Middle Eastern American Communities

General Considerations and Risk factors

• There are significant health disparities experienced by Middle Eastern Americans, however there is limited data around their health needs and care.

• Middle Eastern Americans come from several countries and are not monolith in religious identity

• Immigrants & refugees factors

  • Many are also recent immigrants who migrated from countries experiencing wars and economic and social instability. Middle Eastern Americans who migrated due to political violence and religious persecution in their home countries are also more likely to experience higher levels of depression and anxiety. COVID-19 may increase anxiety and worries about family in their home countries, potential impacts on their immigration status, and access to community resources and support. Middle Eastern refugees may have more challenges integrating and accessing social and economic opportunities than US born Middle Eastern Americans .

• Family counsel priority over mental health professional

  • Middle Eastern Americans are more likely to seek the counsel of family over mental health professionals when experiencing mental health symptoms. Engaging the Middle Eastern American community in community settings may also help to reduce stigma around mental health treatment. 

• Somatization of symptoms & stigma towards mental illness 

  • There are high levels of internalized and cultural stigma associated with mental health. Middle Eastern Americans tend to associate mental illness in a biological framework vs psychological, thus leading them to seek treatment from a primary care physician vs mental health professional. Linking medical diagnosis and behavioral health diagnosis may also increase engagement in mental health treatment. This includes discussing the mental health implications of COVID-19 and the importance of both medical and mental health care. Middle Eastern Americans may present with more somatic symptoms due to psychological distress. Therefore, Middle Eastern American patients presenting with stress, anxiety, or depression due to COVID-19 may endorse aches, pain, tiredness rather than DSM diagnostic criteria.

• Consider having medical chaperones or a patient-identified chaperone present

(SCRIPTS) Questions to help assess and intervene around mental health concerns

• Ask the patient more about their specific cultural and/or religious identity and use the patient’s language, which may require a translator

• People often understand their problems in their own way, which may be similar to or different from how doctors describe the problem. How would you describe your problem? And they may describe it in a different way to their family or friends. Ask: How would you describe your problem to a friend or family member?

• Ask: Why do you think this is happening to you? What do you think are the causes of your [problem]?

• Ask: Are there any kinds of support that make your problem better, such as support from family, friends, or others?

Resources

• ACCESS (Arab Community Center for Economic and Social Services)

• Arab American and Chaldean Council

• Arab American Chaldeon Council COVID-19 Response

• Muslim Family Services

• iAmerica Behavioral and Mental Health

• Arab American Civic Council COVID-19 (some resources specific to California)

• University of Michigan Arab and Muslim American Studies

• American-Arab Anti-Discrimination Committee (ADC)

Comprehensive Michigan COVID-19 Pandemic Resource Guide is available in Arabic. It provides information on how to access various resources aimed at supporting Michiganders through the coronavirus pandemic and related economic slowdown.