Assessing Predictors of Help-Seeking Behavior Among Middle Eastern Migrant Women

Background and Purpose: Middle Eastern (ME) migrant women face various challenges that significantly contribute to their mental health and psychological well-being. Despite the high levels of depression, anxiety, and PTSD found in this population, they report higher rates of delayed help-seeking for mental health problems in comparison to men. Mental health literacy (MHL) plays a prominent role in the recognition of mental health symptoms and help-seeking behavior. The purpose of this study is to examine the factors of help-seeking behavior for mental health problems among ME migrant women residing in Buffalo, New York.

Methods: A total of 164 Middle Eastern migrant women living in Buffalo, aged 18 to 80 years, participated in the study by completing a self-administered questionnaire in either English or Arabic languages. The outcome variable was whether the participant had engaged in help-seeking behavior in the past 12 months (Yes=1). Based on the Andersen-Newman model, we conducted a binary logistic regression analysis that incorporated predisposing factors (age, years residing in the U.S., county of origin, having children, marital status, occupation, monthly income, and education), enabling factors (English language proficiency and four components of MHL--endorsement of biomedical beliefs of mental illness, stigma towards mental illness, stigma toward seeking formal mental health services, knowledge of formal mental health services), and a need factor (Somatic Symptom). Stata v12 was used to conduct the analysis.

Results: Descriptive results showed that on average participants were 35.9 (SD=14.1) years old and had resided in the U.S. for 14.8 (SD=11.3) years. The majority of women were from Iraq (35.4%), followed by Yemen (34.8%) and other countries (29.9%). The majority had children (61.4%), were married (56.2%), were housewives (31.7%), made between $1,501-$2,500 per month (17.1%), and had a high school degree (33.8%). Binary logistic regression analysis results showed that women with lower odds of help-seeking behavior (HSB) were older (Odds ratio(OR)=0.94; 95% confidence interval (CI)=0.90-0.99), Yemeni (OR=0.10; 95% CI=0.02-0.42) or Other (OR=0.24; 95% CI=0.06-0.94), did not have children (OR=0.09; 95% CI=0.02-0.52), and good/excellent English skills (OR=0.27; 95% CI=0.08-0.95) while those with “very high” somatic symptoms (OR=7.47; 95% CI=2.03-27.5) had increased odds of HSB.

Conclusion and Implications: This study identified a distinctive pattern of help-seeking behavior among ME migrant women. The results revealed that younger and Iraqi women were more likely to engage in help-seeking behavior than ME women from other countries. This finding could be explained by the significantly higher levels of somatic symptoms found among Iraqi compared to Yemeni women as very high somatic symptoms were predictive of help-seeking behavior. In the context of counseling, this finding highlights the importance of recognizing that mental health problems can manifest as somatic symptoms among Iraqi women. Interestingly, women with low English proficiency were more likely to engage in help-seeking behavior, suggesting that these women may turn to informal sources such as friends or spouses, for support. Finally, the finding that women with children are more likely to engage in help-seeking behavior has important implications for using family connections as a means of promoting help-seeking behavior.