Mental health outcomes among Arab refugees, immigrants, and U.S. born Arab Americans in Southeast Michigan: a cross-sectional study

BACKGROUND: Arab refugees and immigrants living in the United States may be exposed to political, economic, social, and environmental stressors that may affect their mental health. Yet, little is known regarding mental health outcomes among Arab Americans. The purpose of this study was to measure depression and anxiety levels among Arabs in Southeast Michigan and determine whether these levels differ by resident status: refugee, immigrant, or U.S. born. METHODS: We conducted a cross-sectional study in a convenience sample of 275 adults who self-identify as Arab living in Southeast Michigan. Participants were recruited from a non-profit health and social services organization between August–November 2015. Data were collected via self-administered questionnaires, using standardized instruments to assess depression and anxiety symptoms. RESULTS: All three resident groups exhibited high mean levels of depression and anxiety. Refugees reported higher levels of depression and anxiety than either immigrants or U.S. born Arab Americans. After adjustment for sociodemographics, differences between U.S. born Arab Americans and refugees were statistically significant for depression (b = 2.84; 95% CI: 0.21, 5.47), but not for anxiety. Refugees had significantly higher depression scores (b = 3.18, 95% CI: 1.52, 4.84) and anxiety scores (b = 1.31, 95% CI: 0.11, 2.50) than immigrants. Those reporting political violence and religious persecution as reasons for immigration had the highest levels of depression and anxiety. CONCLUSIONS: This convenience sample of Arab Americans reported high levels of depression and anxiety symptoms. Refugees appear to have poorer mental health outcomes than either immigrants or U.S.-born Arab Americans.