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.