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Edit Allasi

on 6 June 2015

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Program Delivery
Health Policy
Health Communication & Social Marketing
Training & Advocacy
Research & Evaluation
Health Information Services
(Access & Availability)
Understanding the "System"
Health Literacy
of Public Health Institutions
How action in this issue may affect other issues
What do we know??
$ Free
Monday, May 25, 2015
Vol I, No. 2015
To Summarise.....
Mental Health issues are ranked as the leading causes of suffering along with heart diseases, cancer, AIDS, obesity and injuries.
Deepmala Awasthi, Edit Allasi, Ewa Mazuruk, Farid Khan and Nikul Kantibhai

Is Australia capable to respond?

Migrants in Australia at glance
Current approaches
Australian Bureau of Statistics. (2015, Jan 29). Migration, Australia 2013-14, Summary. Retrieved Apr 29, 2015, from Australian Bureau of Statistics Website: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/3412.0Main%20Features12013-14?opendocument&tabname=Summary&prodno=3412.0&issue=2013-14&num=&view=
Commonwealth of Australia. (2009). Fourth National Mental Health Plan— An agenda for collaborative government action in mental health 2009–2014. Canberra: Commonwealth of Australia.

Bloland, P.,Simone, P., Burkholder, B., Slutsker, L. & De Cock, K. (2012). The Role of Public Health Institutions in Global Health System Strengthening Efforts: The USCDC’s Perspective. PloSMedicine. April 2012: 9(4); e1001199

Deakin University Australia Worldly. (2014, Sep 3). Migrating to Australia a bad health move for immigrants. Retrieved May 1, 2015, from Deakin University Australia Worldly Website: http://www.deakin.edu.au/news/latest-media-releases/2014/migrating-to-australia-a-bad-health-move-for-immigrants

Draybi, D., & Dossetor, D. (2011, July 21). Immigration and its impact on mental health. Sydney, NSW, Australia. Retrieved from Diversity Health Institution Website.
Foundation House (2002). Caring for Refugee Patients in General Practice: A desktop guide (4th ed.) Victoria. Retrieved from: http://refugeehealthnetwork.org.au/desktop-guide-victoria/

Hawe, P., Shiell, A. and Riley, T. Theorising Interventions as Events in Systems. American Journal of Community Psychology (2009); 43: 267-276. National Network of Public Health Institutes (NNPHI). Retrieved from: http://www.nnphi.org/about/what-is-a-public-health-institute

Khoo, S. E. (2010). Health and humanitarian migrants’ economic participation.Journal of immigrant and minority health, 12(3), 327-339.


Mental Health and Australia’s Culturally and Linguistically diverse communities.(2011). The Federation of Ethnics Communities’ Councils of Australia (FECCA). Retrieved from http://www.fecca.org.au/images/stories/documents/Submissions/2011/submissions_2011050.pdf

Minas, H., Kakuma, R., Too, L. S., Vayani, H., Orapeleng, S., Ildes, R. P., et al. (2013). Mental health research and evaluation in multicultural Australia: developing a culture of inclusion. International Journal of Mental Health Systems , 7 (23), 1-25.

Robert, S., Scorsonelli, L., & Brewerton, R. (2009). DEPARTMENT OF HEALTH AND AGEING REVIEW OF THE MULTICULTURAL MENTAL HEALTH AUSTRALIA (MMHA) PROJECT . South Australia: Health Outcomes International (HOI) Pty Ltd.

Schweitzer, R. D., Brough, M., Vromans, L., & Asic-Kobe, M. (2011). Mental health of newly arrived Burmese refugees in Australia: contributions of pre-migration and post-migration experience. Australian and New Zealand Journal of Psychiatry, 45(4), 299-307.

Shannon, P. J., Wieling, E., McCleary, J. S., & Becher, E. (2014). Exploring the mental health effects of political trauma with newly arrived refugees. Qualitative health research, 1049732314549475.

The Department of Health. (2014, Aug 14). Multicultural mental health. Retrieved May 3, 2015, from The Department of Health Webasite: http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-multi

The Department of Health. (2014, Aug 14). Multicultural mental health. Retrieved May 3, 2015, from The Department of Health Website: http://www.health.gov.au/internet/main/publishing.nsf/Content/mental-multi

Victoria, G. o. (2006- 2010). Cultural diversity plan for Victoria’s specialist mental health services.Melbourne: Victorian Government, Dept of Human Services.

Waxman, P. (1998). Service Provision and the Needs of Newly Arrived Refugees in Sydney, Australia: A Descriptive Analysis. International Migration Review; 32(3): p761-777.

Victorian Department of Human Services, (2010), Refugee health and wellbeing action plan: Current and future initiatives. Melbourne

National Mental Health Consumer and Carer Forum. (2014). Culturally and Linguistically Diverse (CALD) Mental Health Brief. National Mental Health Consumer and Carer Forum
The increasing rates in allocation of mental health funding shows the interest on tackle the problem. However it is still not enough.

Standarized: HTQ and
Understand cultural-specific experiences of mental health and distress
Specific clinical disorders vary across migrant populatons
Vulnerable groups: asylum seekers, refugees, unestablished communities and those on Temporary Protection Visa (service funding).
(Waxman, 1998).
Institutions to Organise and Implement Actions
Social Participation
Reduce Stigma
Policy Change
Discrimination & Stigma
Social Participation
Increase visibility
Build sense of cultural community & integrity
Decrease isolation
Organisational change
- Cultural -
Mental Health
- Racism -
Culturally Relevant
Knowledge, institutions and strategies that may be needed to bring about a successful response to the issue

Mental Health Data Collection
Additional and Consistent Research
Increase Funding
Training and Employment
Community Education and Outreach Programs
Depression, anxiety or other mental related issues will result in better socially integrated migrants which will reflect total economy

Mentally unbalanced people are prone to commit crime more often than sane individuals.

Effective mental health action cannot succeed without appropriate approach to these areas

Various programs by government to deal with mental health services for the people of CALD community are as follows:

1. Mental health in Multicultural Australia Project:
2. Access to Allied Psychological Services (ATAPS):
3. Programme of Assistance for Survivors of Torture and Trauma (PASTT):
4. Suicide Prevention Program
5. Support for Day to Day Living in Community:
6. Establishment of a national mental health online portal:
7. Targeted community care(Mental health) Programme:
8. Personal Helpers and Mentors (PHaMs):
9. Family Mental Health Support Service:
10. Mental Health Respite: Carer Support (MHR: CS):

"The greatest need for action is during the initial resettlement period and service providers play a key role during this stage to reduce potential negative long-term impacts." (Waxman, 1998)
Barriers in guiding action: political will, limited resources, lack of commitment, lack of collaboration and "disease" based approaches.
Knowledge available not robust but draw insights to guide an action plan.
Partnerships between service providers and policy makers = transform data into knowledge → informed policy & guidelines → improved programs & practice. (Bloland et al, 2012)
Increase funding for research and community programs
(+evaluation and community feedback).
Making national health policy culturally appropriate.
Poorer mental health may impact on the contribution made by skilled migrants to Australia and subsequently on the Australian economy.
(Reid, 2012)
Between 36% and 49% of migrants do not use their skills/qualifications in their jobs, up to 42 months after arrival in Australia.
(Reid, 2012)
Humanitarian entrants experience greater levels of stress and social difficulties than other migrant populations (Waxman, 1998)
Victoria receives one third of the total migrants entering to Australia. i.e settling in Victoria: 10 000 migrants (Asylum Seekers & Refugees)
There are many culture-specific mental health concepts and idioms of distress in refugee populations, need to identify them.
BARRIERS to an effective cross-cultural communication about mental health
Lack of knowledge in mental health of newly arrived migrants and limited funding allocate to mental health of newly arrived migrants
Studies support that mental health issues in newly arrived migrants are rising. Need for national data collection, no data on quality of mental health service outcomes
This knowledge of understanding of how mental mental health varies in diferrent cultures is valuable when taking decisions in an action plan guide, WORKFORCE AND SERVICES.
Creating Cultural Diverse Reference Groups
Government is working on it but due to the lack of enough research and enough information available regarding the exact problem and who are the sufferers, they lack need based implications or solutions.
The few research available and limited funding cannot be a excuse to not address mental health issue in migrants, culturally appropriate strategies are urgently needed.
$7.6 billion in aid is being cut over the next five years, making Australia one of the world's least generous donors to foreign aid
This demonstrates our lack of political and social will to address the health needs of priority groups like asylum seekers & refugees.
Development of Frameworks such as Mental Health in Multicultural Australia: Towards Culturally Inclusive Service Delivery by MHiMA includes 13 organisations that participated in national pilot testing of the framework. However, lack of funding and cooperation need to be addressed.
Mental health problems among immigrants is an issue which Australia has been facing last 50 years. For some reason, this crucial factor was neglected by Federal government until now. Newly prepared reports and plans are addressing the issue and those steps can only be implemented when Federal government approves it.
Strategies and frameworks implemented but still not monitored. FRAMEWORK FOR MENTAL HEALTH IN MULTICULTURAL AUSTRALIA (to help to help services
evaluate their cultural responsiveness and develop action plans to enhance their delivery of services to CALD communities) as well as AMEP and PASST.
Language, stigma, mistrust and discrimination -> use services
Barriers within services to people accessing a service
Variants interact with psychological distress following traumatic events
Refugees and asylum seekers (part children) are at greater risk of developing mental health problems and suicidal behaviours than the general Australian population.
According to population projections: Immigration, including a significant humanitarian intake, will be a continuing major contributor to Australia’s future.
Develop and retain a culturally competent workforce
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