Culture and Mental Health: Exploring Challenges and Resiliency for Diverse Communities The California MHSA Multicultural Coalition September 30, 2015 Carlsbad, CA

Middle Eastern Communities Middle Eastern is a geopolitical term that refers to a region of the world that includes both Arab and non-Arab countries (i.e., Turkey, Iran, Israel) Middle Eastern used by itself is not an ethnicity, so it’s important to identify specific ethnic background if using the term Middle Eastern to describe and approach communities; e.g., Arab; Turkish; or Iranian

How Many Countries Are There in the Arab World? A. 9 B. 15 C. 22

Arab Diversity The Arab World stretches from northern Africa to western Asia, and Arabs are as diverse as the 22 countries from where they come Distinct identities, such as Palestinian, Lebanese, Syrian, Iraqi, Egyptian (e.g., Christian Coptic), etc., define our communities Although there is a majority of Muslims in the Arab World, many Arabs are Christians of Catholic, Orthodox, or Protestant denominations

THE ARAB WORLD

Arabs have a shared sense of history; common values; and cultural heritage. We are connected by the language of Arabic, which is spoken in slightly different dialects that vary from country to country, even region to region within countries.

Demographics The statewide Arab population, adjusting for under-reporting, is more than 817,000 (research by Zogbi International and the Arab American Institute) California is among the fastest growing in Arab populations in the country California has the largest Palestinian population in the U.S. According to the 2010 Census, more than 1/3 of Arabs in the state have Lebanese or Egyptian roots There have been significant increases in the number of Californians who are of Iraqi and Syrian descent Source: American Community Survey Rolling 5-Year Average – U.S. Census Bureau ©2011 Arab American Institute Foundation

Top 5 California Counties With Arab Communities (Listed in order of Arab Population Size) Los Angeles County San Diego County Orange County San Bernardino County San Mateo County

Cultural Values Family is the most important social and economic institution The wellbeing of the community and that of the family are stressed over that of the individual There is a strong respect for elders in Arab culture – individuals gain status as they age and their advice and opinions become more valued and respected Education, family businesses, generosity and hospitality are highly regarded

Resiliency Traits There is a strong achievement orientation that results in success in the areas of business, technology, medicine and education Successful community members give back, volunteering and providing financial support for community programs, scholarships, the underprivileged, etc.

Key Informant Interviews While the extent of gender and generational roles are emphasized by the family/individual’s level of acculturation, for many immigrants gender and generational roles are critically important in determining behavior. One participant described the challenges faced by some Muslim refugee women who obtain housing in shelters: “ They need a space to pray... and... a private bathroom and may feel compelled to watch over their female children at night.” Parents worry about their children losing their connection to their culture of origin (enculturation), and the resulting acculturation gaps create distance between parents and children.

Priority Issues Facing Arab Communities Lack of access to culturally and linguistically competent community services is an ongoing concern Delivery of health, mental health, and social services to vulnerable populations such as women (esp. respecting importance of gender relations/roles); the elderly; undocumented and other out-of-status immigrants Provision of legal services to address immigration-related matters and protect civil rights and liberties must be supported

Priority Issues, cont’d. Some seniors live in isolation at home, due to lack of English skills and awareness of and connections to community resources. They face challenges such as depression, stress about generational roles and level of acculturation, and lack of access to healthcare. Many immigrant community members, both young and old, are unaware of the health, social and legal services available to them; cannot access them due to language and cultural barriers; or are not comfortable seeking help outside of the community. Recent immigrants have endured complex traumas from homeland displacement, war/violence, and refugee conditions.

Needs and Action Steps Facilities for community services and youth activities are an important need and provide cultural resources such as language and traditional cooking classes, festivals, etc. The burden on ethnic- and faith-based community organizations to conduct outreach and education to inform community members of available services and how to access them, as well as to build trust, must be alleviated by support and partnership from counties. Training and internship programs need to be supported to address the shortage of culturally competent social workers directly serving low-income Arabs & others from the Middle East

Raja Mitry, M.A.