Multicultural Dimensions in the Office for Mental Health
Thank you, Madam Speaker.
As is often mentioned in this chamber, we live in a richly multicultural city, with 32 per cent of residents born overseas and another 15 per cent having at least one parent who was born overseas. A non-English language is spoken in nearly 24 per cent of Canberra’s households.
The prevalence of mental health issues in Australia’s multicultural communities is no greater than in the population at large, but Australians from culturally and linguistically diverse (or CALD) backgrounds do face specific challenges.
Concepts associated with mental health sometimes don’t exist in other languages or backgrounds. Psychiatric nurse Sione Vaka has noted that ‘there is no direct translation in some Pacific languages’ for the word depression. And Fatima Mohamed has pointed out that the phrase ‘mental health’ does not even occur in Somali. ‘In Somalia, you’re either crazy or you’re OK’, she added. ‘Even if they’re sick, they won’t tell you what’s wrong. They keep it in until it’s really bad’.
This illustrates another obstacle, Madam Speaker. Whilst stigmas surrounding mental illness are common, these stigmas are often more pronounced in CALD communities and need to be specifically targeted. At the same time, it is also essential that the help provided is culturally competent, and this goes far beyond just a token access to interpreters.
It is good when mental health practitioners can amplify ‘cultural concordance’ between themselves and their CALD patients. Psychiatrist Siale Foliaki calls this practising ‘from a place of intimacy’, where he can be ‘enmeshed in [a] client’s world’.
But a perfect match is not always possible. Another option is when mental health practitioners are able to ‘leverage their [own] ethnicity, religion, experience practising overseas, speaking languages other than English and/or existing cultural knowledge and experience to effectively communicate with their … patients’. Professionals who come from a non-dominant culture or have lived where they were part of a non-dominant culture often find it easier to relate to patients from a variety of multicultural backgrounds.
As one doctor reported, and I quote, ‘Having lived myself in another situation where you don’t understand the language, you don’t understand the culture and everything, I guess it makes me a bit more patient and also makes me try and understand where they are coming from so that I can better communicate with them’.
For this reason, policy in New South Wales states that ‘Diversity in the local population needs to be reflected in the skill base and composition of the mental health workforce’. This is why Mr Vaka, the psychiatric nurse mentioned earlier, actively works to recruit nurses from CALD backgrounds.
Madam Speaker, much has already been made in this chamber about the delays in implementing an ACT office for mental health. These delays are to be regretted, but I would suggest that they also provide the Minister for Mental Health an opportunity to make sure that important multicultural dimensions are not overlooked in the creation of this office.
In light of the fact that the Adult Mental Health Unit at Canberra Hospital is currently experiencing what the union has called a ‘crippling shortage’ of permanent psychiatrists and that, as a consequence, ‘ACT Health is continuing to undertake a national and international recruitment activity to fill vacant positions’, I specifically recommend to Mr Rattenbury that professionals with demonstrable cultural competence be specifically targeted as part of this recruitment drive and that cultural sensitivity be embedded in everything this office does.
Madam Speaker, I look forward to hearing more on this topic from the minister.