BACKGROUND: Israel's 2015 mental health reform transferred responsibility for mental health services from the government to community health maintenance organisations (HMOs), aiming to improve accessibility and equity and reduce stigma. However, its implications for different populations remain significantly underresearched. AIMS: To examine trends in mental health service utilisation and psychiatric medication issue rates among Arab and Ultra-Orthodox Jewish populations before and after the 2015 mental health reform. METHOD: = 2 847 184). Participants were classified as either general (non-Ultra-Orthodox Jewish), Ultra-Orthodox Jewish or Arab. The study analysed annual community visits to mental health professionals and dispensed psychiatric prescriptions. RESULTS: Between 2012 and 2019 the number of mental health service users increased across all populations, most prominently among Ultra-Orthodox Jewish and Arab populations (1.94- and 1.91-fold, respectively), compared with 1.55-fold in the general population. Annual community visits increased 2.4-fold in the general population, 2.2-fold in the Ultra-Orthodox Jewish population and 3.7-fold among Arabs, who had the lowest baseline utilisation. Psychiatric medication issue rates increased most in the Ultra-Orthodox Jewish population (2.5-fold), compared with 1.7-fold in the Arab and 1.5-fold in the general population. Women consistently used more services than men, with the greatest relative increase among Arab women. CONCLUSIONS: The findings suggest improved access to mental health services over the study period spanning the 2015 mental health reform, particularly in previously underserved populations. Continued progress requires culturally sensitive, community-tailored interventions for Arab and Ultra-Orthodox Jewish populations.
This study aimed to examine the relationship between post-traumatic stress disorder (PTSD) and attachment styles among older adults exposed to traumatic events. A descriptive–correlational design was employed using a stratified random sample of 534 participants from Irbid Governorate, Jordan. The study makes three key contributions to the literature by addressing the underrepresentation of elderly populations in trauma research, particularly within non-Western and Arab contexts. Data were collected using validated measures of PTSD and attachment styles. The findings indicated that PTSD symptoms and attachment styles were present at moderate levels. Anxious attachment was the most prevalent style, followed by avoidant and secure attachment. Correlation analysis revealed that secure attachment was negatively associated with PTSD, whereas anxious and avoidant attachment styles showed significant positive associations with PTSD symptoms. These findings highlight the dual role of attachment styles as both protective and risk factors in trauma-related outcomes. The results underscore the importance of developing culturally sensitive interventions that enhance secure attachment, strengthen social support, and improve emotional regulation among older adults. The study provides valuable cross-cultural evidence that contributes to the global understanding of PTSD and attachment processes in later life
هدف این پژوهش بررسی رابطه بین اختلال استرس پس از سانحه (PTSD) و سبک‌های دلبستگی در سالمندانی بود که در معرض رویدادهای آسیب‌زا قرار گرفته‌اند. این مطالعه با طرح توصیفی-همبستگی و با استفاده از نمونه‌گیری تصادفی طبقه‌ای بر روی ۵۳۴ شرکت‌کننده از استان اربد، اردن انجام شد. پژوهش حاضر سه سهم کلیدی در ادبیات علمی دارد: پرداختن به کم‌نمایی جمعیت سالمندان در پژوهش‌های تروما، به‌ویژه در زمینه‌های غیرغربی و عربی. داده‌ها با استفاده از ابزارهای معتبر سنجش PTSD و سبک‌های دلبستگی گردآوری شد. یافته‌ها نشان داد که علائم PTSD و سبک‌های دلبستگی در سطح متوسطی قرار دارند. سبک دلبستگی اضطرابی شایع‌ترین سبک بود و پس از آن سبک اجتنابی و سبک ایمن قرار داشتند. تحلیل همبستگی نشان داد که دلبستگی ایمن با PTSD رابطه منفی دارد، در حالی که سبک‌های دلبستگی اضطرابی و اجتنابی با علائم PTSD ارتباط مثبت معناداری نشان دادند. این یافته‌ها نقش دوگانه سبک‌های دلبستگی را به‌عنوان عوامل محافظتی و خطر در پیامدهای مرتبط با تروما برجسته می‌کند. نتایج بر اهمیت توسعه مداخلات حساس به فرهنگ که دلبستگی ایمن را تقویت می‌کند، حمایت اجتماعی را افزایش می‌دهد و تنظیم هیجانی را در سالمندان بهبود می‌بخشد، تأکید دارد. این پژوهش شواهد ارزشمند بین‌فرهنگی ارائه می‌دهد که به درک جهانی فرآیندهای PTSD و دلبستگی در دوران سالمندی کمک می‌کند.
