Who You Gonna Call?

[Donte]

Navigating the mental health system is complex for most Australians but there are additional challenges for people from culturally and linguistically diverse backgrounds which add to the complexity. How can one find comprehensive information in their native tongue for example? What happens to populations who do not have access to computers or the internet or are not computer literate and smart phone savvy? How many psychiatrists or other mental health professionals are bilingual and bi cultural? How does indirect discrimination restricts multicultural people from having full and equitable access to services? How often do mental health services consult with ethnic communities? How do we effectively engage culturally and linguistically diverse populations? How do we work with minorities within minorities e.g. people or groups who do not identify with the mainstream aspect of an ethnic culture or the dominant religion in that culture? People of diverse cultures, languages or religions may have difficulty with or cannot receive the benefits of mental health services and supports. Additionally, when family members interpret there could be breaches in privacy and confidentiality and a conflict of interest. A person-centre approach to service provision and care is pivotal to meet the diverse complex needs of various multicultural people and break stereotypes and a false sense of knowledge about a cultural group. So who you gonna call?

[Hayfa]

Hi Donte'

some excellent points! As a person who has been through this situation and still going through it with ageing parents, I have watched my parents experience all of this.
One thing I found most difficult and disturbing was not only the hardships my parents faced trying to navigate systems and understand difficult terminology where their health was concerned, but the added stress, fear and anxiety that was brought on sometimes from the doctors. There are so many things that are different here for some communities as opposed to home, for example, a terminally ill patient may not be told their diagnosis for fear of further causing them stress, instead the family is told and with time it becomes communicated to the person.

I certainly found a lack of bilingual health workers, I remember a time where I rang around trying to find an Arabic speaking psychologist to help my dad and this particular Arabic Council representative said 'your dad doesn't need one of those, just get him a ticket to go overseas, that's all he needs to become better'.
It can be a very daunting and stressful experience on the whole family, I find it is the same for every migration wave in almost all communities and even though there is more support services now-a-days the underlying structures of the stress never change but certainly we know more now than we did with the early migrants and our models of support are working better.

[Donte]

Hi Hayfa,

Yes. The human experience is universal. Mental health, for instance. The cultural response to this universal issue varies from group to group and within the diversity of each sub-group within each culture. The individual reaction to this universal issue within any cultural context will also vary. Beyond the common barriers faced by non-English speaking people, there are systemic issues that are pertinent to the culture of mental health and other services and medical/health supports and the way they are operating and as you said, big differences from country to country. One thing is certain,often, the person has to fit the service, instead of the other way around. This automatically excludes certain individuals or groups who are not familiar with processes in this country and may not have a common point of reference if let's say mental health services didn't exist in their country of origin at the time of their migration or they had never utilized them. Even the concept of time, appointments, assessments, reports, referrals etc can be alien to some. In terms of diagnosis and prognosis, as very well said, the response and way to go about it may vary enormously in certain groups. Some don't even mention the word depression or the term mental health and common reactions may be 'why me?', 'what have we done wrong?', 'no one needs to know', 'we will cope' etc. Others look to spiritual supports, alternative methods, or new age practices for solace. Some may view mental illness as a weakness or a sin or a punishment from god. Others as 'karma' or a 'lesson to learn' etc. Not everyone shares the Western model of care. Clearly one size doesn't fit all when we engage with people and a 'person-centered-approach' is needed. Just listening to the needs and issues of the individual and the family without treating the person as their culture or their religion or their sexuality. When dealing with terminal illness, aging, palliative care, loss and grief then things become even more challenging. It is a universal reality experienced at various times in the timeline of migration to this country and no individual or group escapes it. Reactions and responses may vary accordingly subject to generational, cultural, spiritual and social attitudes and expectations. Yes, the stress is always there and as you stated, we certainly know more now and respond accordingly than what we did years ago and one would hope that our models of support are indeed working better. 🙂

[blueskye]

I think that is a good issue raised, Donte.

I am honestly unaware of who to call for multicultural people that speak a different language.

I had a look on the Beyondblue website and found Mental Health in Multicultural Australia (MHiMA) - http://www.mhima.org.au/resources-and-information/Services-and-organisations/mental-health-services which provides a list of the main providers of mental health services around Australia, transcultural mental health programs, multicultural psychosocial recovery-oriented services and specialist refugee support, etc ~ Have a look!

Hayfa, I am sorry to hear about the situation with your dad. I do hope that Australia increases their support available for multicultural people regarding mental health.

[Donte]

Thank you blueskye,

I'll look at these. It's good to know what's available in other languages. Especially for carers and children of migrants. One of the issues that many people from culturally and linguistically diverse backgrounds face is access to technology - computers, internet, smartphones etc, - and how to navigate these if they manage to obtain them, e.g. if they do not read or write English they most likely won't even get to 'arrive' at the webpage! This is especially true for the thousands of newly-arrived migrant and refugees and also for large ethnic communities that are aging rapidly and disproportionately to the rest of the population as they arrived at a similar time and are the same age, e.g. the majority of Greeks or Italians who arrived in the post-war era and now all age simultaneously. Many of these people were unskilled workers and may have minimal or no education in their own language as they escaped war and poverty. Also, due to the lack of supports at the time of their arrival and their priorities (work hard and make money so you can return back home once the crisis is over), many didn't learn English or they just 'made do' due to the comfort in big numbers (they were arriving by the thousands), which contributed to the development of their communities in Australia. They lived, worked, and developed their schools, churches, museums, communities (which is a great advantage for them and for Australian culture, economy, society in general), however, many have also being disadvantaged as an outcome as that hindered their integration process. The ones who studied and learnt English and integrated better to society are also faced with dementia and other illnesses and the aging process which often makes people revert back to their primary tongue. Additionally, from service provision perspective, the majority of this population doesn't meet the funding criteria to qualify for supports as services are mostly nowadays geared towards newly-arrived communities who've been here 0-5 years (settlement services etc). A mythology also exists which claims that well-established communities do not need support as they have been here forever and have their own supports in place even if they are non-English speaking. Even though there is some truth in this, many are vulnerable and disadvantaged and no different in terms of need for support to the newly-arrived migrants and refugees. That's why I said 'Who You Gonna Call?' not 'Who You Gonna Google?'...