Almost four million Australians are being diagnosed with mental illness each year. However, Mental Health Research shows that people from CALD [culturally and linguistically diverse] communities are less likely to access specialist services than others. Head of the Global and Cultural Mental Health Unit at Melbourne University, Professor Harry Minas says there are multiple barriers stopping people from seeking mental health help.
“So a very clear example is that interpreters are not readily available, so for people whose English is not fluent it can be very difficult to communicate. And that can be a barrier to both actually accessing mental health help and also a barrier to the quality of mental health help that can be provided when there are communication problems.”
He says religious and cultural beliefs can create further problems.
“The level of stigma and shame attached to mental illness can be very high particularly in some communities; families may be reluctant to acknowledge that a family member has a mental problem because they are concerned about the implications of acknowledging this. And therefore, keep the problem for themselves, and maybe very reluctant to seek outside mental health help.”
Sometimes it’s also a question of not knowing where to find help.
Professor Minas says while there is good general information about mental health services, it is not always available in community languages.
He says General Practitioners should be the first point of contact for everyone.
“GPs are much better trained in mental health than they were 10 or 20 years ago. Many of them have had continuing education in both diagnosis and treatment, particularly of the more common mental illnesses, such as depression and anxiety. And very often the problems can be dealt with at the level of the GP and can be dealt with very effectively.”
GPs provide support; brief counselling and can prescribe medication. They can draw up a Mental Health Treatment Plan so patients get a Medicare rebate for 10 psychological treatments.
Under the Treatment Plan means patients do not have to pay upfront.
The Australian Institute of Health and Welfare data shows, that in 2013-2014 over 9 million services on mental health help went through the Medicare Benefit Schedule.
Professor Minas says GPs can also refer people to a mental health specialist such as a psychologist or psychiatrist.
“So, they may be able to for example to see a psychologist who works in a GP practice, they may be better to be referred to a psychiatrist for both diagnoses of more complex and difficult cases and also for more complex treatment. So in the first instance, the first port of call should generally be a GP. And in that way, I think the person can get very good information about what sort of direction to follow in dealing with the problem they have.”
Beyond Blue support service outlines how different health professionals can assist. Clinical psychologists specialise in the assessment, diagnosis and treatment of mental health problems. Many other psychologists such as counselling and educational and developmental psychologists can also assist someone with depression or anxiety.
No referral is required to see a psychologist – people can book directly.
However, to utilise bulk-billing or Access Allied Psychological Services (ATAPS) programs, patients must have a Mental Health Treatment Plan from a GP. Some private health insurances may cover part of specialists or psychologists fees.
The Head of Mental Health Australia Frank Quinlan says specialists from multicultural backgrounds are always in demand. He says mental health providers should be ready to exert a special approach to new arrivals.
“We need to be very clear about recognising that people who are coming from a refugee background and who had lived through possibly some awful experiences both in their country of origin but also in the torturous journeys that they may have taken to Australia, will perhaps be experiencing particular trauma and particular mental health challenges, and so I think we need to ensure that we’re well geared up to be delivering, in particular, trauma-aware services that people will be able to draw experiences in away again, recognising the cultural diversity of how that might be experienced by people.”
Torture and trauma survivors are often referred to STTARS, which is the Survivors of Torture and Trauma Assistance and Rehabilitation Service. When hospital admission is required, a psychiatrist will be in charge of the person’s treatment.
Psychiatrists are doctors who have undergone further training to specialise in the assessment, diagnosis and treatment of mental health problems. A referral is needed from a GP to see a psychiatrist and to claim Medicare rebates.
Professor Minas says it’s difficult for a lot of communities to navigate the complex Australian mental health care system.
“In general, access to private specialist mental health care requires a referral from a General Practitioner, but it is possible to get direct access to community mental health centres for example in the community. Where it’s not necessary to go through a GP. You can go directly to a community mental health centre and so on.’
In Australia, there are legal requirement to provide information in the language the person understands. Dr Minas says that’s not always available due to inadequate funds to employ sufficient interpreters and translators which can lead to incorrect assessments.
He says a common language is essential in responding to any mental health problems.
“In the area of mental health and psychiatry communication is absolutely critical, of course it’s important in every aspect of medicine, but in psychiatry in particular, communication is the primary instrument, both for the assessment of the nature of the problem and also for the treatments that are going to be effective. So, a lot more attention needs to be given to the issue of the quality of communication.”
Professor Minas says while the number of bilingual mental health care specialists is increasing in Australia, some recently arrived communities lack access to properly trained interpreters.
“There are not so many professionals who are fluently bilingual at least in the mental health area and it can be very difficult for people to find somebody who speaks their own language and who has the appropriate skills. That situation creates many difficulties it can lead to incorrect assessments of what the nature of the problem is; there are frequent misunderstandings about what is being recommended in terms of treatment and what will be most effective in terms of dealing with the problem.”
Often people have difficulty finding the right mental health help. Mr Quinlan says people should keep searching for the right medical professional.
“If they don’t have the service and best support that they need when they first reach out for help, to please try and reach out again and reach out to different places and to investigate different resources because there is help available. There are people about who are ready, able and willing to provide assistance and the fact that you didn’t find that person the first time, doesn’t mean that you won’t find the help that you need in the long run.”
Medicare rebates include services from psychiatrists, psychologists, clinical psychologists, social workers and occupational therapists.
It’s under a government program called the Better Access to Psychiatrists, Psychologists and General Practitioners through the Medicare Benefits Schedule (Better Access) initiative.
Information on the is available on the Department of Social Services website.
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