Background
Israeli health plans are required to supply culturally- and linguistically-adapted services in order to reduce health inequality. Cultural and linguistic adaptation is particularly important in mental health services since treatment is mainly based on communication and dialogue between therapists and patients. One way to achieve such adaptation is to incorporate therapists from the target population into the service system. The Arab population currently comprises 21% of the Israeli population, yet only 1.9% of Israel’s psychiatrists and 1.4% of its clinical psychologists are Arabs. This underrepresentation reflects the difficulties encountered by the mental health system in recruiting professionals from the Arab population.
Study Goals
The goals of the study were to identify the obstacles to recruiting Arab students into the various training tracks for mental-health professions and to subsequently finding work in their professions; to identify the factors encouraging their integration into these tracks; to learn of existing solutions to cope with the obstacles; and to suggest additional modes of action to increase the supply of Arab professionals in these disciplines.
Method
In 2016 the study team held 52 in-depth interviews with head-office personnel from government ministries and health plans, senior academics, key stakeholders in the Arab community and Arab professionals in mental healthcare – psychiatrists, psychologists and mental-health social workers.
Interviewees were recruited using snowball sampling,
They were asked about the reasons for the shortage of Arab professionals in mental health, the place of cultural adaptation in mental health, and possible solutions to reduce the shortage.
Findings
■ Many of the obstacles identified in the study are not directly connected to the health system, but stem from inequality in other Israeli systems (education, social services, infrastructures).
■ Two levels of obstacles were identified within the education and training system: (a) obstacles facing all young Arabs when attempting to enter the academic world and the job market; (b) obstacles that specifically impede the choice of mental health as a discipline.
■ Although the issue is on the agenda of several organizations, many of the solutions offered to date have been localized rather than part of a comprehensive strategy
Discussion and Conclusions
The findings indicated the need to implement solutions through a joint effort and cooperation of the various ministries involved (and the various agencies related to training and employment processes). To be effective, it is important that the solutions be carried out systematically by the establishment and be supported by clear policy and dedicated budgets
Recommendations: (1) To increase the number of applicants for these professions by increasing the rate of participants in higher education and improving pre-university academic infrastructures; (2) To channel potential candidates from other professions to mental health by providing incentives.
Both these courses of action should be accompanied by cross-cutting activities to promote mentalhealth awareness in Arab society and reduce the stigma connected to the provision and receipt of mental healthcare. These processes should be carried out with cultural sensitivity
Citing suggestion: Elroy, I. Samuel, H., & Artom, T. (2018). The Shortage of Arab Professionals in Mental-Health Services — Causes and Solutions. RR-767-18. Myers-JDC-Brookdale Institute. (Hebrew)