People seeking help with their mental health should speak to their GP. They can get a second opinion if their doctor doesn’t understand their cultural background. Beyond Blue has a 24/7 coronavirus support line — 1800 512 348 — linked to an interpreter service. Many migrants and settlers face language and cultural barriers to accessing mental health support.
It was not the first time Ms Bui, a support worker in Melbourne, had experienced those uncomfortable physical symptoms, but she did not immediately recognise that they were connected to her mental health. Her anxiety was later diagnosed as being linked to hormonal changes caused by perimenopause.
“I learned that anxiety was not only in people’s minds, but it also impacts physical conditions,” Ms Bui said.
It’s a realisation that many people have likely had this year, with the coronavirus pandemic leading to a spike in mental health issues across Australia. But for people in culturally and linguistically diverse (CALD) communities, it can often be difficult to seek and receive the right treatment when problems arise.
The ‘obstacle race’ to accessing help
Ms Bui said at the beginning of her treatment journey, she had to change psychologists several times before finding the right person. Born and raised Muslim in Indonesia, Ms Bui said some therapists didn’t accommodate her Islamic values and rituals when planning her treatment.
“Australia has amazing services for mental health … what is lacking in the service is just cultural understanding,” she said.
Having a spiritual connection to her faith played a significant role in her healing, Ms Bui said, however she was annoyed when some people in her community suggested her illness was due to lack of connection with God. “I’ve heard comments that I need to pray more or read the Koran more, but that’s not enough,” she said.
Bad advice and misunderstandings around mental health are common issues across society, but can be particularly difficult in CALD communities if information about the services available are not widely known.
Leanne Beagley, CEO of Mental Health Australia, told the ABC it was especially important to get the right messages about mental health out there now, given the additional stress coronavirus was putting on people. This is especially the case for people who face language and cultural barriers when it comes to accessing help.
“There’s this additional spike in problems that comes from the economic and financial issues, and from the isolation, and also from the racism,” Dr Beagley said. “These are all things that kind of add layers of complexity to accessing and seeking help that were already there for CALD communities. “These are communities that have extra barriers, it’s just like an obstacle race where you have to start another 50 metres back, and with more obstacles to get over.”
Beyond Blue’s lead clinical advisor Dr Grant Blashki said, in his capacity as a GP, some of his patients had experienced discrimination and xenophobia during the pandemic. “We do know that racism and discrimination worsen mental health,” he said. “I think COVID brings out the best and worst in people … it’s really time for communities to pull together and support each other.”
‘They’re brought up to be providers’
Negative attitudes towards mental health can also prove difficult, and make it harder for people to seek help from the people around them or professionals. One Māori woman the ABC spoke to, who asked to be known as Felicity, is a member of a few Melbourne Māori community Facebook pages and said there was a sense of hopelessness, as people struggle mentally throughout the pandemic.
“These are trying times for anyone, but for Māori or Pacific men, they’re brought up to be the providers so their sense of identity is being questioned,” she said. “It takes a lot of bravery for them to come forward because our people are very whakamā (feel shame) when it comes to reaching out and asking for help.” Felicity said a lot of people had forgotten the true meaning of aroha (love) and koha (giving gifts without conditions).
“It’s quite sad to see some men reaching out for help on Facebook, and people are judging, and then we don’t see that person again.” Dr Blashki pointed out while some might feel embarrassed or face stigma in reaching out for help, cultural communities could also be key pillars of support for people who are struggling.
“We’ve got to remember that culture can actually be very positive, that it can help build resilience for mental health through strong communities, strong family support networks and a strong sense of identity,” he said. There are more than 650,000 New Zealanders living in Australia, making them the largest migrant group here.
However, the New Zealand Government estimates that a third of them are currently struggling to make ends meet during the pandemic, as they are not eligible for Australian welfare benefits despite paying taxes. Felicity said it was hard to see her people shunned and ignored, because in New Zealand any Australian has the right to qualify for government benefits.
‘We couldn’t pay rent for four months’
Single dad Peter, who is Māori and from New Zealand, arrived in Australia last year as a 444 visa holder — meaning he could stay indefinitely in Australia and work full time — with his two teenage kids. “Once the virus came in, I lost my job instantly and my son was laid off from his full-time job,” Peter said, adding he and his son were not eligible for JobKeeper or JobSeeker. “We couldn’t pay rent for four months and lived off church handouts and donations from the Sikh community.”
Peter said he applied for 150 jobs over four months and, during that time only heard back from three of them. “I got told you’re not a citizen, go home because we’re not hiring non-citizens,” he said. “It got to the point where suicide came [into the picture], and it got to the point where I wanted to get a gun and do an armed robbery just to feed my children.”
In the past month, Peter and his son have found full-time work. “I know that it can drop on a dime within 24 hours and then we’re back in the same boat, so we have stocked up with food and we haven’t spent any excess money — we’re saving everything,” Peter said.
$150 a week to sleep on this couch. Andrew Suitupe is one of nine Samoans paying $150 per week for a house in Inverell, sharing one toilet and bathroom. They are here on the Pacific Labour Scheme.
One Samoan New Zealander, who asked to be known as John as he was working to overcome drug addiction, said the lockdown had compounded his struggles with his identity. “Some people here in Australia are like ‘you’re not a real Samoan because you can’t speak the language’, and since lockdown, it feels like drugs are way more accessible,” he said.
John, who has been in Australia for seven years, said while it was hard only being able to communicate with his loved ones through a phone screen, he was not going back to New Zealand. “If I go home it’ll feel like what I’ve gone through or what I’ve done would have been for nothing — you just have to fight your way out there, I guess,” he said. “Some things you don’t want to share, so you just try to deal with them by yourself, but in the last week or two I’ve started reaching out.”
‘Many people don’t know where to start’
Leanne Beagley from Mental Health Australia said the first port of call for anyone seeking help with their mental health should be their GP, whether in person or via telehealth services. “GPs are extremely well-attuned to some of the issues around language particularly, and the context someone’s coming from,” she said, adding that accredited interpreters are also available to doctors and patients.
Dr Beagley said specialised transcultural mental health services were also available in New South Wales, Victoria and Queensland. The Federal Government is spending $3.5 million on mental health in CALD communities as part of its Mental Health and Wellbeing Pandemic Response Plan, which is intended to go towards providing culturally appropriate services and ensuring information is available in languages other than English.
Dr Beagley said the additional funding was welcome, as long as it went towards addressing the barriers those communities were facing. “I think that’s best done by working with the communities, it’s about working with the leaders in those communities and the workers who are tuned into some of these issues, and helping them deal with some of the misconceptions about mental health,” she said.
Beyond Blue’s Dr Blashki agreed GPs were a good first port of call, and encouraged people to seek a second opinion if their mental health provider wasn’t attuned to their cultural background. He said Beyond Blue worked with the Department of Human Services to translate information in 61 languages, and there was a 24/7 confidential coronavirus support line — 1800 512 348 — which linked to a translator interpreter service.
Despite living with the uncertainty brought about by the pandemic, Ms Bui said she now knows how to maintain her well-being due to her past experiences. The former registered nurse said she was “open and very passionate” about discussing mental health with the Indonesian community in Melbourne, because she wanted to help others.
“It was a very awful feeling and I don’t want people experiencing what I have been through,” she said. When she shared her experience on Facebook, she said she was surprised to receive comments and messages from Indonesian community members saying they had also experienced anxiety.
“There were a couple of people who told me that their wives, husbands and kids had anxiety, even for months, but never talked about it,” she said, adding that she thought mental illnesses should be treated the same as any other illness. “Many people don’t know where to start, so with more people talking about mental health, we can save many lives.”