New guide for multicultural families & carers on mental health

By Our Reporter

The pandemic has had dramatic impacts on mental health with a survey confirming that during the first month of the pandemic, the initial mental health impact had been severe, and worse was coming. However, the impact on the lives of Australians is not uniform.

The survey commissioned by Orygen, leading youth mental health not-for-profit and home to the world’s largest youth mental health research institute, found 80 per cent of participants believe the pandemic has worsened the mental health of Australians and half believe it has worsened their own mental health and that of young people.

Professor Patrick McGorry, Executive Director of Orygen, says, “There were particular groups of the population at major risk for a range of negative health and social outcomes include marginalised and disadvantaged Australians; women and those living alone; the unemployed; and, in particular, young people.”

“For some multicultural young people, there are additional stressors that interact and impact on mental wellbeing, to include racism and discrimination,” says Desirée Smith, Clinical Educator, Orygen.

“The problem is even compounded by the fact that many multicultural young people are reluctant to tell their families about their mental health and are afraid to discuss their help-seeking experiences due to the stigma that exists in multicultural communities,” says Phuong Nguyen, peer researcher, Orygen.

In the light of this background, Orygen has developed a guide to help multicultural families and carers know what questions to ask when a young person they care for is receiving mental health support.

Funded by the Australian Government Department of Health, the resource guide is designed to help mental health professionals better support culturally diverse young people. It encourages asking questions about mental health, the mental health system, mental health services, cultural support and self-care.

“While access to appropriate support is therefore highly important, we know that multicultural young people are generally under-represented in youth mental health services, meaning these young people are not necessarily getting the support they need,” says Smith.

Therefore, the resource guide helps suggest queries such as: “how can I best support the young person?”; “how will I be included in the young person’s professional care?”; and, “how can an interpreter be used?”, according to Mich Gador-Whyte, Clinical Educator.

Challenges for youth mental health workers

Angelica Ojinnaka, Youth Research Council Member, Orygen, believes there is a lack of what “family” means to young people from various cultural diversities.

“For young people in communities similar to my own, it can feel exhausting having to repeatedly explain why family involvement or fears of shame associated to mental health are important to think about in our care. At times, assumptions relating to cultural beliefs and language can be made by mental health workers rather than seeing strengths in culture, and this may make families feeling like there is a lack of respect for their cultural sensitives. I experienced this in high school, where a counsellor made assumptions about African people all having “broken families” and no support.

“Young people from cultural backgrounds are not all the same, and when you are not flexible around preference for treatment considering family factors and systems, it can set them back or make them feel reluctant to trust services,” says Ojinnaka.

Other such as Nguyen, who was involved in developing the resource guide, beleives people from the older generations might have misperceptions around mental health. Therefore, they may not be supportive of their younger family members when experiencing mental health challenges. These family members may have mental health struggles or personality disorders themselves without being aware of it.

Other issues facing multicultural youth

“Mental health for youth in communities like my own is about how we are doing spiritually and financially, our connection to land and waters, how close we feel to the community and more. For me and friends, we are juggling changes to this every day, and having to navigate systems that see our cultural experiences as a burden rather than a strength. When it comes to mental health, I also know of young people who are feelings pressures to be beacons of progress for our communities, based on the sacrifices of our parents and extended families.

“Even with the pandemic, we are having to deal with the emotional toll of ongoing discrimination, racism, and social disadvantages. So many youth are just simply trying to re-establish lost connections and a sense of belonging/security, without feeling excluded more than we are already,” says Ojinnaka.

Many migrant and refugee youth do not have the time or believe they have the time to seek help due to their busy schedules. Some of them may not know how to navigate the help-seeking processes, such as knowing where to go or who to speak with when they encounter challenges, says Nguyen.

Multicultural young people encounter complex, culturally diverse, and intersectional mental health challenges in comparison to young people from Caucasian backgrounds. For example, intergenerational trauma or racism can deteriorate their mental health. Many mental health services are not culturally responsive enough to meet these specific needs, she avers.

For some multicultural young people, the experience of having to support their family in the process of navigating and understanding the mental health system and service, whilst they are unwell may create burden for the young person, agrees Smith.

How carers can use the resource guide

The podcast resource, says Ojinnaka, is a great tool that may give one ideas of questions to be asking of services on how they can support one’s cultural needs as a carer.

Youth mental health professionals can use the toolkit to support families in building confidence and knowledge in the mental health care system and in how they can support their young person mental health needs, says Smith.

Nguyen says families and carers can make the resource their own by adding their own questions, taking it to mental health appointments, highlighting the suggested questions they want to ask, or having it translated.

The guide is based on what other families and carers wish they had known, or asked, when supporting a young person experiencing mental ill-health.

As Professor McGorry says, “We have been willing to turn our society upside down to flatten the COVID-19 curve, the same commitment is now required to flatten the mental health curve.”

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