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4.6: Indigenous and CALD Populations

David Featherston

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centred_careLanguage

Research on cultural issues relating to chronic disease management programs reported that eighty-three percent of patients reported that it was important or very important to have education material available in different languages.(1) Eighty-one percent of patients believed it important or very important to have a nurse that spoke the same language.(1) While this is not always feasible, it emphasises the importance of language for a clear understanding of, often complex, health issues.

Choice of language and clarity of expression are key concerns for patients and carers, where English is not their native language. Consider some strategies that can be used to determine the level of understanding. Health literacy may be low when assessed in English, but assessed in the context of the patient’s native tongue, could be high. There are links below to fact sheets in a range of languages.

Carers can be, and often are, used as translators but this should not be as a replacement for the collaborative role they should play within the planning of self-management goals.

 

resourcesResources to support psychiatrists

For further information on cultural competency and appropriate support for Indigenous and CALD patients, the following websites may be of help.

  • The Australian Indigenous Mental Health Website
    This was developed by the Aboriginal and Torres Strait Islander Mental Health Committee of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and beyondblue, the national depression initiative. It was created to support the work of health professionals in improving knowledge and understanding of Aboriginal and Torres Strait mental health issues and to achieve better outcomes.
    http://indigenous.ranzcp.org/
  • The Victorian Transcultural Psychiatry Unit offers an Education & Professional Development Program to provide clinicians and workers in mental health services with knowledge and skills to improve the quality of transcultural interaction between mental health workers and clients from diverse linguistic and cultural backgrounds.
    http://www.vtpu.org.au/programs/education/
  • Māori Health Models
    The Māori philosophy towards health is based on a holistic health and wellness model called Te Whare Tapa Wha, developed by Dr Mason Durie (1982). It can be applied to any health issue, whether it involves physical or psychological well-being. Māori health is underpinned by four dimensions representing the basic beliefs of life: te taha hinengaro (psychological health), te taha wairua (spiritual health), te taha tinana (physical health) and te taha whānau (family health).
    http://maorihealth.govt.nz/moh.nsf/pagesma/445

 

resourcesGeneral resources for Indigenous and CALD patients

These lists are also available as PDF attachments that can be downloaded and printed for personal, patient and carer use. Click to view Resources for Indigenous and CALD 4.6.pdf

  • Transcultural Mental Health Centre – TMHC (Australia)
    TMHC is a statewide service that promotes access to mental health services for people of CALD background, offering clinical consultation and assessment, transcultural mental health promotion, prevention and early intervention, publication and resource development and education and training.
    Phone: (61) 02 9840 3800
    http://www.dhi.gov.au/tmhc/tmhc/default.aspx
  • Co-Exist NSW is a service of TMHC to assist people from culturally and linguistically diverse (CALD) communities and their families living with comorbidity and who may have found it difficult to access mainstream services due to language and cultural barriers.
    http://www.dhi.gov.au/Co-Exist-NSW/Home/default.aspx
  • Multicultural Mental Health Australia – MMHA (Australia)
    MMHA actively promotes the mental health and well-being of Australia’s diverse communities through a series of campaigns, projects and information fact sheets. MMHA also includes a series of resources and training for specialist and mainstream mental health professionals.
    • Fact sheets are available in a range of different languages covering a number of mental health topics and conditions.
    • Carer-specific resources are available in a range of languages.
      Phone: (61) 02 9840 3333
      www.mmha.org.au
  • Health Translations (Australia)
    The State Government of Victoria, Department of Health has an excellent directory which links to online multilingual health resources from government departments, peak health bodies, hospitals, community health centres and welfare agencies.
    Phone: (61) 03 9096 2667
    http://www.healthtranslations.vic.gov.au/
  • District Health Boards (DHB)
    Most District Health Boards in New Zealand have Māori mental health services that have cultural advisors attached.

 resourcesResources for carers of Indigenous and CALD patients

These lists are also available as PDF attachments that can be downloaded and printed for personal, patient and carer use.
Click here to view Resources for Carers of Indigenous and CALD 4.6.pdf

  • Carers Australia
    The website supplies information to Indigenous carers and multicultural carers. The page links to Carers Australia in each state and territory. Phone: (61) 02 6122 9900
    http://www.carersaustralia.com.au/     
    •  
  • Carers NSW (Australia)
    The Department of Ageing, Disability and Home Care has funded Carers NSW to translate four popular carer fact sheets into fifteen community languages plus English. The titles included are: the seven habits of highly effective carers, carer support groups, the impacts of a residential placement and carers NSW.
    Phone: (61) 02 9280 4744 
    • http://www.carersnsw.asn.au/Default.html?/infosupport/translatedInfo.htm
  • beyondblue (Australia)
    The PowerPoint presentation of a CALD Carers Participation Program kit produced by beyondblue and Nova Community Care Ltd (NCCL) is available for viewing on the site. The course is designed as a group learning session specifically for carers who are from a culturally and linguistically diverse background (CALD) and who are caring for a person with a mental illness.
    Info line: 1300 22 4636
    http://www.beyondblue.org.au/index.aspx?link_id=59.1178      
    •  
  • Victorian Transcultural Psychiatry Unit (Australia)
    The VTPU is a statewide unit which supports area mental health and psychiatric disability support services in working with culturally and linguistically diverse (CALD) consumers and carers throughout Victoria.
    Phone: (61) 03 9288 3300
    http://www.vtpu.org.au/

reflectReflective exercise

Reflect on your own self-management practices when consulting with a CALD or Indigenous patient and jot down your thoughts to the following questions.

What changes to your regular practice, if any, do you currently make when consulting with a CALD or Indigenous patient?

Record improvements that you could make to your current practice when consulting with a CALD or Indigenous patient.

ReferencesReferences

  1. Tracey J, Bramley D. The acceptability of chronic disease management programmes to patients, general practitioners and practice nurses. NZ Medical Journal 2003;116(1169):1–8.
Continue to Module 4.7: Working with Young People

Project support

ImageProject support

This RANZCP Chronic Condition Self-management project is supported by funding from the Australian Better Health Initiative: A joint Australian, State and Territory government initiative.

RANZCP

ImageAbout RANZCP

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) is the principal organisation representing the medical specialty of psychiatry in Australia and New Zealand.

The College is responsible for training, examining and awarding the Fellowship of the College qualification to medical practitioners.