Seeking approval first: Mental health care utilization and engagements among MENA adolescents in the United States

Like most adolescents, those from the Middle East and North African (MENA) region face a host of stressors that threaten their mental health. However, evidence suggests that this population may encounter specific barriers to access that inhibit or preclude help-seeking and engagement with mental health services. To better understand how these barriers limit MENA adolescents' engagement with mental health services, we conducted interviews with 27 school-based service providers for MENA students in three U.S. cities and analyzed four focus group discussions from a Photovoice project with seven Arab adolescents in Detroit, MI. Our findings identified four key themes around barriers to service access and utilization: (1) the importance of reputation and adhering to familial and societal expectations, (2) student-parent communication around mental health and psychological distress, (3) the role of gender in seeking and engaging with mental health services, and (4) the quality and cultural appropriateness of mental health services. Strategies and recommendations for future research, policy, and practice to overcome these barriers are discussed.