Arab Israeli callers to an Israeli telephone counseling service are analyzed, comparing them with Jewish Israeli callers, in order to better understand Arab mental health utilization and needs. A questionnaire was used for a sample of 7000 Jewish and 344 Arab callers. Arab callers complained of inter-personal and family problems, and the Jewish sample personal and mental health problems. The discussion relates these to ethno-cultural gender construction, health care utilization, client etiology and family and community structures. The significance for programs and clinical services is considered.