War beyond the frontlines: examining the interplay of lack of protected spaces, war exposure, and mental-health problems among Bedouin Arabs in the Negev

The Bedouin Arab community in southern Israel, a disadvantaged minority within broader Arab society, faces ongoing political, social, and economic challenges that are intensified during times of war, leading to increased mental-health problems. This study examined exposure to war events, lack of protected spaces, and mental health, with a focus on gender. It was hypothesized that men would report greater exposure to war events and that women would report more mental-health problems. It was further hypothesized that access to protected spaces would moderate the relationship between exposure and mental-health outcomes. During December 2023 and January 2024, 166 participants (50 males, 116 females) completed questionnaires on sociodemographic factors, exposure to war events, and mental-health symptoms. Most of the participants reported exposure to sirens and missiles that had fallen in the areas in which they live (95.2% and 78.9%, respectively). About one-third of the participants reported knowing people who were injured or killed during the war. A high prevalence of severe mental-health problems (11.7%) was found. Men reported significantly higher levels of exposure to war events than women ( M = 3.12, SD = 1.57 vs. M = 2.48, SD = 1.32; t = 2.51, p < .01). However, no significant gender differences were found in somatization, depression, anxiety, or total symptom severity. In a regression model, exposure to war events significantly predicted mental-health symptoms ( B = 5.55, 95% CI [2.21, 8.89], p = .001) and younger age was associated with greater distress ( B = -0.55, 95% CI [-1.11, -0.01], p = .05). Lack of ready access to a protected space played a moderating role in the relationship between exposure and mental-health outcomes: Among participants without ready access to a protected space, exposure significantly predicted mental-health symptoms ( B = 4.95, 95% CI [1.30, 8.60], p = .008), while this relationship was non-significant among those who had access to a protected space. These findings highlight the substantial mental-health needs identified among this minority population. Addressing these needs through appropriate mental-health responses is of particular importance. Such responses should be trauma-informed, culturally adapted, and community-based mental-health interventions. The findings also point to the importance of considering systemic barriers, such as home demolitions and construction restrictions, when planning mental-health responses, alongside family-centered initiatives to enhance early identification and access to care.