Researchers: Ora Nakash¹, Leeat Granek²

Background: A significant proportion of women with breast cancer will suffer psychological difficulties. Failed identification and limited mental health treatment may impair the women's quality of life. The treatment gap between those who require mental health intervention and those who receive it reaches 40% and varies as a result of the patient's ethnic background.

Objectives: To investigate possible gaps in the assessment of mental health needs and barriers to care among women with breast cancer by ethnic affiliation.

Method: One hundred and sixty women with breast cancer that were diagnosed within the preceding 8 months participated in the study (n=27 Arab, n=52 Mizrachi Jews, n=68 Ashkenazi Jews). Participants completed structured questionnaires to evaluate their mental health status as well as to assess objective (i.e., availability; accessibility) and subjective (i.e., self- and care stigma) barriers for mental health care. Also, to establish a gold standard for diagnostic reliability, patients will complete a structured psychiatric diagnostic interview. Medical charts were reviewed to ascertain the recorded mental health status and recommendations for care.

Findings: Significant differences were identified in the report of emotional distress and barriers to care among women belonging to different ethnic groups. Arab women reported higher depression and anxiety and subjective and objective barriers to care in compared to Jewish women. Identification of mental health distress and treatment as reported in medical charts showed significant underreporting. The utilization of structured clinical interviews documented significant differences in rates of mood and anxiety disorders among Mizarachi and Ashkenazi women as well.

Conclusions: Ethnic differences are significant in report and identification of mental health distress and access to care.

Recommendations: Screening tools to assess mood and anxiety disorders and well as culturally appropriate referral to mental health services should be implemented to assess mental health distress among women with cancer.

Research end date: 09/2017