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Morse AR, Smith DG, Clifford R, Shrimpton B, Banfield M. Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities. Health Promot Int 2024; 39:daae099. [PMID: 39136156 PMCID: PMC11319870 DOI: 10.1093/heapro/daae099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024] Open
Abstract
Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.
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Affiliation(s)
- Alyssa R Morse
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia
| | - Dianna G Smith
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia
| | - Rosemary Clifford
- Mental Illness Education ACT, Genge Street, Canberra City, Australian Capital Territory, 2601, Australia
| | - Brad Shrimpton
- Mental Illness Education ACT, Genge Street, Canberra City, Australian Capital Territory, 2601, Australia
| | - Michelle Banfield
- Centre for Mental Health Research, National Centre for Epidemiology and Population Health, ANU College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia
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Than V, Doroud N, O'Brien L. Mental health service utilization and help seeking behaviours of adult Cambodians living in Western countries: A systematic scoping review. Int J Soc Psychiatry 2024; 70:778-791. [PMID: 38420918 PMCID: PMC11144358 DOI: 10.1177/00207640241230848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND Health disparity and under-utilization of health services is prevalent among Asian refugees and migrants in Western countries and can profoundly impact health outcomes. Cambodians who survived extreme physical and emotional trauma during the genocides enacted by the Khmer Rouge regime in the 1970's are particularly vulnerable to poor mental health outcomes decades later. Understanding the experiences of help-seeking and service use by displaced Cambodians in Western countries may help to design more effective and culturally safe healthcare services. AIMS To identify characteristics or factors associated with help seeking behaviours and service utilization of displaced Cambodians with mental health issues living in Western countries. METHODS This review followed the Arksey & O'Malley methodological framework for scoping reviews. Articles for review were identified through searches of nine electronic databases and manual searches. Relevant articles were selected, and data was extracted and synthesized into key themes. RESULTS This review included 15 articles. Most of the studies were conducted in the USA (n = 13) with one each conducted in Canada and New Zealand. Seven studies used qualitative interviews, five used a cross-sectional survey approach, two used a mixed-methods approach and one was a narrative review and case series. Key findings highlighted the impact of Cambodian cultural beliefs about mental health (guilt, shame and help-seeking stigma) on service utilization and the disconnect between Western models of service provision and preferred Cambodian ways of receiving support. CONCLUSION Mental health services in Western countries are likely to be under-utilized by Cambodians due to a mismatch between health beliefs and Western models of care. Further investigation of the association between health beliefs and barriers to service utilization among adult Cambodian refugees is warranted.
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Affiliation(s)
- Vannaral Than
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nastaran Doroud
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Lisa O'Brien
- Swinburne University of Technology, Hawthorn, VIC, Australia
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Madsen J, Jobson L, Slewa-Younan S, Li H, King K. Mental health literacy among Arab men living in high-income Western countries: A systematic review and narrative synthesis. Soc Sci Med 2024; 346:116718. [PMID: 38489937 DOI: 10.1016/j.socscimed.2024.116718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024]
Abstract
While interest in mental health literacy (MHL) is growing rapidly, cross-cultural research focusing on MHL is developing more slowly. This inaugural systematic review explored the recognition and beliefs about the causes of mental health disorders amongst Arab men living in high income Western countries (HIWC), their help-seeking beliefs, behaviors, and sources of help, as well as barriers and facilitators to help-seeking. Six electronic database searches were conducted using Medline, Embase, ProQuest Dissertations & Theses Global, PsycINFO, Scopus, and Web of Science. These searches yielded a total of 9,460 citations. After applying inclusion criteria through both database and manual hand searches, 46 studies were identified. The findings corresponded with four of the socioecological model's five factors: intrapersonal, interpersonal, societal, and institutional. Intrapersonal factors included attributing mental health illness to life and migration stressors, and religious reasons. Interpersonal and societal factors included men favoring informal help-seeking sources as stigma was a barrier to formal help-seeking. Institutional factors around the perceived cultural competence of healthcare professionals and access difficulties were obstacles to seeking formal help. The growth in Arab migration to HIWC highlights the need for culturally tailored care. Research is needed to understand the perspectives of healthcare providers working with Arab men in addition to how men's stigmatizing attitudes are an obstacle to formal help-seeking. Interventions should be designed to address the unique mental health needs of Arab men, recognizing that some explanatory beliefs may not align with current Western models of mental health. Moreover, efforts should be made to integrate men's informal sources of support into treatment planning.
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Affiliation(s)
- Julian Madsen
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Shameran Slewa-Younan
- Macarthur Clinical School, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 275, Australia.
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
| | - Kylie King
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Building 17, 18 Innovation Walk, Wellington Road, Clayton, VIC, 3800, Australia.
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Mehjabeen D, Blignault I, Taha PH, Reavley N, Slewa-Younan S. A mixed methods systematic review of mental health self-care strategies for Arabic-speaking refugees and migrants. BMC Public Health 2023; 23:2544. [PMID: 38124024 PMCID: PMC10731719 DOI: 10.1186/s12889-023-17395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Self-care strategies can improve mental health and wellbeing, however, the evidence on preferred strategies among Arabic-speaking refugees and migrants is unclear. This mixed methods systematic review aimed to identify and synthesise the global research on mental health self-care strategies used by these populations. METHODS English and Arabic language studies reporting on positive mental health self-care strategies to address symptoms of posttraumatic stress disorder, generalised anxiety and depression in the target populations were identified by systematically searching eight electronic databases and grey literature. Studies were deemed eligible if they were published from 2000 onwards and included Arabic-speaking migrants, refugees or asylum seekers aged 12 years and above. A narrative synthesis of study characteristics and relevant key findings was undertaken. The review protocol was registered on PROSPERO (registration number CRD42021265456). RESULTS Fifty-nine records reporting 57 studies were identified, the majority appearing after 2019. There were 37 intervention studies that incorporated a self-care component and 20 observational studies that reported on self-generated self-care practices. Across both study types, four broad groups of mental health self-care were identified-social, psychological, religious/spiritual, and other (e.g., expressive arts and exercise). Psychological strategies were the most reported self-care practice overall and featured in all intervention studies. Religious/spiritual and social strategies were more common in the observational studies. Intervention studies in diverse settings reported statistical improvements on a range of outcome measures. Observational studies reported a range of individual and community benefits. Linguistic, cultural and religious considerations, inherent in the observational studies, were variably addressed in the individual and group interventions. CONCLUSION Overall, study participants experienced self-care as helpful although some encountered challenges in practicing their preferred strategies. Further research on mental health self-care strategies among Arabic-speaking refugees and migrants is needed in Western resettlement countries to guide mental health service delivery and primary healthcare initiatives for new arrivals and in transit countries.
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Affiliation(s)
- Deena Mehjabeen
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia.
| | - Ilse Blignault
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Perjan Hashim Taha
- College of Medicine, University of Duhok, Duhok, Iraq
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Shameran Slewa-Younan
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Khatri RB, Assefa Y. Drivers of the Australian Health System towards Health Care for All: A Scoping Review and Qualitative Synthesis. BIOMED RESEARCH INTERNATIONAL 2023; 2023:6648138. [PMID: 37901893 PMCID: PMC10611547 DOI: 10.1155/2023/6648138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/03/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023]
Abstract
Background Australia has made significant progress towards universal access to primary health care (PHC) services. However, disparities in the utilisation of health services and health status remain challenges in achieving the global target of universal health coverage (UHC). This scoping review aimed at synthesizing the drivers of PHC services towards UHC in Australia. Methods We conducted a scoping review of the literature published from 1 January 2010 to 30 July 2021 in three databases: PubMed, Scopus, and Embase. Search terms were identified under four themes: health services, Australia, UHC, and successes or challenges. Data were analysed using an inductive thematic analysis approach. Drivers (facilitators and barriers) of PHC services were explained by employing a multilevel framework that included the proximal level (at the level of users and providers), intermediate level (organisational and community level), and distal level (macrosystem or distal/structural level). Results A total of 114 studies were included in the review. Australia has recorded several successes in increased utilisation of PHC services, resulting in an overall improvement in health status. However, challenges remain in poor access and high unmet needs of health services among disadvantaged/priority populations (e.g., immigrants and Indigenous groups), those with chronic illnesses (multiple chronic conditions), and those living in rural and remote areas. Several drivers have contributed in access to and utilisation of health services (especially among priority populations)operating at multilevel health systems, such as proximal level drivers (health literacy, users' language, access to health facilities, providers' behaviours, quantity and competency of health workforce, and service provision at health facilities), intermediate drivers (community engagement, health programs, planning and monitoring, and funding), and distal (structural) drivers (socioeconomic disparities and discriminations). Conclusion Australia has had several successes towards UHC. However, access to health services poses significant challenges among specific priority populations and rural residents. To achieve universality and equity of health services, health system efforts (supply- and demand-side policies, programs and service interventions) are required to be implemented in multilevel health systems. Implementation of targeted health policy and program approaches are needed to provide comprehensive PHC and address the effects of structural disparities.
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Affiliation(s)
- Resham B. Khatri
- Health Social Science and Development Research Institute, Kathmandu, Nepal
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Yibeltal Assefa
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
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Blignault I, Saab H, Youssef H, Baddah H, Giourgas K, Woodland L. "It Is Definitely a Good Program for Everyone from Every Community": A Qualitative Study of Community Partner Perspectives on the Culturally and Linguistically Diverse (CALD) Mindfulness Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6608. [PMID: 37623191 PMCID: PMC10454450 DOI: 10.3390/ijerph20166608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/04/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Meeting the health needs of migrant and refugee communities is crucial to successful settlement and integration. These communities are often under-served by mental health services. Previous research has demonstrated the effectiveness of a group mindfulness-based intervention tailored for Arabic and Bangla speakers living in Sydney, Australia. This study aimed to explore community partner perspectives on the program's impact, contributing factors and sustainability, and to elicit suggestions for future development. Data were collected via semi-structured telephone interviews with a purposively selected sample of 16 informants. Thematic analysis was conducted using the Rigorous and Accelerated Data Reduction (RADaR) technique. Community partners welcomed the emphasis on promoting wellbeing and reported that the community-based in-language intervention, in both face-to-face and online formats, overcame many of the barriers to timely mental health care for culturally and linguistically diverse (CALD) communities, with a beneficial impact on group participants, program providers, partner organisations and the broader community. Positive outcomes led to stronger community engagement and demand for more programs. For group mental health programs, both trust and safety are necessary. Relationships must be nurtured, diversity within CALD communities recognised, and projects adequately resourced to ensure partner organisations are not overburdened.
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Affiliation(s)
- Ilse Blignault
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Hend Saab
- Multicultural Health Team, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia; (H.S.); (H.B.); (K.G.)
| | - Hanan Youssef
- Multicultural Health Team, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia; (H.S.); (H.B.); (K.G.)
| | - Heba Baddah
- Multicultural Health Team, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia; (H.S.); (H.B.); (K.G.)
| | - Klara Giourgas
- Multicultural Health Team, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia; (H.S.); (H.B.); (K.G.)
| | - Lisa Woodland
- Health Equity, Promotion and Prevention Service, South Eastern Sydney Local Health District, Darlinghurst, NSW 2010, Australia;
- Centre for Primary Health Care and Equity, UNSW Sydney, Sydney, NSW 2052, Australia
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Krstanoska-Blazeska K, Renzaho A, Blignault I, Li B, Reavley N, Slewa-Younan S. A Qualitative Exploration of Sources of Help for Mental Illness in Arabic-, Mandarin-, and Swahili-Speaking Communities in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105862. [PMID: 37239588 DOI: 10.3390/ijerph20105862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Despite being disproportionately affected by poor mental health, culturally and linguistically diverse (CaLD) individuals seek help from mental health services at lower rates than others in the Australian population. The preferred sources of help for mental illness amongst CaLD individuals remain poorly understood. The aim of this study was to explore sources of help in Arabic-, Mandarin-, and Swahili-speaking communities in Sydney, Australia. Eight focus-group discussions (n = 51) and twenty-six key informant interviews were undertaken online using Zoom. Two major themes were identified: informal sources of help and formal sources of help. Under the informal sources of help theme, three sub-themes were identified: social, religious, and self-help sources. All three communities strongly recognised the role of social sources of help, with more nuanced roles held by religion and self-help activities. Formal sources of help were described by all communities, although to a lesser extent than informal sources. Our findings suggest that interventions to support help-seeking for all three communities should involve building the capacity of informal sources of help, utilising culturally appropriate environments, and the collaboration between informal and formal sources of help. We also discuss differences between the three communities and offer service providers insights into unique issues that require attention when working with these groups.
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Affiliation(s)
| | - Andre Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
| | - Ilse Blignault
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
| | - Bingqin Li
- Social Policy Research Centre, University of New South Wales, Sydney 2052, Australia
| | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
| | - Shameran Slewa-Younan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown 2571, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne 3010, Australia
- School of Medicine, Western Sydney University, Campbelltown 2571, Australia
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Chimoriya R, Mohammad Y, Thomson R, Webster C, Dunne R, Aibangbee M, Ip D, Slewa-Younan S. Mental illness stigma and associated factors among Arabic-speaking refugee and migrant populations in Australia. Int J Ment Health Syst 2023; 17:11. [PMID: 37138317 PMCID: PMC10155307 DOI: 10.1186/s13033-023-00580-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 04/13/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Arabic-speaking refugee and migrant populations form a significant proportion of Australia's population. Despite high levels of psychological distress among Arabic-speaking populations, low uptake of mental health services has been demonstrated. Evidence suggests poor levels of mental health literacy (MHL) and high levels of stigmatising attitudes among Arabic-speaking populations, which may act as barriers to help-seeking behaviours. This study aimed to explore the relationships between measures of mental illness stigma, socio-demographic factors and psychological distress, as well as to determine the factors associated with MHL (i.e., correct recognition of mental illness and knowledge of causes) among Arabic-speaking refugee and migrant populations in Australia. METHODS Participants were recruited from non-government organisations in Greater Western Sydney that provided support services to Arabic-speaking migrants and/or refugees. As this study is nested within an interventional pilot study evaluating a culturally tailored MHL program, only the pre-intervention survey responses for 53 participants were utilised. The survey measured key aspects of MHL (i.e., recognition of mental illness, knowledge of causes), levels of psychological distress (using K10 scale), and stigmatising attitudes towards mental illness (using Personal Stigma Subscales and Social Distance Scale). RESULTS The Personal Stigma subscale of 'Dangerous/unpredictable' was strongly positively correlated with participants' K10 psychological distress scores and strongly negatively correlated with years of education completed. There were moderate negative correlations between two Personal Stigma subscales ('Dangerous/unpredictable' and 'I-would-not-tell-anyone') and the length of stay in Australia. Being female was associated with an increase in personal stigma demonstrated by higher scores for 'I-would-not-tell-anyone' subscale than males. Similarly, increase in age was associated with a decrease on scores of the personal stigma 'Dangerous/unpredictable'. CONCLUSIONS While future research with larger sample size are needed, the study findings can be considered as adding to the evidence base on mental illness related stigma in Arabic-speaking populations. Further, this study provides a starting point in developing the rationale for why population sub-group specific interventions are required to address mental illness stigma and improve MHL among Arabic-speaking refugee and migrant populations in Australia.
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Affiliation(s)
- Ritesh Chimoriya
- School of Medicine, Western Sydney University, Campbelltown, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Yaser Mohammad
- Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Russell Thomson
- School of Computer, Data and Mathematical Sciences, Western Sydney University, Penrith, Australia
| | - Cheryl Webster
- Anglicare, Anglican Community Services, Baulkham Hills, Australia
| | - Rachel Dunne
- Anglicare, Anglican Community Services, Baulkham Hills, Australia
| | | | - David Ip
- Anglicare, Anglican Community Services, Baulkham Hills, Australia
| | - Shameran Slewa-Younan
- School of Medicine, Western Sydney University, Campbelltown, Australia.
- Translational Health Research Institute, Western Sydney University, Campbelltown, Australia.
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Daluwatta A, Fletcher K, Ludlow C, Virgona A, Murray G. A Mixed-Methods Investigation of Facilitators to Accessing and Utilising Mental Health Services amongst Sri Lankan Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5425. [PMID: 37048039 PMCID: PMC10093901 DOI: 10.3390/ijerph20075425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 06/19/2023]
Abstract
Many individuals with mental health conditions avoid, delay, discontinue, or do not seek mental health services and treatments, despite the existence of evidence-based treatments and support methods. Little is known about the barriers to mental health service utilisation for Sri Lankan Australians, and there is no research on factors that facilitate access for this group. Using quantitative and qualitative methods, this study explored the perspectives of Sri Lankan Australians (N = 262) on the facilitators of mental health service utilisation. Participants rated a set of 18-items (Facilitator Set) and 7 public health interventions (Intervention Set) in relation to their capacity to improve the uptake of mental health services. Participants also completed two open-ended questions about the enablers to seeking professional mental health care. Descriptive statistics were used to summarise quantitative findings, while open-text responses were analysed using reflexive thematic analysis. The Facilitator Set demonstrated that trust in the provider and their confidentiality processes, positive relationships with mental health professionals, and the community having positive attitudes towards seeking help were the primary facilitators to seeking professional help. The Intervention Set suggested that raising community awareness of mental health conditions and providing public stigma reduction interventions may increase access to care. Themes identified in the open-ended responses included access to culturally safe and responsive services and clinicians, improved accessibility and affordability of services, trust, and a community-based approach to increasing mental health literacy and addressing stigma beliefs. Within its limitations, the present study's findings suggest that providing culturally safe and responsive care, dispelling mental health stigma, and increasing knowledge of mental health conditions within Sri Lankan Australian communities are potential facilitating factors that would enable Sri Lankan Australians to seek and use mental health services. Implications for clinical care and future research are discussed.
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Affiliation(s)
- Amanda Daluwatta
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia (G.M.)
| | - Kathryn Fletcher
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia (G.M.)
| | - Chris Ludlow
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Ariane Virgona
- Department of Psychology, Counselling and Therapy, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Greg Murray
- Centre for Mental Health, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia (G.M.)
- Department of Psychological Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC 3122, Australia
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Radhamony R, Cross WM, Townsin L, Banik B. Perspectives of culturally and linguistically diverse (CALD) community members regarding mental health services: A qualitative analysis. J Psychiatr Ment Health Nurs 2023. [PMID: 36947100 DOI: 10.1111/jpm.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/14/2023] [Accepted: 02/28/2023] [Indexed: 03/23/2023]
Abstract
WHAT IS KNOWN ABOUT THE SUBJECT?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issues National mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communities Several barriers exist for people from CALD communities in Victoria to access and utilise mental health services Improving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and services Various challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in Australia The data generated on the beliefs about mental health issues and consequent help-seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The information from the study can be adapted for quality improvement and culturally responsive practices The strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakers The findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. ABSTRACT INTRODUCTION: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023). AIM This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi-method research project. METHOD A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis. RESULTS The themes and sub-themes identified were: Settling issues; Perceptions of understanding of mental health issues (help-seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio-cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals. DISCUSSION Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria. IMPLICATIONS FOR PRACTICE The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice.
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Affiliation(s)
- Reshmy Radhamony
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
| | | | - Louise Townsin
- Federation University, Berwick, Australia
- Torrens University, Adelaide, South Australia
| | - Biswajit Banik
- Institute of Health and Wellbeing, Federation University, Berwick, Australia
- Manna Institute, Regional Australia Mental Health Research and Training Institute, A project of Regional University Network (RUN), led by the University of New England, Armidale, NSW, Australia
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Malviya S. The Need for Integration of Religion and Spirituality into the Mental Health Care of Culturally and Linguistically Diverse Populations in Australia: A Rapid Review. JOURNAL OF RELIGION AND HEALTH 2023:10.1007/s10943-023-01761-3. [PMID: 36780111 PMCID: PMC10366032 DOI: 10.1007/s10943-023-01761-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
Australia is a multicultural and linguistically diverse country. Despite the vital role of religion/spirituality in the mental health of people from culturally and linguistically diverse (CALD) backgrounds, it is not commonly included in their mental health care. A rapid review was conducted to critically evaluate the studies that identified relevant religious/spiritual aspects regarding mental health care for CALD communities. After a systematic search and screening, sixteen empirical studies were included. The findings of the review suggest that people from CALD backgrounds draw strength and comfort from their religion to support mental health. Religious/spiritual practices were identified as effective mental health strategies by CALD people. Religious leaders were noted to be important sources of mental health support and guidance for individuals from some CALD communities. Collaboration of religious leaders in the mental health care, and integration of religious/spiritual practices into mainstream mental health interventions, may improve mental health care for people with CALD backgrounds.
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Affiliation(s)
- Shikha Malviya
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia.
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12
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Garcia de Blakeley M, Stuart J, Sheeran N. Development and initial validation of a measure of cross-lingual practice among mental health practitioners. Psychother Res 2023; 33:251-263. [PMID: 35759688 DOI: 10.1080/10503307.2022.2090300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Despite the importance of spoken language in psychotherapy processes with clients whose native language is distinct from the language of therapy, there is a dearth of research on mental health practitioners (MHPs) language competence. This research aimed to develop the Perceptions of Cross-lingual Practice (PCLP) scale designed to aid MHPs' cross-lingual practice. METHOD Study 1 developed items and collected data from Australian MHPs (n = 155) to test the scale's factor structure through exploratory factor analysis. Study 2 (n = 257) confirmed the emergent factor structure of the scale through confirmatory factor analysis and further assessed its reliability and convergent validity. RESULTS The final 23-item measure had good reliability and validity. Three factors emerged; MHPs' perceptions of self-competence, MHPs' perceptions of difficulties faced by clients, and MHPs' perceptions of barriers for themselves imposed by language. The perceptions of self-competence subscale was weakly related to the other subscales highlighting a disconnect between MHPs' self-perceptions and perceptions of contextual factors. CONCLUSION The PCLP is a reliable and valid measure of MHPs' perceptions of cross-lingual practice composed of three subscales each with good psychometric properties that can be used for various purposes in the evaluation and development of MHPs in post-graduate and professional settings.
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Affiliation(s)
| | - Jaimee Stuart
- School of Applied Psychology, Griffith University, Brisbane, Australia
| | - Nicola Sheeran
- School of Applied Psychology, Griffith University, Brisbane, Australia
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13
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Aylward P, Sved Williams A. Holistic community-based group parenting programs for mothers with maternal mental health issues help address a growing public health need for a diversity of vulnerable mothers, children and families: Findings from an action research study. Front Glob Womens Health 2023; 3:1039527. [PMID: 36733300 PMCID: PMC9887053 DOI: 10.3389/fgwh.2022.1039527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background Maternal mental illness is a major growing global concern which can affect parenting with serious negative implications for offspring. Group-based parenting programs for mothers which both enhance the parent-child relationship and address mental health symptoms in a supportive social setting may optimise better outcomes for mothers and children. The Acorn program in South Australia draws on attachment theory to integrate dance play, reflective diary keeping and therapeutic letters in a holistic program for a diversity of vulnerable mothers and children aged 1-36 months. The program seeks to nurture and enhance parental wellbeing and the quality of the parent-child relationship for mothers experiencing identified mental health illnesses that impinge upon their parenting. This study presents the evaluation of the program and its effectiveness. Methods Action research approach for continuous monitoring and program improvement engaging Acorn program staff in evaluation data collection and interpretation of pre and post self-completion measures and standardized observations. Additional data was collected through a telephone interview of attending mothers 6-8 months after program completion to address sustainable impacts on parenting and wellbeing. Results The program engaged 353 diverse vulnerable mothers with their children. Many had profound overlapping mental health issues including borderline personality disorder (BPD) and depression. The quality of the parent-child interaction, parental confidence, competence and enjoyment were enhanced; mothers' wellbeing, ability to cope and lasting social supports were augmented. This occurred for a number of "most vulnerable" subgroups including single mothers, mothers with BPD, mothers from non-English speaking households and those with lower levels of education or household income. Mothers reported sustained improvements in their wellbeing, parenting, social and family lives, and feeling closer to their child as a result of participating in the program. Conclusions Given the high prevalence of maternal mental health issues and substantial potential negative consequences for mothers and offspring, the Acorn parenting program offers an effective means of addressing this pressing public health issue potentially helping large numbers of vulnerable mothers and their children. This has additional gravitas in the shadow of COVID-19 due to expanded numbers of those experiencing greater parental stress, isolation and mental illness.
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Affiliation(s)
- Paul Aylward
- Action Research Partnerships, Adelaide, SA, Australia
- Torrens University Australia, Public Health, Equity and Human Flourishing, Adelaide, SA, Australia
| | - Anne Sved Williams
- Department of Psychiatry, Women’s and Children’s Health Network, SA, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
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14
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Crawford G, Connor E, McCausland K, Reeves K, Blackford K. Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16946. [PMID: 36554827 PMCID: PMC9778908 DOI: 10.3390/ijerph192416946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
Migrants from culturally and linguistically diverse (CaLD) backgrounds experience factors that may increase health inequities related to a range of determinants of health including housing and mental health. However, the intersection between mental health and housing for migrants is poorly understood. A scoping review searched four academic databases for concepts related to cultural and linguistic diversity, housing conditions, and public health interventions to address homelessness. A total of 49 articles were included and seven key themes identified: housing provision; mental health intersections and interventions; complexity and needs beyond housing; substance use; service provider and policy issues; the role of cultural and linguistic diversity; and consumer experience. The intersection of ethnicity with other social determinants of health and housing was highlighted though there were limited interventions tailored for migrants. Studies generally pointed to the positive impacts of Housing First. Other sub-themes emerged: social connection and community; shame, stigma, and discrimination; health and support requirements; and employment, financial assistance, and income. Consumer choice was identified as vital, along with the need for systemic anti-racism work and interventions. To support secure housing for migrants and mitigate mental health impacts, closer attention is required towards migration factors along with broader, tailored services complementing housing provision.
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Affiliation(s)
- Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Elizabeth Connor
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Kahlia McCausland
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Karina Reeves
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
| | - Krysten Blackford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Perth, WA 6845, Australia
- School of Population Health, Curtin University, Perth, WA 6845, Australia
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15
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Slewa-Younan S, Krstanoska-Blazeska K, Blignault I, Li B, Reavley NJ, Renzaho AMN. Conceptualisations of mental illness and stigma in Congolese, Arabic-speaking and Mandarin-speaking communities: a qualitative study. BMC Public Health 2022; 22:2353. [PMID: 36522660 PMCID: PMC9753024 DOI: 10.1186/s12889-022-14849-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Australia is an ethnically diverse nation. Research has demonstrated an elevated risk of developing a mental illness in culturally and linguistically diverse (CaLD) communities yet uptake of mental health services is low. To improve mental health treatment seeking and outcomes for CaLD individuals in Australia there is an urgent need to deeply understand barriers to treatment such as stigma. Using an exploratory qualitative approach, the aim of the study was to explore how CaLD communities' conceptualise and interpret mental illness and associated beliefs and experiences of stigma. METHODS The study focused on three key CaLD groups: the Congolese, Arabic-speaking and Mandarin-speaking communities residing in Sydney, Australia. A series of eight focus group discussions (n = 51) and 26 key informant interviews were undertaken online using Zoom during the period of November to December 2021. Focus group discussions and key informant interviews were digitally recorded, transcribed, and analysed using NVivo software. RESULTS Three major themes were identified. The first theme related to mental illness terminology used in the three communities. Despite variation in the terms used to refer to 'mental illness' all three communities generally distinguished between 'mental illness', a more severe condition and 'mental health problems', considered to arise due to stressors. The second theme centred on beliefs about mental illness; with all three communities identifying migration-related stressors as contributing to mental illness. Culturally related beliefs were noted for the Congolese participants with the perception of a link between mental illness and supernatural factors, whereas Mandarin-speaking participants highlighted lack of inter and intrapersonal harmony and failure to adhere to values such as filial piety as contributing to mental illness. The final theme related to mental illness related stigma and the various ways it manifested in the three communities including presence of collectivist public stigma felt across all three groups and affiliate (family) stigma reported by the Arabic and Mandarin-speaking groups. CONCLUSIONS We found rich diversity in how these communities view and respond to mental illness. Our findings provide some possible insights on both service provision and the mental health system with a view to building effective engagement and pathways to care.
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Affiliation(s)
- Shameran Slewa-Younan
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia.
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | | | - Ilse Blignault
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Bingqin Li
- Social Policy Research Centre, University of New South Wales, Sydney, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Andre M N Renzaho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
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16
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Levy-Fenner E, Colucci E, McDonough S. Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2022:1-26. [PMID: 36533215 PMCID: PMC9735058 DOI: 10.1007/s40737-022-00319-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 06/17/2023]
Abstract
Lived experience research related to mental health recovery is advancing, but there remains a lack of narrative material from the perspectives of people from under-represented, non-dominant cultural backgrounds in this domain. This study aimed to explore the lived experiences of mental health recovery in people of culturally and linguistically diverse (CALD) backgrounds in the Australian context. The current study involved a secondary analysis of audio and visual data collected during the digital storytelling project Finding our way in Melbourne, Australia. Thematic analysis was used to understand the lived experience narratives of nine participants in relation to mental health recovery. Five themes were identified through an iterative process of analysis, including Newfound opportunities and care, Family as key motivators and facilitators, Coping and generativity, Cultivating self-understanding and resilience, and Empowerment through social engagement. First person lived experience narratives offer deep insight into understanding the ways in which individuals of marginalised communities conceptualise and embody recovery. These findings further the literature and understanding on how to better serve the needs of people with mental health challenges from CALD communities through informed knowledge of what may be helpful to, and meaningful in, individuals' recoveries.
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Affiliation(s)
- E. Levy-Fenner
- Department of Psychology, Middlesex University, London, UK
| | - E. Colucci
- Department of Psychology, Middlesex University, London, UK
- Global and Cultural Mental Health Unit, The University of Melbourne, Melbourne, Australia
| | - S. McDonough
- Victorian Transcultural Mental Health, St. Vincent’s Hospital, Melbourne, Australia
- Australian Institute for Primary Care and Ageing, La Trobe University, Melbourne, Australia
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17
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Murray KE, Musumeci CJ, Cassidy E. Crossing the digital divide: A content analysis of mainstream Australian mental health websites for languages other than English. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4831-e4839. [PMID: 35733378 PMCID: PMC10084177 DOI: 10.1111/hsc.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/11/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
Growth in e-mental health services in the past decade has been significant, corresponding with rising rates of mental health concerns and amplified by social isolation strategies imposed by the COVID-19 global pandemic. Governments, mental health services and practitioners have identified this as a significant area for investment and highlight its capacity for widespread reach, prevention and early intervention. At a time of growth and investment, it is critical to evaluate the extent to which online mental health platforms are effective in reaching the diverse populations they aim to serve. The current study used content analysis to evaluate 33 Australian mental health websites receiving government funding for the availability of translated materials and resources for culturally and linguistically diverse people. The websites analysed covered a range of mental health topics and overall had limited translated materials available. Only four websites (12.12%) provided a translation tool and none of the interactive tools offered, such as web chat services, were available in languages other than English. From a total of 1100 subsections across all websites, eight subsections (0.73%) were specifically targeting populations identifying as culturally and linguistically diverse. Strategic reconsideration and investment are required to enhance the capacity of current mental health platforms to engage and support the mental health needs of the diverse communities they intend to serve. The research and its findings can provide a basis for research and reflection within other health and social services as online platforms proliferate.
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Affiliation(s)
- Kate E. Murray
- School of Psychology and CounsellingQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Chantelle J. Musumeci
- School of Psychology and CounsellingQueensland University of TechnologyKelvin GroveQueenslandAustralia
| | - Elija Cassidy
- Digital Media Research Centre, School of CommunicationQueensland University of TechnologyKelvin GroveQueenslandAustralia
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18
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James PB, Renzaho AMN, Mwanri L, Miller I, Wardle J, Gatwiri K, Lauche R. The prevalence of anxiety, depression, and post-traumatic stress disorder among African migrants: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114899. [PMID: 36252417 DOI: 10.1016/j.psychres.2022.114899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. METHODS We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I2 statistic was used to measure heterogeneity. RESULTS Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60%;95%CI (26.30-43.00), 33.20%;95%CI (27.70-38.37) and 37.9%;95%CI (23.5- 52.4) respectively. Significant heterogeneity (I2 >98%) existed in the prevalence estimates for anxiety, depression, and PTSD. Sub-group analyses indicate a significantly higher prevalence of anxiety and depression but PTSD for studies conducted in Africa than outside Africa. Similarly, higher prevalence rates for anxiety, depression, and PTSD were seen in studies that used a screening tool than in those that used a diagnostic tool, although a significant difference was observed for depression only. CONCLUSION Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Andre M N Renzaho
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Lillian Mwanri
- Research Centre for Public Health Policy, Torrens University Australia, Adelaide, SA 5000, Australia
| | - Ian Miller
- Sport and Exercise Science, Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Kathomi Gatwiri
- Centre for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Romy Lauche
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
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19
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Shepherd S, Bailey A, Masuka G. The Experiences and Perspectives of African-Australian Community Service Providers Who Work with At-Risk and Justice-Involved Youth. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1432-1453. [PMID: 34075798 DOI: 10.1177/0306624x211022652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
African-Australian young people are over-represented in custody in the state of Victoria. It has been recognized in recent government and stakeholder strategic plans that African-Australian community service providers are well placed to help address the increasing complex needs of at-risk African-Australian youth. However little is known about the capacities of such providers to effectively contend with this growing social concern. In response, this study aimed to explore the perspectives and operational (service delivery and governance) experiences of African-Australian community organizations which provide services to at-risk young people in Victoria. Through a series of in-depth interviews with the leadership of eight key African-Australian service providers, we aimed to identify their perceived strengths, obstacles faced and proposed strategies to realize key objectives. Perspectives on key risk factors for young African-Australian justice system contact were also gathered. Several themes were extracted from the interviews, specifically (i) Risk factors for African-Australian youth justice-involvement (school disengagement, peer delinquency, family breakdown, intergenerational discord, perceived social rejection), (ii) The limitations of mainstream institutions to reduce African-Australian youth justice-involvement (too compliance focused, inflexible, business rather than human-centered, disconnected from communities and families), (iii) The advantages of African-Australian community service providers when working with African-Australian youth (community credibility, client trust, flexibility, culturally responsive), (iv) The challenges faced by African-Australian service providers (lack of funding/resources, professional staff shortages, infrastructural/governance limitations), and (v) "What works" in service provision for at-risk African-Australians (client involvement in program design, African staff representation, extensive structured programming matched with client aspirations, prioritizing relationship building, persistent outreach, mental health and legal literacy for clients and families). Implications for service delivery and social policy are discussed within.
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Affiliation(s)
- Stephane Shepherd
- Swinburne University of Technology & Victorian Institute of Forensic Mental Health, Alphington, VIC, Australia
| | - Aisling Bailey
- Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Godwin Masuka
- Victorian Public Service Officer & Community Advocate, Williams Landing, VIC, Australia
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20
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Burrows TL. Mental health is EVERY dietitian's business! Nutr Diet 2022; 79:276-278. [PMID: 35796180 DOI: 10.1111/1747-0080.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Tracy L Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Hunter Medical Research Institute, Callaghan, Australia
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21
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Ingram J, Lyford B, McAtamney A, Fitzpatrick S. Preventing suicide in refugees and asylum seekers: a rapid literature review examining the role of suicide prevention training for health and support staff. Int J Ment Health Syst 2022; 16:24. [PMID: 35562790 PMCID: PMC9107234 DOI: 10.1186/s13033-022-00534-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 03/29/2022] [Indexed: 11/30/2022] Open
Abstract
Background Refugees and asylum seekers are exposed to a unique set of circumstances and experiences that are associated with an increased suicide risk. Suicide prevention training has been recognised as a central component supporting a comprehensive approach to suicide prevention. Limited literature exists exploring the role of suicide prevention training for health and support staff working with refugee and asylum seeker consumers. Methods To determine the impact suicide prevention training for health staff may have in supporting refugee and asylum seeker suicide prevention, researchers undertook a rapid literature review exploring what elements should be considered when developing suicide prevention training for health and support staff working with refugee and asylum seeker consumers. Results Results of academic and grey literature screening identified 14 studies exploring suicide prevention training for health and support staff working with refugee and asylum seeker consumers. Findings of the literature review suggest suicide prevention training for health and support staff working with refugee and asylum seekers should consider the inclusion of content which increases participant competence and confidence to identify and respond to suicide risk; provide staff with an understanding of cultural differences and its impact on refugees and asylum seekers recognition of mental health and suicide as a health matter; highlight the importance trauma informed practices in care and consider the lived experience of refugees and asylum seekers. Conclusions Inclusion of specific content in refugee and asylum seeker suicide prevention training may provide health and support staff increased competence and confidence to identify and respond to suicide risk in refugees and asylum seekers.
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Affiliation(s)
| | - Bronte Lyford
- Everymind, 72 Watt St, Newcastle, NSW, 2300, Australia.,School of Medicine and Public Health, University of Newcastle, College of Health, Medicine and Wellbeing, NSW, 2308, Callaghan, Australia
| | | | - Sally Fitzpatrick
- Everymind, 72 Watt St, Newcastle, NSW, 2300, Australia.,School of Medicine and Public Health, University of Newcastle, College of Health, Medicine and Wellbeing, NSW, 2308, Callaghan, Australia
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22
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Anthony C, Grant I, Ashford LJ, Spivak B, Shepherd SM. Exploring Differences in the Experiences, Perceptions and Reporting of Violent Incidents in Australia by Country of Birth. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP6301-NP6328. [PMID: 33063593 DOI: 10.1177/0886260520966676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Australia's fast-growing migrant population encompasses many groups from culturally and linguistically diverse backgrounds. It is well documented that these groups experience varying pre- and post-migratory challenges. Despite this knowledge, little is known about the extent to which these groups experience and perceive violence and how or whether they seek assistance after such incidents. It is important to identify any potential discrepancies to ensure that services can provide the most targeted supports to victims. Data were collected from the 2016 Australian Bureau of Statistics Public Safety Survey. Using chi-square tests, prevalence, experiences, and perceptions of violence occurring after the age of 15, postincident support, reporting behaviors, and health variables related to violent incidents were compared across three cultural groups arranged by region of birth: born in Australia (BIA), born overseas in main English-speaking countries (BNMESC), and born overseas in non-English-speaking countries (BOC). BOC individuals reported much lower rates of violent victimization compared to BIA and BMSEC individuals. More than two-thirds of each cultural group did not report their most recent experience of violence to police. Violence was most commonly experienced at home, although a higher proportion of BIA individuals experienced violence at an entertainment venue, and a higher proportion of BOC individuals experienced violence outside (i.e., in the street). The contribution of Alcohol/Substances was much higher for BIA and BMESC compared to BOC individuals. BOC individuals experienced more anxiety post-incident, while more BIA individuals sustained physical injuries. A similar proportion of each group sought assistance post-incident, however, more BOC individuals had never told anyone about the incident. Perceptions of the violent incident were generally similar across groups, though fewer BOC individuals perceived the incident to be a crime. Some differences were apparent across cultural groups regarding the prevalence, experiences and reporting of violent incidents. Implications and future research directions are discussed within.
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Affiliation(s)
- Casey Anthony
- Swinburne University of Technology, Alphington, Victoria, Australia
| | - Imogen Grant
- Swinburne University of Technology, Alphington, Victoria, Australia
| | - Linda J Ashford
- Swinburne University of Technology, Alphington, Victoria, Australia
| | - Benjamin Spivak
- Swinburne University of Technology, Alphington, Victoria, Australia
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23
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Brijnath B, Croy S, Sabates J, Thodis A, Ellis S, de Crespigny F, Moxey A, Day R, Dobson A, Elliott C, Etherington C, Geronimo MA, Hlis D, Lampit A, Low L, Straiton N, Temple J. Including ethnic minorities in dementia research: Recommendations from a scoping review. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12222. [PMID: 35505899 PMCID: PMC9053375 DOI: 10.1002/trc2.12222] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/18/2021] [Accepted: 10/27/2021] [Indexed: 11/30/2022]
Abstract
Introduction Ethnicity influences dementia etiology, prognosis, and treatment, while culture shapes help-seeking and care. Despite increasing population diversity in high-income settlement countries, ethnic minorities remain underrepresented in dementia research. We investigated approaches to enhance the recruitment, and consistent collection and analysis of variables relevant to, ethnic minorities in dementia studies to make recommendations for consistent practice in dementia research. Methods We did a scoping review, searching Embase, PsycINFO, Medline, CENTRAL, and CINAHL between January 1, 2010 and January 7, 2020. Dementia clinical and cohort studies that actively recruited ethnic minorities in high-income countries were included. A steering group of experts developed criteria through which high-quality studies were identified. Results Sixty-six articles were retrieved (51 observational; 15 experimental). Use of interpreters and translators (n = 17) was the most common method to facilitate participant recruitment. Race and ethnicity (n = 59) were the most common variables collected, followed by information on native language (n = 14), country of birth (n = 9), and length of time in country of settlement (n = 8). Thirty-three studies translated or used a culturally validated instrument. Twenty-three articles conducted subgroup analyses based on ethnicity. Six high-quality studies facilitated inclusion through community engagement, collected information on multiple aspects of ethnic diversity, and adjusted/substratified to analyze the impact of ethnicity on dementia. Discussion We make recommendations for consistent recruitment, collection, and reporting of variables relating to ethnic and cultural diversity in dementia research.
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Affiliation(s)
- Bianca Brijnath
- National Ageing Research InstituteParkvilleVictoriaAustralia
- School of Social SciencesUniversity of Western AustraliaWestern AustraliaPerchAustralia
| | - Samantha Croy
- Centre for Population GenomicsMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Julieta Sabates
- Academic Unit for Psychiatry of Old AgeUniversity of MelbourneParkvilleVictoriaAustralia
| | - Antonia Thodis
- National Ageing Research InstituteParkvilleVictoriaAustralia
| | | | - Fleur de Crespigny
- Australian Institute of Health and WelfareCanberraAustralian Capital TerritoryAustralia
| | - Annette Moxey
- Dementia Australia Research FoundationGriffithAustralian Capital TerritoryAustralia
| | - Robert Day
- Australian Government Department of HealthCanberraAustralian Capital TerritoryAustralia
| | - Annette Dobson
- School of Public HealthUniversity of QueenslandHerstonQueenslandAustralia
| | | | - Cathy Etherington
- Australian Bureau of StatisticsBelconnenAustralian Capital TerritoryAustralia
| | - Mary Ann Geronimo
- Federation of Ethnic Community Councils of AustraliaDeakinAustralian Capital TerritoryAustralia
| | | | - Amit Lampit
- Academic Unit for Psychiatry of Old AgeUniversity of MelbourneParkvilleVictoriaAustralia
| | - Lee‐Fay Low
- Sydney School of Health SciencesUniversity of SydneyCamperdownNew South WalesAustralia
| | | | - Jeromey Temple
- School of Population and Global HealthUniversity of MelbourneParkvilleVictoriaAustralia
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McCulloch K, Murray K, Cassidy E. Bridging Across the Digital Divide: Identifying the Extent to Which LGBTIQ+ Health Service Websites Engage Culturally and Linguistically Diverse (CALD) Users. JOURNAL OF HOMOSEXUALITY 2022:1-23. [PMID: 35452366 DOI: 10.1080/00918369.2022.2060057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
eHealth is promoted as a viable platform for health service provision, as it can deliver relevant information instantaneously and anonymously, whilst circumventing geographical and discriminatory barriers that can occur in face-to-face settings. Lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities stand to benefit greatly from eHealth services, however, the way in which culturally and linguistically diverse (CALD) LGBTIQ+ users are included within eHealth service provision is currently unknown. The current study observed the way in which Australian LGBTIQ+ health service websites are inclusive of CALD users. Quantitative content analysis was performed on 19 Australian LGBTIQ+ health service websites, with a focus on translation of services and materials, English and digital literacy, and CALD specific resources. Results showed limited translated information across all websites, an absence of translation tools embedded in the home page, as well as moderate to high levels of digital and English literacy required, and largely absent CALD specific resources. These results suggest that Australian LGBTIQ+ health service websites are not currently meeting the unique needs of their CALD constituents. Increased availability of translation services, navigation tools, and CALD LGBTIQ+ stakeholder inclusion during website development is recommended to ensure more equitable access for CALD LGBTIQ+ communities.
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Affiliation(s)
- Katherine McCulloch
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Kate Murray
- School of Psychology & Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elija Cassidy
- School of Communication, Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
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Promoting Mental Health and Wellbeing in Multicultural Australia: A Collaborative Regional Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052723. [PMID: 35270415 PMCID: PMC8910043 DOI: 10.3390/ijerph19052723] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023]
Abstract
Migrant communities are often under-served by mental health services. Lack of community engagement results in missed opportunities for mental health promotion and early intervention, delayed care, and high rates of untreated psychological distress. Bilingual clinicians and others who work with these communities lack linguistically and culturally appropriate resources. This article reports on the implementation and evaluation of a community-based group mindfulness program delivered to Arabic and Bangla-speaking communities in Sydney, Australia, including modifications made to the content and format in response to the COVID-19 pandemic. The program was positioned within a stepped-care model for primary mental health care and adopted a collaborative regional approach. In addition to improved mental health outcomes for face-to-face and online program participants, we have documented numerous referrals to specialist services and extensive diffusion of mindfulness skills, mostly to family members, within each community. Community partnerships were critical to community engagement. Training workshops to build the skills of the bilingual health and community workforce increased the program’s reach. In immigrant nations such as Australia, mainstream mental health promotion must be complemented by activities that target specific population groups. Scaled up, and with appropriate adaptation, the group mindfulness program offers a low-intensity in-language intervention for under-served communities.
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Radhamony R, Cross WM, Townsin L. Nursing Education to Enhance Culturally and Linguistically Diverse (CALD) Community Access to Mental Health Services: A Scoping Review. Issues Ment Health Nurs 2021; 42:1048-1063. [PMID: 34080932 DOI: 10.1080/01612840.2021.1925792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research has found that training health care professionals can enhance the access of the culturally diverse community to appropriate mental health services. Yet, little research has been conducted that explicitly focuses on improving nursing knowledge, skills, attitudes, and behaviours that can enhance the access of the Culturally and Linguistically Diverse (CALD) community. This scoping review aims to locate, summarise, and recap what is known in the academic literature about educational interventions and programs to improve mental health nurses' cultural competence. Examining how educational interventions and programs can improve mental health nurses' knowledge, skills, attitudes, and behaviours to facilitate Culturally and Linguistically Diverse (CALD) community access to mental health services can also identify gaps in knowledge to report future research areas. Fifteen studies included in the review reported a positive effect of cultural competence interventions; however, it was difficult to establish a single effective intervention method due to the significant heterogenicity in cultural competence intervention strategies. Most studies in this scoping review included nurses as participants. However, only one study solely focussed on cultural competence intervention for mental health nurses. Two other studies included mental health nurses as participants, along with other mental health professionals. Henceforth, there is a prerequisite for more research focussing on enhancing mental health nurses' cultural competency. Additional research is required to evaluate educational interventions' impact on improving cultural competence attributes on specific practitioner behaviours and the effects on health care and health care outcomes. This review can form a basis for future research studies that will emphasise the impact of cultural competence interventions for mental health nurses.
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Affiliation(s)
- Reshmy Radhamony
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Wendy M Cross
- School of Health, Federation University Australia, Berwick, Victoria, Australia
| | - Louise Townsin
- Research Office, Torrens University Australia, Adelaide, South Australia, Australia.,Federation University Australia, Berwick, Victoria, Australia
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Terhaag S, Fitzsimons E, Daraganova G, Patalay P. Sex, ethnic and socioeconomic inequalities and trajectories in child and adolescent mental health in Australia and the UK: findings from national prospective longitudinal studies. J Child Psychol Psychiatry 2021; 62:1255-1267. [PMID: 33948953 DOI: 10.1111/jcpp.13410] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study investigates the sex, ethnic and socioeconomic inequalities in emotional difficulties over childhood and adolescence using longitudinal cohort studies in the UK and Australia. Estimating cross-national differences contributes to understanding of the consistency of inequalities in mental health across contexts. METHODS Data from 19,748 participants in two contemporary representative samples in Australia (Growing Up in Australia: The Longitudinal Study of Australian Children, n = 4,975) and UK (Millennium Cohort Study, n = 14,773) were used. Emotional difficulties were assessed using the parent-reported Strengths and Difficulties Questionnaire at ages 4/5, 6/7, 11/12 and 14/15 years and the self-reported Short Moods and Feelings Questionnaire at age 14/15. Latent Growth Curve Modelling was used to examine mental health over time. RESULTS There were significant increases in emotional difficulties in both countries over time. Emotional difficulties were higher in Australian children at all ages. The gender gap in self-reported depressive symptoms at age 14/15 was larger in the UK (8% of UK and 13% of Australian boys were above the depression cut-off, compared with 23% of girls). Ethnic minority children had higher emotional difficulties at age 4/5 years in both countries, but over time this difference was no longer observed in Australia. In the UK, this reversed whereby at ages 11/12 and 14/15 ethnic minority children had lower symptoms than their White majority peers. Socioeconomic differences were more marked based on parent education and employment status in Australia and by parent income in the UK. UK children, children from White majority ethnicity and girls evidenced steeper worsening of symptoms from age 4/5 to 14/15 years. CONCLUSIONS Even in two fairly similar countries (i.e. English-speaking, high-income, industrialised), the observed patterns of inequalities in mental health symptoms based on sociodemographics are not the same. Understanding country and context-specific drivers of different inequalities provides important insights to help reduce disparities in child and adolescent mental health.
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Affiliation(s)
- Sonia Terhaag
- Australian Institute of Family Studies, Department of Social Services, Australian Government, Melbourne, Victoria, Australia
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, UCL Institute of Social Research, University College London, London, UK
| | - Galina Daraganova
- Australian Institute of Family Studies, Department of Social Services, Australian Government, Melbourne, Victoria, Australia
| | - Praveetha Patalay
- Centre for Longitudinal Studies, UCL Institute of Social Research, University College London, London, UK.,MRC Unit for Lifelong Health and Ageing, University College London, London, UK
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Tabatabaei-Jafari H, Zulfiqar T, Welsh J, Bagheri N. The association between living in socially fragmented neighbourhoods and psychological distress among immigrant and non-immigrant people aged 45 and over in NSW, Australia. Aust N Z J Psychiatry 2021; 55:883-891. [PMID: 33334136 DOI: 10.1177/0004867420981414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Immigrants' mental health is a growing public health concern. Neighbourhood characteristics in the host society may contribute to the poor mental health observed among immigrants. In this study, we aimed to investigate the association between neighbourhood-level social fragmentation and socioeconomic characteristics with psychological distress among immigrants and non-immigrants living in Australia. METHODOLOGY We conducted cross-sectional secondary data analysis of 228,039 participants from the Sax Institute's 45 and Up Study, with psychological distress measured with the Kessler 10 (K10) and area-level social fragmentation and economic advantage/disadvantage measured at the statistical area level 1 (areas containing approximately 400 people). Multilevel logistic models were used to examine the extent to which differences across the least and most fragmented and economic advantage/disadvantage neighbourhoods contributed to the prevalence of high psychological distress (K10 score ⩾ 22). RESULTS Immigrants accounted for about 23% of the sample. Slightly more immigrants (34.8%) compared to non-immigrants (32.9%) lived in fragmented areas. Although immigrants were over represented in areas with socioeconomic advantage (40% vs 33.9%), the prevalence of high psychological distress in neighbourhoods with higher social fragmentation and socioeconomic disadvantage was higher in immigrants than non-immigrants. Immigrants had 17% (95% confidence interval = [12%, 22%]) higher odds of having high psychological distress compared to non-immigrants. There was no evidence of an interaction between social fragmentation or socioeconomic disadvantage and immigrant status. Living in fragmented or socioeconomically disadvantaged areas was associated with higher psychological distress among immigrants and non-immigrants. English as a second language and low annual income were significant predictors of psychological distress in immigrants over and above area-level characteristics. CONCLUSION Immigrants are vulnerable to mental health issues, but the characteristics of the area they live in are also important. Helping immigrants settle into well-integrated and economically advantaged areas may decrease the possibility of mental health issues.
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Affiliation(s)
- Hossein Tabatabaei-Jafari
- Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Tehzeeb Zulfiqar
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Jennifer Welsh
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Nasser Bagheri
- Centre for Mental Health Research, Research School of Population Health, College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
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Migrants and Service Providers' Perspectives of Barriers to Accessing Mental Health Services in South Australia: A Case of African Migrants with a Refugee Background in South Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178906. [PMID: 34501496 PMCID: PMC8430647 DOI: 10.3390/ijerph18178906] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/17/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022]
Abstract
International mobility has increased steadily in recent times, bringing along a myriad of health, social and health system challenges to migrants themselves and the host nations. Mental health issues have been identified as a significant problem among migrants, with poor accessibility and underutilisation of the available mental health services (MHSs) repeatedly reported, including in Australia. Using a qualitative inquiry and one-on-one in-depth interviews, this study explored perspectives of African migrants and service providers on barriers to accessing MHSs among African migrants in South Australia. The data collection took place during the COVID-19 pandemic with lockdown and other measures to combat the pandemic restricting face to face meetings with potential participants. Online platforms including Zoom and/or WhatsApp video calls were used to interview 20 African migrants and 10 service providers. Participants were recruited from community groups and/or associations, and organisations providing services for migrants and/or refugees in South Australia using the snowball sampling technique. Thematic framework analysis was used to guide the data analysis. Key themes centred on personal factors (health literacy including knowledge and the understanding of the health system, and poor financial condition), structural factors related to difficulties in navigating the complexity of the health system and a lack of culturally aware service provision, sociocultural and religious factors, mental health stigma and discrimination. The findings provide an insight into the experiences of African migrants of service provision to them and offer suggestions on how to improve these migrants’ mental health outcomes in Australia. Overcoming barriers to accessing mental health services would need a wide range of strategies including education on mental health, recognising variations in cultures for effective service provision, and addressing mental health stigma and discrimination which strongly deter service access by these migrants. These strategies will facilitate help-seeking behaviours as well as effective provision of culturally safe MHSs and improvement in access to MHSs among African migrants.
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Blignault I, Saab H, Woodland L, O’Callaghan C. Cultivating mindfulness: evaluation of a community-based mindfulness program for Arabic-speaking women in Australia. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02146-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractArabic-speaking communities in Australia underutilise mental health services. Previous research with Arabic-speakers recruited individually demonstrated that an Arabic Mindfulness Compact Disc (CD) was an acceptable and useful resource for this group. Subsequently, the CD was introduced as part of a 5-week group mindfulness program for Arabic-speaking Muslim women. The intervention was delivered in a community setting by a bilingual (Arabic/English) psychologist with support from a bilingual multicultural health worker. The mixed-methods evaluation incorporated a pre–post study with a wait-list control group. An Arabic translation of the Depression Anxiety and Stress Scale (DASS21) was administered at baseline and program completion. Pre–post differences were tested using the sign test for paired samples (one-sided). Qualitative methods were used to evaluate the program’s acceptability. After five weeks, the intervention group showed statistically significant improvement on all DASS21 subscales (n = 12, p < .001 for depression and stress and p < .01 for anxiety). For the wait-list control group, only anxiety showed significant improvement (n = 8, p < .05). Qualitative analysis revealed how the women grew in their understanding of mindfulness concepts and mastered the different techniques, how they dealt with painful memories, how mindfulness practice assisted them in their daily lives, and how they related mindfulness to Islam. The in-language mindfulness intervention was shown to be culturally and spiritually relevant, and clinically effective. The group program incorporating the Arabic Mindfulness CD has potential for scaling up. Further research is required to investigate effectiveness for Arabic-speaking men with similar backgrounds.
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Said M, Boardman G, Kidd S. Barriers to accessing mental health services in Somali-Australian women: a qualitative study. Int J Ment Health Nurs 2021; 30:931-938. [PMID: 33715289 PMCID: PMC8359963 DOI: 10.1111/inm.12846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/17/2021] [Indexed: 11/29/2022]
Abstract
Despite the global prevalence of mental disorders being widely acknowledged, mental illness, complex trauma and the significant impact on individuals, families and communities continues to be poorly recognized, under-diagnosed and underreported. Based on the 2017 Australian census, one-in-five (20%) people have experienced some type of mental illness within the last 12 months (Australian Bureau of Statistics [ABS], 2019). The prevalence rate of mental illness in culturally and linguistically diverse (CALD) communities is difficult to estimate due to cultural and linguistic issues and underutilization of mental health services. In particular, little epidemiological data is available about the prevalence of mental illness in the Somali-Australian community. The aim of this study was to identify the perceived barriers to help-seeking for mental health for Somali-Australian women. A qualitative descriptive study incorporating focus group discussions with 31 Somali-Australian women was conducted in Melbourne, Australia. Braun & Clarke's (2006) thematic analysis was applied to the data. Four themes relating to help-seeking barriers were abstracted. Influence of faith explored how Islam can impact the person views on mental illness. Stigma focused on the relationship between public and self-stigma and help-seeking. Mistrust of Western healthcare system describes the participants concerns about the cultural disconnect between the community and the Western healthcare system. Finally, denial of mental illness reflected the community views on mental health. This study provides an insight into the factors that influence the Somali-Australian community help-seeking with mental health services. The findings have implications for mental health professionals and the Somali-Australian community.
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Affiliation(s)
- Mulki Said
- Victoria University, Footscray, Victoria, Australia
| | | | - Susan Kidd
- Victoria University, Footscray, Victoria, Australia
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Wei K, Chopra P, Strehlow S, Stow M, Kaplan I, Szwarc J, Minas H. The capacity-building role of community liaison workers with refugee communities in Victoria, Australia. Int J Ment Health Syst 2021; 15:64. [PMID: 34215300 PMCID: PMC8252234 DOI: 10.1186/s13033-021-00485-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 06/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background A range of services within Australia and internationally have been developed that are focused on the engagement of individuals who are of refugee background to work as a liaison between their communities and mental health services. The Community Liaison Worker (CLW) role at the Victorian Foundation for Survivors of Torture (VFST) was developed in 2008 in order to engage in such capacity-building initiatives. Aims To review and document the establishment, evolution and current status of the VFST CLW role, and examine the perspectives of CLWs on their role in trauma-informed community capacity-building. Methods The study comprised of two stages: a historical case study of the development of the CLW role, and a qualitative research study based on interviews with CLWs in order to identify key themes regarding various aspects of their role and understand the facilitators and barriers to their work of trauma-informed capacity-building with their respective communities. Results The CLW role has evolved from the provision of direct services through joint work with Counsellor Advocates at VFST to a broader role that is focused on building the capacity of community members. Thematic analysis of interviews with the seven current CLWs identified the complexity of their dual role as members of their community and employees of VFST, their role in addressing short-term goals to meet community needs, and the long-term objective of empowering their community to become integrated and self-sufficient. Conclusions CLWs at VFST demonstrate important work of liaison workers in facilitating trauma-informed capacity-building initiatives that are of benefit to members of their communities and also to service providers.
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Affiliation(s)
- Karen Wei
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Prem Chopra
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia. .,The Victorian Foundation for Survivors of Torture, Melbourne, Australia.
| | - Susie Strehlow
- The Victorian Foundation for Survivors of Torture, Melbourne, Australia
| | - Mardi Stow
- The Victorian Foundation for Survivors of Torture, Melbourne, Australia
| | - Ida Kaplan
- The Victorian Foundation for Survivors of Torture, Melbourne, Australia
| | - Josef Szwarc
- The Victorian Foundation for Survivors of Torture, Melbourne, Australia
| | - Harry Minas
- School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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Bairami K, Spivak BL, Burke LM, Shepherd SM. Exploring mental illness attributions and treatment-seeking beliefs in a diverse Muslim-Australian sample. CLIN PSYCHOL-UK 2021. [DOI: 10.1080/13284207.2021.1929143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Kemalie Bairami
- Centre for Forensic Behavioural Science, Swinburne University of Technology, Faculty of Health, Arts and Design, School of Health Sciences, Alphington, Australia
| | - Benjamin L. Spivak
- Centre for Forensic Behavioural Science, Swinburne University of Technology & Victorian Institute of Forensic Mental Health, Alphington, Australia
| | - Lisa M. Burke
- Faculty of Health, School of Psychology, Deakin University, Geelong, Australia
| | - Stephane M. Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology & Victorian Institute of Forensic Mental Health, Alphington, Australia
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Cheong Poon AW, Cassaniti M, Sapucci M, Ow R. Wellbeing and experiences of Chinese and Vietnamese carers of people with mental illness in Australia. Transcult Psychiatry 2021; 58:351-364. [PMID: 32969331 DOI: 10.1177/1363461520952629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers' wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers' perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.
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Shepherd S, Harries C, Spivak B, Pichler AS, Purcell R. Exploring presentation differences in multi-cultural youth seeking assistance for mental health problems. BMC Psychol 2021; 9:63. [PMID: 33906682 PMCID: PMC8077851 DOI: 10.1186/s40359-021-00571-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background Mental ill-health can impact an individual’s capacity to interact with others, make decisions, and cope with social challenges. This is of particular importance for many Culturally and linguistically diverse (CALD) individuals who may be at various stages of the acculturation process. The increasing diversity of the Australian population necessitates informed and culturally relevant services that meet the needs of a changing demographic. However the extant research on the mental health needs of CALD Australians is limited. This study aimed to further our understanding of the mental health needs of young CALD Australians by exploring the mental health concerns and social factors exhibited by CALD individuals accessing community based youth mental health services in two major cities. Methods We performed a series of logistic regression models to ascertain if a concert of factors (i.e., clinical, socio-economic, criminal justice system involvement, child maltreatment, social support) were associated with CALD status Results Comparisons across factors revealed no significant differences between groups. A small number of correlates differentiated between CALD and non-CALD participants (mental illness diagnosis during childhood, family history of mental illness/suicide, sensation seeking, sensitivity to punishment, maternal overprotection) however these factors were no longer meaningful after adjustment for multiple comparisons. Conclusions In help-seeking mainstream youth populations, cultural differences across clinical and environmental factors appear to be minimal.
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Affiliation(s)
- Stephane Shepherd
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Victorian Institute of Forensic Mental Health, 1/582 Heidelberg Rd, Alphington, VIC, Australia.
| | - Cieran Harries
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Victorian Institute of Forensic Mental Health, 1/582 Heidelberg Rd, Alphington, VIC, Australia
| | - Benjamin Spivak
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Victorian Institute of Forensic Mental Health, 1/582 Heidelberg Rd, Alphington, VIC, Australia
| | - Anne-Sophie Pichler
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Victorian Institute of Forensic Mental Health, 1/582 Heidelberg Rd, Alphington, VIC, Australia
| | - Rosemary Purcell
- The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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Blignault I, Saab H, Woodland L, Mannan H, Kaur A. Effectiveness of a Community-based Group Mindfulness Program tailored for Arabic and Bangla-speaking Migrants. Int J Ment Health Syst 2021; 15:32. [PMID: 33849610 PMCID: PMC8042358 DOI: 10.1186/s13033-021-00456-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrant communities are often underserved by mainstream mental health services resulting in high rates of untreated psychological distress. This collaborative study built on evidence that mindfulness-based interventions delivered in-language and culturally tailored were acceptable and clinically effective for Arabic speakers in Australia. It aimed to establish whether a group mindfulness program produced expected outcomes under normal operational conditions, and to test its scalability and its transferability to Bangla speakers. METHODS A 5-week mindfulness program was delivered to 15 Arabic-speaking and 8 Bangla-speaking groups in community settings. The mixed-methods evaluation incorporated a pre-post study. Descriptive statistics were used to summarise the socio-demographic data, group attendance and home practice. Differences in DASS 21 and K10 scores from pre to post-intervention were tested using the nonparametric sign test for paired samples (two-sided). Multiple linear regression analysis was performed to determine the effects of selected sociodemographic variables, group attendance and home practice on clinical outcomes, based on intention to treat. Content analysis was used to examine the qualitative data. RESULTS The program attracted 168 Arabic speakers and 103 Bangla speakers aged 16 years and over, mostly women. Cultural acceptability was evident in the overall 80% completion rate, with 78% of Arabic speakers and 84% of Bangla speakers retained. Both language groups showed clinically and statistically significant improvements in mental health outcomes on the DASS21 and K10. Thirty new referrals were made to mental health services. Participant feedback emphasised the benefits for their everyday lives. All but one participant reported sharing the mindfulness skills with others. CONCLUSIONS Across multiple and diverse groups of Arabic and Bangla speakers in Sydney, the community-based group mindfulness program was shown to have high levels of cultural acceptability and relevance. It resulted in clinically and statistically significant improvements in mental health outcomes, facilitated access to mental health care and boosted mental health literacy. This innovative, low-intensity, in-language mental health intervention that was originally developed for Arabic speakers is scalable. It is also transferable-with cultural tailoring-to Bangla speakers.
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Affiliation(s)
- Ilse Blignault
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Hend Saab
- Multicultural Health Service, South Eastern Sydney Local Health District, PO Box 1614, Sydney, NSW, 2001, Australia
| | - Lisa Woodland
- Priority Populations, Population and Community Health, South Eastern Sydney Local Health District, PO Box 1614, Sydney, NSW, 2001, Australia
| | - Haider Mannan
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Arshdeep Kaur
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
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Woodland L, Blignault I, O'Callaghan C, Harris-Roxas B. A framework for preferred practices in conducting culturally competent health research in a multicultural society. Health Res Policy Syst 2021; 19:24. [PMID: 33602261 PMCID: PMC7893969 DOI: 10.1186/s12961-020-00657-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 11/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Improving the health and well-being of the whole population requires that health inequities be addressed. In an era of unprecedented international migration, meeting the health care needs of growing multicultural or multiethnic societies presents major challenges for health care systems and for health researchers. Considerable literature exists on the methodological and ethical difficulties of conducting research in a cross-cultural context; however, there is a need for a framework to guide health research in multicultural societies. Methods The framework was informed by “research on research” that we have undertaken in community and primary health care settings in Sydney, Australia. Case studies are presented as illustrative examples. Results We present a framework for preferred practices in conducting health research that is culturally informed, high-quality, safe, and actionable. Conclusions The framework is not intended to be universal, however many of its aspects will have relevance for health research generally. Application of the framework for preferred practices could potentially make health research more culturally competent, thus enabling enhanced policies, programmes and practices to better meet population health needs. The framework needs to be further tested and refined in different contexts.
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Affiliation(s)
- Lisa Woodland
- Priority Populations, Population and Community Health, South Eastern Sydney Local Health District, 301 Forbes St, Darlinghurst, NSW, 2010, Australia. .,South Eastern Sydney Research Collaboration Hub, Centre for Primary Health Care and Equity, University of NSW, Level 3, AGSM Building, UNSW, Sydney, NSW, 2052, Australia.
| | - Ilse Blignault
- Translational Health Research Institute, School of Medicine, Western Sydney University, Translational Health Research Institute, Building 3, David Pilgrim Avenue, Campbelltown, NSW, 2560, Australia
| | - Cathy O'Callaghan
- South Eastern Sydney Research Collaboration Hub, Centre for Primary Health Care and Equity, University of NSW, Level 3, AGSM Building, UNSW, Sydney, NSW, 2052, Australia
| | - Ben Harris-Roxas
- Priority Populations, Population and Community Health, South Eastern Sydney Local Health District, 301 Forbes St, Darlinghurst, NSW, 2010, Australia.,Population and Community Health, South Eastern Sydney Local Health District, 301 Forbes St, Darlinghurst NSW 2010, Sydney, NSW, 2010, Australia
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Cheng VWS, Piper SE, Ottavio A, Davenport TA, Hickie IB. Recommendations for Designing Health Information Technologies for Mental Health Drawn From Self-Determination Theory and Co-design With Culturally Diverse Populations: Template Analysis. J Med Internet Res 2021; 23:e23502. [PMID: 33565985 PMCID: PMC7904400 DOI: 10.2196/23502] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/14/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
Background Culturally diverse populations (including Aboriginal and Torres Strait Islander people, people of diverse genders and sexualities, and culturally and linguistically diverse people) in nonurban areas face compounded barriers to accessing mental health care. Health information technologies (HITs) show promising potential to overcome these barriers. Objective This study aims to identify how best to improve a mental health and well-being HIT for culturally diverse Australians in nonurban areas. Methods We conducted 10 co-design workshops (N=105 participants) in primary youth mental health services across predominantly nonurban areas of Australia and conducted template analysis on the workshop outputs. Owing to local (including service) demographics, the workshop participants naturalistically reflected culturally diverse groups. Results We identified 4 main themes: control, usability, affirmation, and health service delivery factors. The first 3 themes overlap with the 3 basic needs postulated by self-determination theory (autonomy, competence, and relatedness) and describe participant recommendations on how to design an HIT. The final theme includes barriers to adopting HITs for mental health care and how HITs can be used to support care coordination and delivery. Hence, it describes participant recommendations on how to use an HIT. Conclusions Although culturally diverse groups have specific concerns, their expressed needs fall broadly within the relatively universal design principles identified in this study. The findings of this study provide further support for applying self-determination theory to the design of HITs and reflect the tension in designing technologies for complex problems that overlap multiple medical, regulatory, and social domains, such as mental health care. Finally, we synthesize the identified themes into general recommendations for designing HITs for mental health and provide concrete examples of design features recommended by participants.
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Affiliation(s)
| | - Sarah E Piper
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Antonia Ottavio
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | | | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
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O'Brien J, Fossey E, Palmer VJ. A scoping review of the use of co-design methods with culturally and linguistically diverse communities to improve or adapt mental health services. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1-17. [PMID: 32686881 DOI: 10.1111/hsc.13105] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 05/21/2023]
Abstract
Mental health services are increasingly encouraged to use co-design methodologies to engage individuals and families affected by mental health problems in service design and improvement. This scoping review aimed to identify research that used co-design methods with Culturally and Linguistically Diverse (CALD) communities in mental health services, and to identify methodological considerations for working with this population. In October 2019, we searched five electronic databases (CINAHL, PsycINFO, EMBASE, MEDLINE, Web of Science) to identify papers published in which people from CALD backgrounds were engaged in the co-design of a mental health service or program. Searches were limited to peer-reviewed articles published in English in the last 25 years (1993-2019). The search identified nine articles that matched the inclusion criteria. Using a scoping review methodology, the first author charted the data using extraction fields and then used qualitative synthesis methods to identify themes. Data were grouped into themes relevant to the research question. The two key themes relate first, to improving the experience for CALD communities when engaging in co-design research and second, to the development of co-design methods themselves. These findings support the need for further research into the transferability of co-design tools with CALD communities, particularly if co-design is to become a best practice method for service design and improvement. This scoping review identified methodological and practical consideration for researchers looking to use co-design with CALD communities for mental health service design, re-design or quality improvement initiatives. Further research is required to explore experiences of co-design methods, including documented protocols such as experience-based co-design, with CALD communities. This review indicates that explanatory models of mental health, community and co-design impact partnerships with CALD communities, and need to be understood to optimise the quality of these relationships when using co-design methods.
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Affiliation(s)
- Jennifer O'Brien
- Department of Occupational Therapy, Monash University Peninsula Campus, Frankston, Vic., Australia
- School of Occupational Therapy, Australian Catholic University, Melbourne, Vic., Australia
| | - Ellie Fossey
- School of Occupational Therapy, Australian Catholic University, Melbourne, Vic., Australia
| | - Victoria J Palmer
- Integrated Mental Health Research Program & Co-Design Living Lab, Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Vic., Australia
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Hu J, Wang Z. Exploring the associated factors of elevated psychological distress in a community residing sample of Australian Chinese migrants. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jie Hu
- Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, Queensland, Australia,
| | - Zhiqiang Wang
- Centre for Chronic Disease, School of Medicine, University of Queensland, Herston, Queensland, Australia,
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Guo S, Liu M, Chong SY, Zendarski N, Molloy C, Quach J, Perlen S, Nguyen MT, O'Connor E, Riggs E, O'Connor M. Health service utilisation and unmet healthcare needs of Australian children from immigrant families: A population-based cohort study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2331-2342. [PMID: 32573864 DOI: 10.1111/hsc.13054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/08/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
Compared with most other Organization for Economic Co-operation and Development (OECD) countries, information about the patterns of health service use for children from immigrant families in Australia is currently limited, and internationally, data on unmet healthcare needs are scarce. This study aims to examine the distribution of health service utilisation and unmet healthcare needs for immigrant children aged 10-11 years in Australia. We drew on data from the Longitudinal Study of Australian Children Birth (B; n = 5,107) and Kindergarten (K; n = 4,983) cohorts. The exposure was family immigration background collected at 0-1 (B-cohort) and 4-5 (K-cohort) years. Outcomes were parent-reported child health service use and unmet healthcare needs (defined as the difference between services needed and services received) at 10-11 years. Logistic regression analyses were used to examine associations between family immigration background and health service use/unmet healthcare needs, adjusting for potential confounders. Results showed that one-third of Australian children (B-cohort: 29.0%; K-cohort: 33.4%) came from immigrant families. There were similar patterns of health service use and unmet healthcare needs between children from English-speaking immigrant and Australian-born families. However, children from non-English-speaking immigrant families used fewer health services, including paediatric, dental, mental health and emergency ward services. There was a disparity between the services used when considering children's health needs, particularly for paediatric specialist services (B-cohort: OR = 2.43, 95% CI 1.11-5.31; K-cohort: OR = 2.72, 95% CI 1.32-5.58). Findings indicate that Australian children from non-English-speaking immigrant families experience more unmet healthcare needs and face more barriers in accessing health services. Further effort is needed to ensure that the healthcare system meets the needs of all families.
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Affiliation(s)
- Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Mengjiao Liu
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Shiau Yun Chong
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Nardia Zendarski
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Carly Molloy
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Jon Quach
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Melbourne Graduate School of Education, The University of Melbourne, Melbourne, Australia
| | - Susan Perlen
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Minh Thien Nguyen
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
| | - Elodie O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
| | - Elisha Riggs
- Intergenerational Health Group, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
| | - Meredith O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia
- Department of Pediatrics, The University of Melbourne, Melbourne, Australia
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Physical Activity Among Immigrant Children: A Systematic Review. J Phys Act Health 2020; 17:1047-1058. [PMID: 32858526 DOI: 10.1123/jpah.2019-0272] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 04/22/2020] [Accepted: 06/19/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The health benefits of physical activity (PA) for children are well documented. However, little is known about PA patterns among immigrant children. METHODS The authors reviewed research on PA patterns of immigrant children. The inclusion criteria included peer-reviewed articles published from January 2010 to May 2018 in English, French, or Spanish that included primary-school-aged (6-12 y) children, and data on immigration status. RESULTS A total of 11 articles were included in the analyses. These studies revealed a deficit of PA among immigrant children. Immigration status (immigrant or nonimmigrant) and generation of immigration (first, second, and third), ethnic origin, and gender were associated with PA patterns. In general, PA levels were lower among first-generation immigrant children, children of Hispanic and East Asian origin, and girls. The results suggest that questionnaire measures might be biased or inaccurate among immigrant children, highlighting the need for the integration of mixed methods (objective and subjective measures). CONCLUSIONS A large proportion of children do not meet PA guidelines, and this might be more problematic for immigrant children. Future studies incorporating time since immigration, comparative analyses on gender, sociocultural and socioeconomic characteristics, and mixed methodology could provide a more complete portrait of PA patterns and opportunities for immigrant children.
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Raphiphatthana B, Maulana H, Howarth T, Gardner K, Nagel T. Digital Mental Health Resources for Asylum Seekers, Refugees, and Immigrants: Protocol for a Scoping Review. JMIR Res Protoc 2020; 9:e19031. [PMID: 32831185 PMCID: PMC7477666 DOI: 10.2196/19031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Asylum seekers, refugees, and immigrants experience a number of risk factors for mental health problems. However, in comparison to the host population, these populations are less likely to use mental health services. Digital mental health approaches have been shown to be effective in improving well-being for the general population. Thus, they may provide an effective and culturally appropriate strategy to bridge the treatment gap for these populations vulnerable to mental health risks. OBJECTIVE This paper aims to provide the background and rationale for conducting a scoping review on digital mental health resources for asylum seekers, refugees, and immigrants. It also provides an outline of the methods and analyses, which will be used to answer the following questions. What are the available digital mental health resources for asylum seekers, refugees, and immigrants? Are they effective, feasible, appropriate, and accepted by the population? What are the knowledge gaps in the field? METHODS The scoping review methodology will follow 5 phases: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarizing, and reporting the results. Searches will be conducted in the following databases: EBSCOhost databases (CINAHL Plus with Full Text, MEDLINE with Full Text, APA PsycArticles, Psychology and Behavioral Sciences Collection, and APA PsycInfo), PubMed, and Scopus. Additionally, OpenGrey, Mednar, and Eldis will be searched for gray literature. All primary studies and gray literature in English concerning the use of information and communication technology to deliver services addressing mental health issues for asylum seekers, refugees, and immigrants will be included. RESULTS This scoping review will provide an overview of the available digital mental health resources for asylum seekers, refugees, and immigrants and describe the implementation outcomes of feasibility, acceptability, and appropriateness of such approaches for those populations. Potential gaps in the field will also be identified. CONCLUSIONS As of February 2020, there were no scoping reviews, which assessed the effectiveness, feasibility, acceptability, and appropriateness of the available digital mental health resources for asylum seekers, refugees, and immigrants. This review will provide an extensive coverage on a promising and innovative intervention for such populations. It will give insight into the range of approaches, their effectiveness, and progress in their implementation. It will also provide valuable information for health practitioners, policy makers, and researchers working with the population. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/19031.
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Affiliation(s)
| | - Herdiyan Maulana
- Faculty of Psychology, State University of Jakarta, Jakarta, Indonesia
| | - Timothy Howarth
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia.,College of Health and Human Sciences, Charles Darwin University, Darwin, Australia
| | | | - Tricia Nagel
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Psychological distress among migrant groups in Australia: results from the 2015 National Health Survey. Soc Psychiatry Psychiatr Epidemiol 2020; 55:467-475. [PMID: 31659375 DOI: 10.1007/s00127-019-01782-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To understand the relationship between migration and psychological distress, we (a) calculated the prevalence of psychological distress in specific migrant groups, and (b) examined the association between specific birth groups and psychological distress, while controlling for confounding variables to understand vulnerabilities across migrant groups. METHODS The prevalence of psychological distress, disaggregated by birthplace, was calculated using data from the Australian 2015 National Health Survey, which measures psychological distress via the Kessler Screening Scale for Psychological Distress (K10). Multivariable logistic regression models, with adjustments for complex survey design, were fitted to examine the association between country of birth and psychological distress once extensive controls for demographic, and socioeconomics factors were included. RESULTS 14,466 individuals ≥ 18 years completed the K10. Migrants from Italy (20.7%), Greece (20.4%), Southern and Eastern European (18.2%), and North African and Middle Eastern (21.9%) countries had higher prevalence estimates of distress compared to Australian born (12.4%) or those born in the United Kingdom (UK) (9.5%)-the largest migrant group in Australia. After adjusting for demographics, SES factors, duration in Australia, a birthplace in Italy (OR = 2.79 95% CI 1.4, 5.7), Greece (OR = 2.46 95% CI 1.1, 5.5), India (OR = 2.28 95% CI 1.3, 3.9), Southern and Eastern Europe (excluding Greece and Italy) (OR = 2.43 95% CI 1.5, 3.9), North Africa and the Middle East (OR = 3.39 95% CI 1.9, 6.2) was associated with increased odds of distress relative to those born in the UK. CONCLUSIONS Illuminating variability in prevalence of psychological distress across migrant communities, highlights vulnerabilities in particular migrant groups, which have not previously been described. Identifying such communities can aid mental health policy-makers and service providers provide targeted culturally appropriate care.
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Cheah SL, Jackson E, Touyz S, Hay P. Prevalence of eating disorder is lower in migrants than in the Australian-born population. Eat Behav 2020; 37:101370. [PMID: 32087555 DOI: 10.1016/j.eatbeh.2020.101370] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There are limited data on the epidemiology of eating disorders (ED) in migrants. Recent Scandinavian research suggests that migrants are at lower risk of eating disorders, however, to our knowledge there have not been comparable studies exploring eating disorders in Australian adult populations. We sought to explore the prevalence of EDs in first-generation migrants to Australia in comparison with the Australian-born population. A secondary aim was to explore ED prevalence across first-generation migrants from different regions of birth (Europe, Asia, Africa, and Other). METHODS We conducted sequential cross-sectional population surveys in South Australian individuals aged over 15 years in 2015 and 2016 (n = 6052). Demographic data were collected and migration status was inferred based on a country of birth outside Australia. Questions asked regarding disordered eating were based on the Eating Disorders Examination. FINDINGS The 3-month prevalence of any ED was found to be significantly lower in first-generation migrants born outside Australia (4.5%, 95% CI 3.6-5.6) in comparison to the Australian-born population (6.4%, 95% CI 5.7-7.2). People born in countries in Africa (11.0% 95% CI 6.1-19.1) had a significantly higher prevalence of EDs than those born in Asia (4.0% 95% CI 2.7-5.8). CONCLUSIONS First-generation migrants to Australia may be at lower risk of eating disorders compared to their Australia-born peers, suggesting support for a 'healthy immigrant effect'.
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Affiliation(s)
- Su Lynn Cheah
- Hunter New England Mental Health, Australia; School of Medicine, University of Newcastle, Australia.
| | | | - Stephen Touyz
- InsideOut Institute, Australia; School of Psychology, University of Sydney, Australia
| | - Phillipa Hay
- Translational Health Research Institute, Western Sydney University, Australia; Campbelltown Hospital, Australia; Eating Disorder Unit Wesley Hospital, Australia
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Kayrouz R, Karin E, Staples LG, Nielssen O, Dear BF, Titov N. A comparison of the characteristics and treatment outcomes of migrant and Australian-born users of a national digital mental health service. BMC Psychiatry 2020; 20:111. [PMID: 32160913 PMCID: PMC7065305 DOI: 10.1186/s12888-020-02486-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 02/07/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND To explore the characteristics and compare clinical outcomes of non-Australian born (migrant) and Australian-born users of an Australian national digital mental health service. METHODS The characteristics and treatment outcomes of patients who completed online treatment at the MindSpot Clinic between January 2014 and December 2016 and reported a country of birth other than Australia were compared to Australian-born users. Data about the main language spoken at home were used to create distinct groups. Changes in symptoms of depression and anxiety were measured using the Patient Health Questionnaire-9 Item (PHQ-9), and Generalized Anxiety Disorder Scale - 7 Item (GAD-7), respectively. RESULTS Of 52,020 people who started assessment at MindSpot between 1st January 2014 and 22nd December 2016, 45,082 reported a country of birth, of whom 78.6% (n = 35,240) were Australian-born, and 21.4% (n = 9842) were born overseas. Of 6782 people who completed the online treatment and reported country of birth and main language spoken at home, 1631 (24%) were migrants, 960 (59%) were from English-speaking countries, and 671 (41%) were from non-English speaking countries. Treatment-seeking migrant users reported higher rates of tertiary education than Australian-born users. The baseline symptom severity, and rates of symptom reduction and remission following online treatment were similar across groups. CONCLUSIONS Online treatment was associated with significant reductions in anxiety and depression in migrants of both English speaking and non-English speaking backgrounds, with outcomes similar to those obtained by Australian-born patients. DMHS have considerable potential to help reduce barriers to mental health care for migrants.
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Affiliation(s)
- Rony Kayrouz
- MindSpot Clinic, Macquarie University, Sydney, Australia. .,eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia.
| | - Eyal Karin
- MindSpot Clinic, Macquarie University, Sydney, Australia.,eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia
| | - Lauren G Staples
- MindSpot Clinic, Macquarie University, Sydney, Australia.,eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia
| | - Olav Nielssen
- MindSpot Clinic, Macquarie University, Sydney, Australia
| | - Blake F Dear
- MindSpot Clinic, Macquarie University, Sydney, Australia.,eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia
| | - Nickolai Titov
- MindSpot Clinic, Macquarie University, Sydney, Australia.,eCentreClinic, Department of Psychology, Macquarie University, Sydney, New South Wales, 2109, Australia
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Uribe Guajardo MG, Kelly C, Bond K, Thomson R, Slewa-Younan S. An evaluation of the teen and Youth Mental Health First Aid training with a CALD focus: an uncontrolled pilot study with adolescents and adults in Australia. Int J Ment Health Syst 2019; 13:73. [PMID: 31798683 PMCID: PMC6884747 DOI: 10.1186/s13033-019-0329-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Australia is an ethnically diverse nation with one of the largest refugee resettlement programs worldwide. Evidence suggests that although the risk of developing mental disorders in culturally linguistically diverse (CALD) adolescents may be elevated, professional help-seeking in CALD youth is low. This study sought to evaluate the face-to-face teen (tMHFA) and Youth Mental Health First Aid (YMHFA) training with a CALD focus, which aimed at improving mental health literacy (MHL) and skills in youth and adults assisting adolescents with mental health problems. METHODS An uncontrolled pre-, post-, and follow-up design was used to measure improvement in MHL measures in year 10 students and adults. RESULTS A total of 372 year 10 students from 2 high schools were trained. 308 responded to the pre-training questionnaire, 220 responded to the post-training questionnaire, and 256 completed the 3-month follow-up questionnaire. A total of 34 adults were trained, 32 responded to the pre-questionnaire and 31 responded to the post-training questionnaire and 20 completed the 3-month follow-up questionnaire. Following training, students were more likely to endorse 'helpful' adults as valid sources of help (p < 0.001) and these gains were maintained at follow-up (p < 0.01). Significantly higher levels of concordant (helpful) helping intentions were found after training (p < 0.01), and this was maintained at follow-up (p < 0.05). Significant lower levels of discordant (harmful) helping intentions were found after training (p < 0.001), and this was maintained at follow-up (p < 0.01). A significant improvement in adults' knowledge of youth mental health problems and Youth Mental Health First Aid was noted from pre- to post-training (p < 0.01) and was maintained at follow-up (p < 0.01). Confidence when helping a young person with mental health problems increased significantly after training (p < 0.001) and this was maintained at follow-up (p < 0.05). CONCLUSION Our findings indicated the training led to an improvement in a number of measures of MHL and helpful intentions of both the adolescents and adults evaluated. These results indicate that CALD tMHFA and YMHFA are a recommended way of upskilling those trained and thereby leading to the improvement youth mental health in areas with high proportion of ethnically diverse groups.
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Affiliation(s)
- Maria Gabriela Uribe Guajardo
- Mental Health, Translational Health Research Institute, Macarthur Clinical School, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW 2751 Australia
| | - Claire Kelly
- Mental Health First Aid Australia, Melbourne, Australia
| | - Kathy Bond
- Mental Health First Aid Australia, Melbourne, Australia
| | - Russell Thomson
- Centre for Research in Mathematics, School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, Australia
| | - Shameran Slewa-Younan
- Mental Health, Translational Health Research Institute, Macarthur Clinical School, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, Sydney, NSW 2751 Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Bowden M, McCoy A, Reavley N. Suicidality and suicide prevention in culturally and linguistically diverse (CALD) communities: A systematic review. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1694204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
| | | | - Nicola Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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Wamwayi MO, Cope V, Murray M. Service gaps related to culturally appropriate mental health care for African immigrants. Int J Ment Health Nurs 2019; 28:1110-1118. [PMID: 31207014 DOI: 10.1111/inm.12622] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2019] [Indexed: 11/29/2022]
Abstract
The population of overseas-born Australians continues to grow including the recent increase of immigrants and refugees from African countries. Due to this increase, healthcare services need to assess if current available services are culturally appropriate for African immigrant inpatients. This qualitative study, with a quality improvement focus, examined current services to identify key service gaps and consider recommendation to improve care of African immigrant mental health inpatients in the hospital from the point of view of staff working within the organisation. What was revealed is that services currently offered to African mental health inpatients were culturally inappropriate. Emerging themes included inadequate interpreter services, lack of cultural awareness staff training, lack of organisation link with other services, unmet spiritual needs, use of staff/families as interpreters, culturally inappropriate information, and lack of or inadequate culturally appropriate policies and framework. Changes to current practices are recommended to provide culturally appropriate mental health care to African inpatients.
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Affiliation(s)
- Michael O Wamwayi
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - Vicki Cope
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - Melanie Murray
- Discipline of Nursing, College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
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Daly C, Phillips K, Kanaan R. The effect of limited English proficiency and interpreter service use on clinical outcomes in psychiatric inpatient units. Australas Psychiatry 2019; 27:465-468. [PMID: 31282178 DOI: 10.1177/1039856219859280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The effects of limited English and interpreter use on clinical outcomes in mental health are poorly understood. This paper describes an exploratory study examining those effects across three adult inpatient psychiatric units, predicting it would lead to increased length of stay. METHODS Forty-seven patients with limited English proficiency (LEP) were retrospectively identified and compared with 47 patients with proficient English. Length of stay, number of consultant reviews and discharge diagnosis were recorded and compared. RESULTS An increased length of stay for those with LEP was not statistically significant (p=0.155). The LEP group did undergo more consultant reviews (p=0.036), however, and attracted different discharge diagnoses, with no primary discharge diagnoses of personality disorder made (p=0.018). CONCLUSIONS This study provides evidence of significant effects of limited English on both service burden and outcome.
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Affiliation(s)
- Conor Daly
- Psychiatry Registrar, Mental Health Program, Eastern Health, Box Hill, VIC, Australia
| | - Karen Phillips
- Consultant Psychiatrist, Mental Health Program, Eastern Health, Box Hill, VIC, Australia
| | - Richard Kanaan
- Professor of Psychiatry, Department of Psychiatry, University of Melbourne, Chair of Psychiatry, Austin Health, Heidelberg, VIC, Australia
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