioeconomically accessible interventions.

  • They advocate integrating MHL education into secondary educational settings.
  • They recommend policy reforms addressing both material disparities and cultural barriers to care.

What This Means

This study surveyed 372 Palestinian citizens of Israel, most of them women, about how well they understand mental health, including recognizing disorders, knowing what treatments help, knowing how to give first aid, and holding stigmatizing attitudes. It then looked at how these related to education, income, and use of mental health services. People with more education and higher income generally recognized mental disorders more accurately, knew more about appropriate treatments, and showed less stigma. When all factors were considered together, education, income, and first-aid knowledge were linked to whether people used mental health services, while stigma and knowing who can help were not. The income association was borderline and pointed in the opposite direction from education, so the pattern is not simple. This research suggests that both economic inequality and cultural factors shape how people understand and use mental health care in minority communities. The authors propose teaching mental health literacy in secondary schools and making services more culturally sensitive and affordable. The sample had more women, older people, and highly educated people than the overall population, and the design was cross-sectional, so the results cannot show cause and effect and may not represent everyone in the community.

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Citation

Abo-Ras N, Youngmann R, Neter E. (2026). Mental health literacy among Arab-Palestinians in Israel and its association with socioeconomic characteristics and healthcare utilization.. Israel journal of health policy research. https://doi.org/10.1186/s13584-026-00789-6