Unraveling Trust Issues Towards Mental Health Professionals Among Bedouin-Arab Minority in Israel.

Trust in mental health professionals and services profoundly impacts health outcomes. However, understanding trust in mental health professionals, especially in ethnic minority contexts, is lacking. To explore this within the Bedouin-Arab minority, a qualitative study conducted semi-structured interviews with 25 Bedouins in southern Israel. Participants were primarily female (60%) married (60%), averaging 34.08 years old. Employing grounded theory, three themes emerged. Firstly, concerns about confidentiality were central, eroding trust due to societal repercussions. Secondly, factors influencing confidentiality concerns and distrust were tied to Bedouin-Arab social structures and cultural values rather than professional attributes. Lastly, the consequences of distrust included reduced help-seeking. This study enriches the understanding of trust in mental health professionals among non-Western ethnic minorities, highlighting how cultural factors shape perceptions of mental health services and distrust. Addressing confidentiality worries demands Bedouin mental health professionals to acknowledge hurdles, build community ties, and demonstrate expertise through personal connections and events.

Mental health literacy as a barrier and facilitator for service use: Qualitative inquiry among Palestinian Bedouins in Israel.

BACKGROUND: Mental health literacy (MHL) has been related to health behaviors and outcomes. However, studies examining MHL as a barrier and facilitator to service use are limited, especially among minority groups. AIMS: This study examined MHL as a barrier and facilitator to mental health service use among the Palestinian Bedouin minority in Israel. METHODS: Twenty-five Bedouins (15 women) from southern Israel participated in semi-structured, in-depth interviews. The participants were recruited by publishing an ad on social media about the study, then through a snowball technique. The data were analyzed thematically using ATLAS.ti.9, and the intercoder reliability was 92%. RESULTS: We identified four major themes in the interviews: (1) MHL as a barrier to service use, due to lack of knowledge about professionals in the field, mental health services, or reasons and risk factors for mental health problems; (2) traditional attitudes that acted as barriers to service use, including a preference for informal treatment, a lack of faith in mental health treatment, aversion to discussing private feelings, and the perception that mental health is a luxury; (3) MHL as a facilitator to service use by enabling accurate identification of mental distress and suggesting practical avenues for seeking help; and (4) ways to improve MHL that should be culturally sensitive and under the government agencies' responsibility. CONCLUSIONS: Interventions aimed at increasing the use of mental health services among Bedouins and reducing racial/ethnic disparities should increase knowledge in culturally adapted ways, especially regarding professionals and services, and change negative attitudes such as mental health treatment as ineffective or bonus.

Job satisfaction and well-being among college-educated Bedouin Arab and ultra-Orthodox women in the Israeli workforce: the roles of individual, familial, communal, and organizational resources.

Over the past two decades, increasing numbers of Bedouin Arab and ultra-Orthodox women have been integrated into the Israeli labor market. The integration of these women from traditional and minority communities into the general workforce involves significant coping on the practical, social, and emotional levels. This study examined factors that may facilitate the integration of college-educated Bedouin Arab and ultra-Orthodox women in the Israeli labor market. The sample included 304 ultra-Orthodox women and 105 Bedouin Arab women, who were employed in a variety of fields. Participants completed questionnaires designed to collect data on demographics, sense of personal coherence (SOC), family quality of life, sense of community coherence (SOCC), diversity climate, inclusive management, job satisfaction, and well-being. The ultra-Orthodox women reported higher levels of most of the resources; whereas the Bedouin Arab women reported higher levels only of inclusive management. Hierarchical regressions showed that income, SOC, and inclusive management each contributed significantly to job satisfaction. Levels of well-being were explained by SOC, family quality of life, and inclusive management. This study highlights the importance of individual, familial, and organizational resources for the integration into the workforce of female members of minority groups.

Mental Health Underutilization by Palestinian-Arabs in Israel: Stigma-Related, Attitudinal, and Instrumental Barriers.

BACKGROUND: Many studies show that members of minority groups underutilize mental health services and report more barriers to such utilization than majority groups. However, very little is known about these barriers and their relation to mental health service use among the Palestinian-Arab minority in Israel. AIMS: This study examined barriers to mental health service use in this population based on the stigma-related, attitudinal, and instrumental barriers dimensions of the Barriers to Care Evaluation scale (BACE v3) and its correlates to mental health service use. METHODS: The participants were a convenience sample of 231 Palestinian Arabs. They completed measures of BACE v3, mental health service use, and sociodemographic characteristics. RESULTS: The findings showed that participants who reported using mental health services had lower levels of barriers in all dimensions compared to those who did not use such services. Attitudinal barriers were found to be the main determinants of mental health service use. CONCLUSIONS: This study underscored the role of attitudinal barriers to the utilization of mental health services. The findings indicated that interventions addressing such barriers might be helpful in increasing mental health service use among the Palestinian-Arab minority in Israel as well as other minorities in Israel and elsewhere, who might share similar backgrounds and perceptions.

Challenges, Opportunities, and Coping in the Wake of the COVID-19 Pandemic: The Case of Jewish Communities around the World.

Against the backdrop of the COVID-19 pandemic, which lasted more than two years and included several waves, the present study focused on Jewish communities around the world, in order to understand the role of community during the pandemic. This study focused on the community mechanisms that helped community members to cope with the pandemic. To that end, between October 2021 and July 2022, in-person interviews were conducted with leaders and members of the following communities: Budapest, Hungary; Subotica, Serbia; Vienna, Austria; Bratislava, Slovakia; Vilna, Lithuania; Buenos Aires, Rosario, Salta, and Ushuaia in Argentina; and Mexico City and Cancun in Mexico. Each interview lasted between 45 min and 1.5 h. All of the interviews were audio-recorded and transcripts of those recordings were prepared. Three major themes emerged from the interviews: challenges, coping, and opportunities. Most of these themes were common to the different communities around the world. The findings of this work are discussed in terms of the concept of sense of community and resiliency theories.

Ultra-Orthodox Women in the Job Market: What Helps Them to Become Healthy and Satisfied?

This study explored the mental health and job satisfaction of Ultra-Orthodox women who work in different cultural environments. Data were gathered from 304 Ultra-Orthodox women who belong to various streams in this society and who were recruited by the Midgam research panel. The participants filled out self-reported questionnaires that assessed their family quality of life, community sense of coherence, diversity climate, inclusive leadership, job satisfaction, and mental health. The participants ranged in age between 19 and 64 years (M = 30.86, SD = 8.71); 43.1% worked within the Ultra-Orthodox enclave, while 22.4% worked with both Ultra-Orthodox and secular individuals and 34.5% worked in mainly secular environments. We observed differences and similarities among the three groups of women. Community sense of coherence was weakest among those who worked outside the enclave, while diversity perception and inclusive leadership were highest among that group. In all three groups, family and community were the most important resources for mental health. Both traditional resources (i.e., family and community) and other resources (i.e., perception of diversity climate and inclusive leadership) were important for job satisfaction.

Diversity Climate, Salutogenic Theory, and the Occupational Health of College-Educated Women from Conservative Communities.

Over the past four decades, there have been significant changes in workplaces around the world, including a workforce that has become more diverse as the relative proportion of women in the workforce has increased. This trend has included the increased workforce participation of women from conservative minority groups. This article discusses the significance of the integration of college-educated women from conservative minority groups into the workforce in terms of their own personal health and well-being. This work focuses on two groups of college-educated women from conservative minority groups that have joined the Israeli workforce: Ultra-Orthodox women and Bedouin Arab women. This qualitative study was based on five focus groups, which included 16 women from the two examined groups. The main themes raised in those focus groups were categorized and analyzed. The data analysis was guided by the diversity-climate approach and salutogenic theory. The research findings indicate that a diversity climate that included most of the different aspects of this approach was present in the participants' statements regarding their workplaces. In practice, diversity climate supported sense of coherence, such that both diversity climate and a sense of coherence led directly to the occupational health of these college-educated, minority women.

What factors explain anger and mental health during the COVID-19 pandemic? The case of Israeli society.

BACKGROUND: What factors affected the levels of anger and emotional distress experienced during the coronavirus disease 2019 (COVID-19) pandemic? We hypothesized that (1) sociodemographic factors and resiliency factors would partially explain psychological distress and anger, with stronger resiliency associated with lower levels of distress and anger; (2) women would report more trust in national leadership, as well as more psychological problems; (3) individuals of low socioeconomic status would report less resiliency, less trust in national leadership, and greater distress than individuals of higher socioeconomic status; and (4) hope would mediate the relationships between the other resiliency factors and both anger and distress. AIM: To explore whether community resilience, hope, and trust in leaders were associated with lower levels of anger and emotional distress during the COVID-19 pandemic. METHODS: For this observational study, data were gathered in Israel during the second wave of the COVID-19 pandemic, just before the Jewish New Year (mid-September 2020), as a second lockdown was announced. Data were gathered from 636 Israeli adults, who were recruited by the Midgam research panel. The participants filled out self-reported questionnaires including one on state anger, the Brief Symptom Inventory as a measure of mental-health problems (i.e., somatization, depression, and anxiety), and questionnaires about trust in the state's leaders, community resilience (CCRAM), and hope as measures of coping resources and resiliency. t-tests were used to explore differences between men and women and between those of lower and higher socioeconomic status. A hierarchical multiple regression analysis was then used to examine whether and how the sociodemographic and resiliency variables explained state anger and psychological distress. A Sobel test was used to evaluate the possible effects of hope on community resilience and trust in leadership in the context of both distress and anger. RESULTS: Our results revealed differences between women and men in terms of anger and mental-health problems, but not in terms of coping resources. Women reported higher levels of both anger and mental-health problems. Participants of lower socioeconomic status reported more mental-health problems, more anger, and greater trust in the state's leaders; whereas those of higher socioeconomic status reported greater hope. Furthermore, hierarchical multiple regression analyses revealed that the sociodemographic factors of gender, age, and socioeconomic status, as well as community resilience, trust in the state's leaders, and hope explained mental health with a total of 19% of the variance and anger with a total of 33% of the variance. The Sobel tests showed that hope mediated the relationships between community resilience and mental health (z = 3.46, P < 0.001), community resilience and anger (z = 2.90, P < 0.01), and trust in leaders and anger (z = 3.26, P < 0.01), but did not affect the relationship between trust in leaders and mental health (z = 1.53, P > 0.05). CONCLUSION: Personal and communal factors affect psychological distress. Personal resilience is an important factor that should be strengthened throughout life. Trust in leadership is important for citizens' mental health.

Effective Ways to Encourage Health-Care Practices among Cultural Minorities in Israel during the COVID-19 Pandemic.

Following the worldwide outbreak of COVID-19, policymakers have been occupied with the questions of whether and how to specially address unique cultural groups coping with the pandemic. This study aimed to evaluate the potential for a culturally tailored approach to the transmission of health messages in a time of crisis among two minority populations within Israeli society: the Ultra-Orthodox population and the Arab population. To that end, 380 individuals from Israeli Ultra-Orthodox society and 360 individuals from Israeli Arab society completed a self-reported questionnaire in early April 2020, in the midst of the COVID-19 pandemic. The findings of this study reveal differences between these groups in terms of the effectiveness of different channels for conveying messages and the channels that were preferred, as well as significant relationships between community sense of coherence and the study variables. We found that advocacy and motivation based on values, on the one hand, and recognition of the effectiveness of a culturally tailored approach, on the other, may be the best approach for persuading members of minority populations, who belong to collectivist societies, to comply with epidemic-control instructions.

Hope and Resilience During a Pandemic Among Three Cultural Groups in Israel: The Second Wave of Covid-19.

The aim of this study was to explore the coping resources of hope and sense of coherence, which are rooted in positive-psychology theory, as potential resilience factors that might reduce the emotional distress experienced by adults from three cultural groups in Israel during the chronic-stress situation of a pandemic. The three cultural groups examined were secular Jews, Ultra-Orthodox Jews, and Arabs. We compared these cultural groups during the second wave of the Covid-19 pandemic, just before the Jewish New Year (mid-September 2020) as a second lockdown was announced. Data were gathered from 248 secular Jews, 243 Ultra-Orthodox Jews, and 203 Arabs, who were 18-70 years old (M = 37.14, SD = 12.62). The participants filled out self-reported questionnaires including the Brief Symptom Inventory as a measure of emotional/psychological distress (i.e., somatization, depression, and anxiety) and questionnaires about sense of coherence and different types of hope (i.e., intrapersonal, interpersonal, and transpersonal) as measures of coping resources and resiliency. Differences were found between the three groups in terms of several variables. The Arab participants reported the highest levels of emotional distress and the lowest levels of interpersonal and transpersonal hope; whereas the Ultra-Orthodox participants revealed the highest levels of sense of coherence and other resilience factors. A structural equation model revealed that, in addition to the sociodemographic factors, only sense of coherence and intrapersonal hope played significant roles in explaining emotional distress, explaining 60% of the reported distress among secular Jews, 41% among Ultra-Orthodox Jews, and 48% among Arabs. We discuss our findings in light of the salutogenic and hope theories. We will also discuss their relevancy to meaning-seeking and self-transcendence theory in the three cultural groups.

Community coherence and acculturation strategies among refugee adolescents: How do they explain mental-health symptoms?

BACKGROUND: Against the backdrop of 10 years of civil war in Syria, with millions of refugees, this study aimed to explore sense of community coherence and the acculturation strategies of separation and competition as factors that might explain mental-health problems among adolescent Syrian refugees in Greece. METHODS: Data were gathered from 173 adolescents aged 13-18 (M = 15.85; SD = 1.49); female adolescents accounted for 60.7% of the sample. Participants filled out a self-reported questionnaire regarding internalizing and externalizing problems, as well as posttraumatic stress disorder (PTSD). They were also asked about their sense of community coherence, their use of different acculturation strategies, and sociodemographic factors (i.e., gender, age, amount of time spent in the camp, and parents' education), as well as contextual factors such as exposure to war events, appraisal of danger, and whether they had received aid from various organizations. RESULTS: The female adolescents reported a stronger sense of community coherence and that they had received more aid from organizations than the male adolescents reported receiving. The male adolescents reported more externalizing problems. Exposure and appraisal of danger, as well as sense of community coherence and the use of the acculturation strategies of separation and competition all significantly explained the various mental-health problems. CONCLUSIONS: This article underscores the significance of gender, community coherence, and acculturation strategies in the prediction of mental health. It presents the results of this research in the context of the salutogenic and acculturation models.

Salutogenesis and Coping: Ways to Overcome Stress and Conflict.

This Special Issue aims to explore the concepts of stress, coping resources, and coping strategies, which are rooted in several theories, such as the stress and coping theory and the salutogenesis theory, and to understand how their core constructs are manifested in various ethnic and cultural groups around the world. This Special Issue includes 13 articles on salutogenesis and coping from different disciplinary, socio-cultural, historical, political, and economic perspectives. These articles address salutogenesis on the individual, organizational, and societal levels. The empirical studies are based in different societal and national contexts and refer to different ethnic groups within those contexts. Other studies examine international leaders in industry from a global perspective and present a systemic review of the literature concerning individuals in specific professions, such as nursing. The studies in the current Special Issue set the ground for continuing research toward even more comprehensive theoretical grounds; studies that incorporate several theoretical backgrounds and explore a broad theoretical model that may help us to understand successful adaptation in various contexts. In summary, results of studies that incorporate these theories may promote our understanding of the effects of coping resources and strategies, including acculturation strategies used among minority groups for positive adaptation.

Do professional communities enhance the personal and professional well-being of minority women? The case of Ultra-Orthodox women in Israel.

The labour market in industrialised countries around the world today faces various challenges associated with the 4th Industrial Revolution, specifically three major developments: innovations in technology and science, demographic changes, and social change. Policymakers and employers are required to examine the economy in light of these changes, which are expected to affect the labour market and the level of employment. In this study, we chose to focus on one of the most prominent areas leading to change in the employment market: the social changes and the adoption of new social platform in the employment market. Israeli society is undergoing a significant change with the increasing entrance of members of Ultra-Orthodox society, specifically Ultra-Orthodox women, into the advanced employment market. The purpose of this qualitative study is to examine whether and how state-funded professional communities help Ultra-Orthodox women to progress at work and enhance their personal and social well-being. The main themes are based on content analysis of two focus groups that included members of a variety of professional communities, content analysis of correspondence on social networks, and five in-depth interviews with the managers of these groups. The findings are analysed through the lens of positive psychology theory and show that professional communities contribute significantly to five personality strengths of the employed women: positivity, engagement and connectedness, positive relationships, meaning, and success. Additionally, these communities help to cultivate the women's professional talents, contribute to strengthening the relationship between general Israeli society and the Ultra-Orthodox community, and, ultimately, all of these help produce satisfaction at work.

Women in Refugee Camps: Which Coping Resources Help Them to Adapt?

: The present study aimed to explore the coping resources and mental health of women who have fled Syria to a neighboring European country. To that end, we examined the roles of sociodemographic factors, situational factors, and personal and community sense of coherence (SOC and ComSOC, respectively) in mental-health outcomes. One hundred and eleven refugee women aged 19-70 filled out self-reported questionnaires during August 2018 in a refugee camp in Greece. The questionnaires asked the participants for demographic information (i.e., age, level of education level, and time spent in the camp) and also addressed the situational factors of having received aid from various organizations, appraisal of danger during the war in Syria, and exposure to war experiences, as well as the coping resources of SOC and ComSOC. The results show that time spent in the camp, appraisal of danger, SOC, and ComSOC all play significant roles in predicting the variance of various mental-health outcomes. Together, those factors predict 56% of anxiety, 53% of depression, and 58% of somatization. SOC was also found to mediate the relationships between time spent in the camp and outcome variables, as well as the relationships between the appraisal of danger and the outcome variables. This indicates that SOC is crucial for good adaptation. These results will be discussed in light of the salutogenic theory.

Analysis of the Differential Relationship between the Perception of One's Life and Coping Resources among Three Generations of Bedouin Women.

Bedouin society has undergone rapid changes over the past decade. The younger generation of Bedouin women is better educated, which has enabled them to enter different professions, increased their incomes and elevated their social status. We examined the sense of coherence (SOC) and its components of meaningfulness, manageability and comprehensibility as well as the use of coping strategies among Bedouin women from three age groups. We also investigated the coping resources and strategies before determining the relationships between these variables in the three groups. One hundred ninety-six women participated in the study. Differences were found mostly between the oldest age group (61 years and older) and the two younger groups (21⁻40 and 41⁻60 years old). The oldest women reported less meaningfulness and used less positive reframing, planning, humor and acceptance. In terms of coping strategies, venting was used more by the youngest group whereas behavioral disengagement was used more by the oldest group. In the younger groups, SOC and its components were positively correlated with the use of coping strategies that are considered to be adaptive and with emotional support. However, the correlations between these factors were negative among the oldest group, which points to non-adaptive coping strategies used by these women. These results are discussed in light of the salutogenic, stress-appraisal and coping theories.

Between the Inside and the Outside World: Coping of Ultra-Orthodox Individuals with Their Work Environment After Academic Studies.

This study has explored how ultra-Orthodox individuals cope when facing secular norms and values in their work environment. The study was conducted in Israel, where 614 ultra-Orthodox adults answered questions regarding demographic characteristics, identities, openness to the workplace, social environment, Brief Cope, community sense of coherence (CSOC) and Employee Satisfaction Inventory. Individuals in the main sectors of the ultra-Orthodox society reported higher CSOC and stronger religiosity while individuals from the minor sectors reported greater openness to the job's social environment. Demographics, coping strategies and CSOC were significant in explaining job satisfaction. The results will be discussed based on stress and coping theories and on the salutogenic theory.

Coping resources and stress reactions among Bedouin Arab adolescents during three military operations.

This study aimed to examine coping resources (sense of coherence and hope) and stress reactions among Bedouin Arab adolescents in southern Israel during three periods of escalated political violence. Two main questions were examined: 1) Did adolescents report different coping resources and levels of stress reactions during these three different periods? 2) Were there any differences in the pattern of the associations between coping resources and stress reactions across those periods? Data were gathered from 81, 91, and 192 Bedouin Arab adolescents, who were 14-18 years old, during three periods. Participants completed self-report questionnaires including the sense of coherence (SOC) scale, a hope index, a measure or state anxiety and state anger, a measure of psychological distress, and a demographic questionnaire. Across the three periods, differences were observed in both coping resources and levels of stress reactions. Over time, SOC was found to be a significant predictor of those stress reactions; whereas the association between hope components and stress reactions weakened over time. These findings support the hypothesis that SOC is a significant component of coping with stressful political events and emphasize the importance of addressing differences in the roles of personal resources over time and transition processes.

Shifts in Traditional Methods of Coping Among Elderly Bedouin Men.

Elderly Bedouin men in southern Israel are a unique traditional population living in remote unrecognized villages and experiencing rapid social transition, in addition to deep poverty and political tension. In this study, we aimed to explore stressful events, as self-defined by the participants, and the ways in which these men have coped with those stressful events. This study involved 12 men, aged 69⁻74, who participated in in-depth narrative interviews during which they were asked about transformative stressful events in their lives and how they had managed, understood, and utilized human capital, meaning-making, and other methods of coping. Analysis of the interviews revealed several themes: (a) the definition of stressful events within the cultural context, (b) the use of human capital to overcome those events, (c) the transformation of experience from hindsight into a didactic narrative that can be used to assign meaning to past events, which can then be passed on to the next generation, and (d) cultural transition as a catalyst for the creation of new understandings of events. This paper sheds new light on how elderly indigenous Bedouin men self-define stressful situations within a complex and unstable cultural context. This specific context, can help us to gain insight into how indigenous impoverished older men in similar contexts may self-define their stress and coping, based on the types of generalization accepted in qualitative research. The methodological contribution of this work lies in its use of narrative to culturally contextualize phenomenological meaning structures. Its theoretical contribution lies in its examination of the concept of stress within a specific cultural context.

Using arts-based research to access sense of coherence in marginalised indigenous Bedouin youth.

The literature describes a mismatch between the core concepts of salutogenesis, or sense of coherence (SOC), meaning manageability and comprehensibility, as these concepts are manifested in research with Western populations, as compared to non-Western populations. The overall objective of this study is to explore this mismatch and to understand how the core concept of salutogenesis is manifested in youth ages 14-16 from the indigenous Bedouin ethnic minority culture of the Negev, Israel, in their own terms through arts-based qualitative methods. The research methods revolved 80 drawings and texts by youth who drew "a good day that went bad - and how [I] fixed it" as well as focus groups. All data, both verbal and visual, were analysed by dividing into themes and then socially contextualising the themes with a peer group. The findings reveal and concretize a mismatch in SOC between these youth and the predominant Western understandings of coping in terms of meanings, manageability and comprehensibility of coping methods. This study's theoretical recommendations are the need to take steps in the direction of closing the gap or mismatch between a universal versus culturally specific body of literature about culture and SOC. Its practical recommendations are to suggest such a methodology.