Australia is one of the most culturally diverse countries in the world, with people from culturally and linguistically diverse (CALD) backgrounds making up a significant proportion of the population aged over 65.
Government figures show that 20 per cent of people aged 65 and over were born outside of Australia, equating to more than 600,000 people. By 2021 this number will rise to more than 30 per cent.
There’s no doubt that living in a foreign land presents ongoing challenges. But for migrants to Australia, research suggests that these challenges increase as they get older, affecting both their vulnerability and, ultimately, their mental health.
One particular study by the Australian Institute of Health and Welfare noted that older CALD Australians were at greater risk of depression, than the Anglo-Australian population.
“Trauma resulting from separation from their culture and land of origin places many CALD Australians at risk of mental health issues, such as suicide and depression,” says Mr Peter Doukas, Chair of Ethnic Communities’ Council NSW.
“Isolation and differences in language, values and customs exacerbates this risk,” he adds.
Despite this risk however, additional research conducted by NSW Department of Health found that there was an underuse of mental health services by CALD Australians.
“Mental health is a recognised concept in the western world with its own stigmas and taboos, but the term is not recognised with “wellness” in other cultures and countries across the world,” says Doukas.
Because of this many CALD Australians do not seek help due to the taboo, cultural implications, faith and fear of losing face in their community.
Yet, settling into the Australian community life is not something that comes easily for many.
“The time and process in adapting to a new culture is an extremely stressful experience and settlement may take years or may not ever successfully occur at all,” says Doukas.
“We’re experiencing elderly people over 70 years of age who are still unable to speak English, understand or navigate basic Australian health care, aged care or welfare supports systems without specific language and cultural supports and heavy reliance on family.”
Whilst Doukas says that there are a number of programs across Australia that are funded by the Department of Health, the availability for CALD responsive mental health services varies depending on location and region.
He also notes that there are challenges in tracking new and discontinued services and those who provide culturally competent staff and bilingual workers.
However, the main problem lies in the fact that not many CALD Australians are taking up what is already on offer.
“Due to the lack of uptake, the perception is that there’s no need or demand,” says Doukas.
“This falsely informs government and commonwealth of the actual need on the ground. As a result, materials and bilingual resources are not readily available, which further affects access and education to CALD communities, and it becomes a vicious cycle.”
Mental health is a recognised concept in the western world with its own stigmas and taboos, but the term is not recognised with “wellness” in other cultures and countries across the world.
Doukas also notes that funding allocated to ageing CALD mental health is minimal and inadequate in comparison to that allocated to mainstream and other mental health streams.
“Australia has a 25% CALD diversity rate, yet 25% of the commonwealth budget is not allocated to CALD issues,” he says.
Other problems with the services currently available include a lack of adequate training amongst the work forces, a lack of referral and engagement to CALD specific services and a lack of bilingual and bicultural mental health workers, counsellors and psychologists.
So why is it so important for us to bridge this obvious gap?
“The aim is to develop a healthy, connected community which values and understands multiculturalism as an asset not a liability,” says Doukas.
“By providing CALD communities with the skills and knowledge to seek support, it will minimise the need for crisis supports, intervention and a further burden on limited resources.”
Doukas notes that global events are predicting that more refugees and migrants will require settlement in western countries such as Australia. Therefore, a national strategy to prepare to respond to changing and complex mental health of our ageing CALD communities is vital.
And it’s something that Professor Jolanda Jetten from the University of Queensland is only too aware of herself.
Jetten is currently researching the vulnerability of older CALD Australians with the aim of understanding how we can best help them stay connected.
“We’re not quite sure what the answer will be, but it’s definitely clear from the literature that we’ve reviewed that there’s an underutilisation of services available for migrants because of many barriers,” she says.
Jetten notes that with the amount of migration expected over the next few years, it’s important to start understanding migrant behaviours and what would encourage them to use the available services.
“It’s easier for migrants to fall into the trap of isolation, so there are all sorts of interventions that we need to put into place to get these people out of their houses and get them to partake in activities,” she says.
“We need to look at how we can facilitate that but we also need to explore if this is beneficial in terms of better health outcomes.”
Working in collaboration with Diversicare, Jetten says they’ve already developed a number of activities that target both multi-cultural and single cultural groups in order to assess if this works in connecting people and improving their wellbeing.
“We’re also exploring whether or not it would help if someone phoned them every morning to make them feel that there’s someone out there thinking of them – just another form of intervention to break that loneliness or potential isolation for them,” she says.
Whilst Jetten has only just commenced her research, she hopes to be able to uncover some useful strategies for the future of ageing CALD Australians and, as a result start to help bridge this gap.
“It’s all open questions for us at the moment, but if we can focus on getting a better grip on all the barriers and start to understand them, we can help fill the gaps and get these communities to connect and feel stronger to reach out in all aspects of life,” she concludes
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