Examining Attitudes Toward Mental Health Treatment Among Jewish Adults

Background: Two-thirds of individuals with mental illness do not access formal mental health treatment, while a third of those who access treatment prematurely terminate. Thirty-six percent of Americans with mental illness seek professional treatment, whereas approximately 13-33% of Jewish adults access treatment. Jewish Americans experience greater mental health disparities. Stigma influences treatment avoidance and negatively impacts the functioning, recovery, and participation of individuals with psychiatric illnesses in society. Unfortunately, little is known about the experiences of Jewish American experience greater mental health disparities. This research examined ways to improve access and engagement for Jewish Houstonians who need mental health treatment. This study explored stigma regarding treatment for depression among a community sample of individuals identifying as Jewish and the link between stigma and gender, age, religiosity, and education.

Methods: Data was collected as part of a larger study examining mental health, stigma, and help seeking among Jewish individuals in Houston, Texas. Using convenience sampling, the study recruited 494 Jewish individuals at Jewish agencies and events. Data collected through Qualtrix used a cross-sectional survey design. Stigma Concerns About Mental Health Care (range: 0-3) measured attitudes toward seeking treatment for depression. Analyses included examining demographics, bivariate analyses (e.g., chi-square, t-tests, ANOVA), and OLS regression modeling of stigma concerns.

Results: 64% of the sample were female, with an average age of 48.9 (SD: 16.3) years. Many participants were married (74.3%) and had children (80.2%). The sample was highly educated, with 80% of participants obtaining a bachelor’s degree or higher; 67% were currently employed; 51% of participants reported an annual household income at or above $140,000. Most of the sample reported knowing someone with mental health problems (MHP; 95.1%), 80% knew a friend with MHP, 77% had a family member with MHP, and 53% reported experiencing MHP. OLS regression was used to model the relationship between demographics and stigma about treatment for depression, F(4,471)=11.69, p<0.001, R²=0.090. Results indicated greater stigma concerns among males (B=-0.108, S.E.=0.053, t=-2.04, p=0.026), younger participants (B=-0.007, S.E.=0.002, t=-3.62, p<0.001), those without post-secondary education (B=-0.234, S.E.=0.115, t=-2.04, p=0.042), and those who were unemployed (B=-0.131, S.E.=0.059, t=-2.22, p=0.027). Item-level analyses of stigma for each characteristic (e.g., gender, age, education, employment) revealed differences in factors driving stigma concerns. For example, concerns that family may disapprove of treatment were similar across gender (χ²(1)=0.82, p=0.365). However, males were more likely than females to fear what others think (13.5% vs. 6.8%; χ²(1)=5.84, p=0.016) and be embarrassed about discussing personal matters with others (11.1% vs. 4.3%; χ²(1)=7.89, p=0.005).

Implications: For individuals experiencing mental illness, successfully accessing and engaging in mental health care can improve functional outcomes and reduce the impact of mental illness on families and society. This study provided an understanding of specific attitudes within the Jewish community toward seeking services for depression and stigma effects on treatment. Findings can increase awareness among mental health professionals and community agencies regarding challenges confronting Jewish Americans when accessing and engaging in treatment. Also, results can assist cultural adaptation of evidence-based treatments addressing needs of Jewish individuals with depression.