Stigma, Discrimination, and Mental Health Help-Seeking across Diverse Communities In Israel

Background: Mental health stigma shapes whether individuals recognize distress, disclose mental health problems, and seek professional support. These processes are embedded in social, cultural, and structural contexts and may operate differently across communities. In Israel, Arab Israeli communities face structural inequities, discrimination, and linguistic and cultural barriers that may intensify distress and reduce willingness to seek care. Arab Israeli experiences must also be understood in relation to General Jewish and Ultra-Orthodox Jewish populations, which differ in cultural norms, institutional access, and community structures. Guided by the Framework Integrating Normative Influences on Stigma (FINIS) and Minority Stress Theory, this study examined predictors of mental distress and help-seeking attitudes prior to October 7, 2023across these three groups, with particular attention to Arab Israeli respondents.

Methods: Participants (N=469) completed a cross-sectional survey assessing poor mental health days, attitudes toward seeking professional psychological help, everyday discrimination, contact with people with mental illness, and key sociodemographic characteristics. The sample included Arab Israeli (27.8%), General Jewish (43.2%), and Ultra-Orthodox (29.0%) respondents. The average age was 34.4 years, and 66.9% were women. Descriptive statistics, one-way ANOVAs, and four ordinary least squares regression models were used to compare cultural groups and examine predictors of poor mental health days and help-seeking attitudes. Initial models included cultural group and sociodemographic covariates; subsequent models added psychosocial predictors, including everyday discrimination and contact.

Results: Arab Israeli participants reported the highest number of poor mental health days (M=14.76), followed by General Jewish (M=8.95) and Ultra-Orthodox respondents (M=7.52). Arab Israeli participants also reported the least favorable help-seeking attitudes (M=7.11), compared with General Jewish (M=8.14) and Ultra-Orthodox respondents (M=7.83). In regression analyses predicting poor mental health days, Arab Israeli participants initially reported significantly more distress than General Jewish participants (b=3.22, p<.05), but this difference became non-significant after adding everyday discrimination and contact. Everyday discrimination was positively associated with poor mental health days (b=2.53, p<.01), while better self-rated health was associated with fewer poor mental health days. In analyses predicting help-seeking attitudes, Arab Israeli participants reported significantly less favorable attitudes than General Jewish participants (b=-1.39, p<.001), and this difference remained significant after adjustment (b=-1.07, p<.01). Women and participants with advanced degrees reported more favorable help-seeking attitudes. Everyday discrimination was negatively associated with help-seeking attitudes (b=-0.44, p<.01), whereas contact with people with mental illness was positively associated (b=0.14, p<.01). After adjustment, Ultra-Orthodox respondents reported slightly more favorable help-seeking attitudes than General Jewish respondents (b=0.52, p<.05).

Conclusions: Findings suggest that discrimination and culturally embedded social norms are stronger predictors of mental distress and help-seeking attitudes than most demographic characteristics. Discrimination appears to function as both a stressor that worsens mental health and a barrier that reduces openness to care. Positive contact with people who have experienced mental illness may help counter stigma and improve attitudes toward help-seeking. Results underscore the need for culturally responsive, anti-stigma, and anti-discrimination mental health strategies tailored to Israel’s diverse communities. Establishing this pre–October 7, 2023 baseline is important for understanding how later conflict may have shifted needs and attitudes toward care.