Perspectives of Culturally And Linguistically Diverse (CALD) community members regarding mental health services : a qualitative analysis
- Authors: Radhamony, Reshmy , Cross, Wendy , Townsin, Louise , Banik, Biswajit
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Psychiatric and Mental Health Nursing Vol. 30, no. 4 (2023), p. 850-864
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- Description: 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 servi es 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. © 2023 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.
Enhancing Culturally and Linguistically Diverse (CALD) community understanding and utilisation of mental health services in Victoria
- Authors: Radhamony, Reshmy
- Date: 2022
- Type: Text , Thesis , PhD
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- Description: The increase in cultural diversity (CD) in Victoria, Australia, demands healthcare professionals to acquire cultural competence. Literature reveals that people from Culturally and Linguistically Diverse (CALD) communities can be disadvantaged in terms of mental health service access and utilisation and the appropriateness of the health care they receive following access. Cultural competence has been advocated as a necessary step to alleviate health disparities and reduce bias and prejudices associated with culturally diverse people. Cultural competence has been endorsed in the government and professional bodies’ policies and guidelines for a long time. Whether this has prepared the mental health nursing workforce with sufficient knowledge, skills, and attitude necessary to be culturally competent, is still questionable. Evidence shows that significant barriers such as language and communication, cultural differences, and a lack of cultural sensitivity by mental health nurses (MHN) limit the quality of care provided to people from various non-dominant cultures. The primary aim of this study was to examine whether an educational intervention can improve mental health nurses' knowledge, behaviour, and attitude. Hence this multiple-method study focused on the educational needs of a cross-section of MHNs in Victoria, utilising online surveys and semi-structured interviews. This project undertook a gap analysis through telephone interviews with the CALD community members in Victoria regarding their mental health service needs and experiences. Then developed, implemented, and evaluated an online education package – “Acknowledging Diversity”, regarding cultural awareness and responsiveness for mental health nurses working with people from CALD communities. A CIPP (Context, Input, Process and Product) model evaluation of the education package confirmed its effectiveness. Andersen's Behavioural Model of Health service use (ABMHSU) was the underlying theoretical framework for this study. The study's findings were further analysed using the contextual variables of Andersen’s model. The study outcome for mental health nurses was improved knowledge, attitude, and competence about the needs of people from CALD backgrounds, even though the findings were not statistically significant. However, it has been conceded that cultural competence cannot be achieved in a single education session. Therefore, attaining cultural proficiency is a continuous process that requires motivation and persistence from MHNs and ongoing cultural encounters with the CALD population. Examining how educational interventions improved MHNs’ cultural competency to facilitate CALD community understanding and utilisation of mental health services also identified the gaps in knowledge to report future research areas.
- Description: Doctor of Philosophy
Nursing education to enhance culturally and linguistically diverse (CALD) community access to mental health services : a scoping review
- Authors: Radhamony, Reshmy , Cross, Wendy , Townsin, Louise
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Issues in Mental Health Nursing Vol. 42, no. 11 (2021), p. 1048-1063
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- Description: 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. © 2021 Taylor & Francis Group, LLC.