S35: Diversity, Culture & Wellbeing

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By September 28, 2023 No Comments

Authors: Jamie Lee, Mydair Hunter, Claire Ralfs, Anna Booth, Allie Bailey, Jenn McIntosh, Erin Joyce, Zoi Jahau, Michael Olasoji, Komal Khan, Dominic Hwang, Anna Browne, Enaam Oudih, Sulutumu Vailoa Milo-Harris, Phyllis Tangitu & Magdel Hammond

Year: 2023

Event: 2023 The MHS conference - Adelaide

Subject: Diversity, Culture & Wellbeing

Type of resource: Video

Presentation 1: Culture makes a difference to safety and wellbeing risks in community-based counselling services.
Authors: Jamie Lee, Mydair Hunter, Claire Ralfs, Anna Booth, Allie Bailey & Jenn McIntosh
In Australia, “white Scandinavian skilled migrants” and “black Sudanese civil-war refugees” are both Cultural and Linguistically Diverse (CALD) but are likely to have different experience of their culture impacting on mental health and needs from counselling. That’s why Relationships Australia SA (RASA) routinely asks clients both their CALD status and whether culture or religion has impacted their presenting issues. Cultural impact is the crucial first question in Family DOORS, the validated self-report tool used for over ten years at RASA to screen all clients for wellbeing and safety risks (Wells et al., 2017; Lee et al., 2021).
We reviewed 722 CALD and 5,731 non-CALD counselling client files over 2.5 years to assess any effect of self-reported cultural impact on safety and wellbeing risks. We found that CALD clients who reported cultural impact had greater safety and wellbeing risks (eg family violence) and lower protective factors (like less suicide risk) compared to non-CALD or CALD clients without cultural impact.
We conclude it’s essential for services to routinely ask clients if culture makes a difference to them and then engage with safety and wellbeing risks with the client’s experience of cultural impacts in counselling.

Learning Objective
The audience will recognise the potential intersection of CALD status, cultural impact and wellbeing or safety risks, then reflect on how they currently make space for engaging with cultural difference and impact in counselling. We encourage mental health professionals to routinely explore safety and wellbeing risks through a cultural lens.

Lee, J., Ralfs, C., Booth, A., & McIntosh, J. E. (2021). Practicing Best Practice: A 10‐Year Retrospective on Universal Risk Screening in a Mediation and Counseling Organization. Family Court Review, 59(4), 697-709.
Wells, Y., Lee, J., Li, X., Tan, E. S., & McIntosh, J. E. (2018). Re-examination of the Family Law Detection of Overall Risk Screen (FL-DOORS): Establishing fitness for purpose. Psychological Assessment, 30(8), 1121.

Presentation 2: The role of Bicultural Workers in Mental Health Settings.
Authors: Erin Joyce, Zoi Jahau, Michael Olasoji, Komal Khan, Dominic Hwang & Anna Browne
Barriers continue to limit access to mental health services for culturally and linguistically diverse (CALD) consumers, including entrenched stigma associated with mental illness in many cultures resulting in poor health seeking behaviours and culturally unsafe mainstream mental health (MH) services. There is limited published work that has examined the role of bicultural workers (BCWs) within MH settings.
This presentation will present the perspectives of MH clinicians who identify as coming from CALD backgrounds on some of the difficulties CALD communities often encounter while seeking MH care, as well as their views on how BCWs in MH systems could improve service equity.
The first phase of this study explored the role of BCWs within MH settings across clinical and community health settings. Semi-structured interviews were conducted among n=18 mental health clinicians working within a public mental health setting as well as a community health service. Data was analysed using thematic analysis.
The participants highlighted the significant role BCWs can play within these settings. The Western biomedical model remains the dominant model in the delivery of MH care which can disadvantage consumers from CALD backgrounds. It is important that MH systems consider the cultural needs of diverse populations that access MH care.

Learning Objective
1. To examine the views of mental health clinicians from culturally and linguistically diverse backgrounds working across public mental health service and a community health setting about the need for bicultural workers in mental health care for people from CALD backgrounds.
2. This project is focused on mental health settings.

Musser-Granski, J., & Carrillo, D. F. (1997). The use of bilingual, bicultural paraprofessionals in mental health services: Issues for hiring, training, and supervision. Community Mental Health Journal, 33, 51-60.
Johnsdotter, S., Ingvarsdotter, K., Östman, M., & Carlbom, A. (2011). Koran reading and negotiation with jinn: strategies to deal with mental ill health among Swedish Somalis. Mental Health, Religion & Culture, 14(8), 741-755.

Presentation 3: Mobilising the power of diverse voices – Lived experience work and CALD communities.
Author: Enaam Oudih
In recent years, peer support and Lived Experience [LE] have been increasingly recognised as powerful tools in mental health recovery. However, many individuals from culturally and linguistically diverse (CALD) backgrounds face challenges in navigating the Australian mental health system and cultural stigma in relation to mental health has meant that people from CALD backgrounds have been underrepresented in the LE workforce [1].
To address this issue, the Australian Institute of Social Relations and Relationships Australia Peace multicultural program supported over 20 individuals with diverse backgrounds and lived experience of mental health, free of charge, through a foundation course for certificate IV Peer Support Mental Health. Participants were asked to discuss their perceptions of peer support and the valuable qualities of a peer support worker. Additionally, they were prompted to consider other factors that may be necessary for CALD individuals interested in entering the workforce as lived experience/peer support workers. As a result, many insights and lessons learnt about how we recruit and work with CALD people with LE.

Learning Objective
Audience will learn about:
1) The value of designing opportunities for CALD individuals interested in joining the lived experience workforce.
2) How to recognise and respond to the unique challenges facing CALD people with LE to promote greater diversity and inclusivity in the mental health workforce.

[1] Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context E. Levy-Fenner . E. Colucci . S. McDonough [2022]

Presentation 4: Te Amorangi ki mua, te hapai o ki muri.
Authors: Sulutumu Vailoa Milo-Harris, Phyllis Tangitu & Magdel Hammond
“The leader at the front and the workers behind the scenes”. Both need to be working together to make sure all is flowing well.
New Zealand’s mental health and addiction problems cannot be fixed by government alone, nor solely by the health system. We can’t medicate or treat our way out of the epidemic of mental distress and addiction affecting all layers of our society. We need to ensure practical help and support in the community are available when people need it, and government has a key role to play here. But some solutions lie in our own hands. We can do more to help each other. (He Ara Oranga 2018)
Further, the New Zealand Health System is currently undergoing significant change. Te Whatu Ora and Te Aka Whaiora. The foundations of this new health system detailed in Pae Ora (Healthy Futures) Act 2022. The intent to embed a Tiriti-dynamic health system, that will enable Health equity for all, implement a population health approach and aim to ensure a sustainable health service delivery system.
The “Three Degree’s” are the leads for “Pou” in Emerge Aotearoa. Emerge Aotearoa is aspiring to become a “Tangata Tiriti organisation. Driven by values and Pou (Pillars) that are inclusive of Pasifika and Lived Experience aspirations. Privileging Lived Experience and Diversity, is a central “Pou” and considers worldviews across the spectrum of experiences of marginalisation, realising systemic change for an inclusive society and full community citizenship. Emerge Aotearoa serves large Pacific populations, and whilst as a lead national mental health and addiction NGO, it already has Pacific initiatives and programmes in place.
Phyllis, Sulutumu and Magdel will share their journeys and the developments occurring within Emerge Aotearoa.
E fofō e le alamea le alamea.
The Samoan Proverb - “the remedy for the toxic sting of the Crown of Thorns starfish, is the Crown of Thorns starfish itself”. The solutions for issues affecting a community can be found within that same community.

Learning Objective
Collaboration and working together to enable, support and inform a way forward. The solutions lie within our own communities.

He Ara Oranga Report of the Government Inquiry into Mental Health and Addiction 2018

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