How we can improve mental health services for CALD communities and young people
3 September 2020 at 7:30 am
Sammy Huynh reflects on the gaps she sees for CALD communities and young people as a young social worker.
Australia is proud of its multiculturalism, with many residents or parents born overseas and originating from non-English speaking countries. But our services, particularly mental health services, often do not cater to our culturally and linguistically diverse (CALD) communities.
As a young Vietnamese-Australian with immigrant parents, my experiences relating to my cultural background have not always been understood by mental health services. Additionally, as a social worker in the mental health space, I have supported young people from CALD backgrounds who have unique experiences and barriers impacting on their mental health and recovery. It is important to focus on young people’s mental health, as over 75 per cent of symptoms of mental ill-health emerge before the age of 25. Young people from CALD communities face unique challenges when it comes to seeking and accessing services, and we must do more to address the gaps.
People’s cultural heritage and life experiences play a role in forming our understanding of and responses to mental illness. The willingness to speak and acknowledge mental illness will depend on our social, biological, religious, and psychological context. But there is no doubt that there is a greater stigma of mental illness in CALD communities. Issues like privacy regarding mental health being more prominent in some cultural groups than others, language barriers, intergenerational conflicts or taboo surrounding mental illness, mean that many young people from CALD communities don’t access the support they need. But the solutions do exist and it is imperative that we act now to reduce the stigma of mental illness in CALD communities and encourage access to mental health support. I have seen the importance and meaningful impact of peer work where young people from CALD communities with lived experiences of mental health act as advocates and educators.
CALD communities have unique experiences such as grief and loss, trauma, war, poverty, a sense of displacement, racism, and discrimination. For CALD young people, this may be in addition to navigating important stages of development such as seeking a sense of belonging, personal identity, transitioning through educational settings, and navigating relationships. Consequently, early intervention and prevention is crucial to ensure CALD young people’s needs are met and they are equipped long-term with the tools to cope and live a healthy life. Young people typically present to services at a later age when symptoms are severe which may require acute inpatient care, thus compromising early intervention and prevention of mental ill-health.
One of the barriers to accessing mental health services that I have encountered as a social worker has been CALD young people living at home with family, where mental illness is stigmatised. Thereby, creating further barriers to mental health support such as transport and affordability. That’s why we need to focus on mental health awareness in CALD communities and ensure there is translated information on how to access appropriate mental health services. It is particularly important to include family members where possible in the prevention and treatment of mental illness to promote a holistic approach.
There can be a reluctance in CALD communities to voluntarily access hospital and community-based mental health services. This lower level service use may be as a result of difficulties in understanding, finding and accessing mainstream services which are culturally safe and appropriate. There are skills specific to working appropriately with CALD communities such as working with interpreters, working with faith and community leaders, cultural brokers, and being aware of verbal and non-verbal communication differences. Culturally safe practice invites practitioners and service providers to challenge their own beliefs, biases, and assumptions, and incorporate reflection on the experience of institutional racism and the impact that can have on someone’s sense of self and safety in the world. Working in a multicultural context requires explicit awareness of the power imbalance between practitioner and client. The power imbalance is emphasised when practitioners value their own “expert” knowledge about what is best for the client rather than considering the clients’ experiences, insights, and values.
Additionally, there is a need to adopt an intersectional approach to support a deeper understanding of how individuals with multiple intersecting identities that are less privileged, can be disadvantaged and experience multiple forms of oppression that cannot be conceptualised separately. Services need to recognise that within the CALD community, there are also additional skills and competencies required to work with young people in CALD communities who are also LGBTIQA+, disabled, living in family violence, seeking asylum or experiencing homelessness. So even though cultural competence training is becoming recognised as mandatory in many services, there needs to be more training provided to services to be better at intersectional approaches to supporting young people.
Unfortunately, there is still limited research and data about mental health in CALD communities and young people. Without reliable data about the different types of mental health conditions in CALD communities, it is challenging to evaluate whether attempts to improve mental ill health for this population is effective. Therefore, further comprehensive research is essential to improve mental health outcomes for CALD communities and young people.
Providing a “one size fits all” approach for our vulnerable populations may result in inferior care. We must continue to work towards culturally safe mental health services which prevent CALD communities and young people from “slipping through the cracks”. This means cultural competence training for practitioners and service providers which promotes an intersectional approach, challenging power imbalances and utilising peer work to raise awareness of mental illness.
This article is part of a monthly series, Youth Matters, a collaboration between Youth Affairs Council Victoria and Pro Bono Australia to inject the voices of young people into the social change sector.