ARTICLES Barriers in the Utilization of Domestic Violence Services Among Arab Immigrant Women: Perceptions of Professionals, Service Providers & Community Leaders Anahid Kulwicki & Barbara Aswad & Talita Carmona & Suha Ballout Published online: 3 August 2010 # Springer Science+Business Media, LLC 2010 Abstract Ten focus group discussions were conducted with Arab American community leaders who had experi- ence with victims of violence in the Arab American population and issues related to domestic violence. Com- munity leaders were selected from an array of backgrounds, ranging from health and human service providers, legal and law enforcement service providers, religious and grass roots community organizations. Focus group discussions ex- plored the role of personal resources, family, religion, culture and social support system in the utilization of domestic violence services by Arab immigrants experienc- ing domestic violence. In addition, issues related to personal, socio-cultural and institutional barriers in domes- tic violence service utilization were addressed along with identifying culturally competent policy strategies in reducing barriers for service utilization by Arab immigrants experienc- ing domestic violence. Keywords Domestic violence . Arab-American population . Barriers in service utilization Literature Review Domestic violence is one of the leading causes of injury among women, leaving behind ‘muggings’, ‘stranger rape’, and car accidents combined. It is estimated that 25.7% of the emergency room visits by women are related to domestic violence (Houry, et al 2008). The problem is pervasive worldwide and can also take specific cultural manifestations such as female genital mutilation, dowry- related violence, femicide, rape, and honor crimes (Anderson and Aviles 2006; Kulwicki 2002). Victims suffer not only serious physical injuries but also emotional scars that precipitate in lowered self-esteem, severe fears, isolation from society, depression, suicide ideation, increased alcohol and drug use and death as a result of the violence. The effects of this type of abuse on the mental health of children witnessing acts of violence are enormous. Consequently, the cost of care is a serious economic burden to the US health system (Tables 1 and 2). Domestic violence is especially difficult to cope with, not only because it disrupts every aspect of the victims’ well-being, but also because of the many obstacles they have to overcome in order to report and to end the abuse. Amongst these obstacles, lack of access to and utilization of social support services carry major weights in women’ s decision to stay in abusive relationships (Bowker 1984; Dobash and Dobash 1979; Hamlin 1991; Robinson and Spilsbury 2008; Sullivan et al. 1992). Domestic violence appears to be especially problematic among immigrant and refugee women and it is known to claim more lives among minorities than in Western populations (Abu-Ras 2007; Lee 2007; Liao 2006; Pan et al 2006). Some researchers attribute this difference to inequalities in social services and the lack of ability to respond to immigrants’ needs in culturally appropriate ways; others believe that immigrants This research was supported by Blue Cross Blue Sheild of Michigan Foundation A. Kulwicki : T. Carmona (*) : S. Ballout College of Nursing and Health Sciences, Florida International University, Miami, FL, USA e-mail: tcarm001@fiu.edu B. Aswad Department of Anthropology, Wayne State University, Detroit, MI, USA S. Ballout Nursing Services, American University of Beirut Medical Center, Beirut, Lebanon J Fam Viol (2010) 25:727–735 DOI 10.1007/s10896-010-9330-8