Transcript Multicultural Mental Health Forum

Multicultural Mental Health
Forum
Recognising and responding to Mental
health concerns in young people from
multicultural backgrounds
By David Keegan
What is a mental illness?
DEFINITION
A mental illness is a diagnosable illness which
causes major changes in a person’s thinking,
emotional state and behaviour, and disrupts the
person’s ability to study or work and carry on
their usual personal relationships.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)
Washington DC: American Psychiatric Association
PERCENTAGE OF AUSTRALIANS
WITH A MENTAL ILLNESS IN ONE YEAR
% MALE
16-24
% FEMALE
% TOTAL
16-85
16-24
16-85
16-24
16-85
Any Anxiety
Disorder
9.3
11.0
21.7
18.0
15.4
14.4
Any Depressive
Disorder
4.3
5.3
8.4
7.1
6.3
6.2
Any Substance
Use Disorder
15.5
7.0
9.8
3.3
12.7
5.1
Any Common
Mental Disorder
22.8
18.0
30.1
22.0
26.4
20.0
Australian Bureau of Statistics. 2007 National Survey of Mental Health and Wellbeing: Summary of Results. (Document 4326.0) Canberra: ABS 2008
Multicultural Statistics
There is very little data about prevalence within multicultural
communities
ABS data suggests similar rates for overseas born Australians
Data suggests high prevalence amongst indigenous people
Outline of Common Mental
Illnesses
Depression
– unusually sad mood characterised by persistent symptoms over a
period of at least 2 weeks (5 or more symptoms needed)
- Main treatments for youth include CBT and anti-depressants in some
cases
Anxiety
– an unusually and persistently anxious response to common situations
or to particular triggers. Includes phobias, PTSD, OCD and Panic
attacks.
- Main treatments for youth include relaxation, meditation and CBT type
therapies
Outline of Common Mental
Illnesses
Psychosis
– a loss of reality characterised by delusions and hallucinations.
Includes schizophrenia, bipolar disorder and drug induced
psychosis
Substance Use Disorder
– Severe addiction to alcohol or other drugs (AOD)
Eating disorders
– characterised by distorted view of self and control through food
(includes Anorexia, Bulimia, Binge Eating disorder)
Other disorders include personality disorders which are hard to
understand and treat.
Risk Factors
•Search for own identity/culture
•Anxiety, depression, Isolation, alienation
•Difficulty to be understood and form new relationships
•Language and communication issues
•Adolescence/personal issues
•Relationships with peers
•Feeling of guilt of being here with family and loved ones
back in camps or country of origin
•Dealing with individual rights of a child/young adult
•Adapting to peer influences
•Feel frustrated with speed to learn the language for Communication
•Different value system
•Difficulty feeling accepted
•Negative media portrayal
•Understanding law/authority challenging if they were perpetrators in country of
origin
•Employability poor due to unrecognized skills
•Racism and stereotyping in the broader community (including in schools and
the media);
• Access to culturally-appropriate sport and recreation opportunities;
• Opportunities for meaningful participation in community debates, structures,
groups and environments.
•Juggling cultures/expectations within family
•Loss of family members(due to being killed
or going missing in home country).
•Reorganization of family hierarchy
•Reshaping power to young person -Changes
in family roles where young people are
expected to adopt adult roles, such as
advocating on behalf of the family due to
their stronger English language skills;
•Pressure to succeed
•Family conflict and support: Intergenerational conflict within families due to
changing values and expectations;
•Changes in family make-up and dynamics as
families are reunified after many years of
separation, or young people are sponsored
out to Australia by distant relatives;
•Contributing to family finances including
repaying pre-arrival airfare debts;
•Need to send money back home
•Pressure to maintain religious/cultural
tradition at home
•Overcrowded housing and a lack of study
space
Source: Hunt, D. (2000), Refugee Adaptation in the Resettlement Process (pp. 17-20), and the Minnesota Centre for Victims of Torture.
Hunt, D. (2000), Refugee Adaptation in the Resettlement Process. In The National Alliance for Multicultural Mental Health. Lessons from the Field: Issues
and Resources in Refugee Mental Health. (pp. 17-20).
Multicultural Experiences of MH
There are many ways that people understand mental illness.
For example….
-
A result of past wrongs in the family or by the individual
-
A curse
-
Demon possessed
-
Shame/denial
-
Some cultural practices can be confused for mental illness
Cultural barriers to help
seeking
• Australia has a very medical approach to Mental
Health
• Language and terminology
• Shame
• Spiritual and personality based understanding of
mental health
• Lack of culturally appropriate healing and support
options
Social Determinants of
Mental Health
Some factors promote good mental health
regardless of culture
• Social and family connectedness
• Positive self esteem
• Knowledge about coping strategies and how to
get help early
• Sense of purpose and belonging
Cultural Competence
Being culturally competent when providing assistance involves:
• Being aware that a person’s culture will shape how they understand
health and ill-health
• Learning about the specific cultural beliefs that surround mental
illness in the person’s community
• Learning how mental illness is described in the person’s community
(knowing what words and ideas are used to talk about the
symptoms or behaviours)
• Being aware of what concepts, behaviours or language are taboo
(knowing what might cause shame)
Cultural Safety
Practicing cultural safety means:
• Respecting the culture of the community by using the
appropriate language and behaviour
• Never doing anything that causes the person to feel
shame
• Supporting the person’s right to make decisions about
seeking culturally-based care
Further info
Mental Health First Aid Guidelines http://www.mhfa.com.au/Guidelines.shtml
Youth Beyond Blue – http://www.ybblue.com.au
Transcultural Mental Health - http://www.dhi.gov.au/TransculturalMental-Health-Centre/Transcultural-Mental-Health-CentreHome/default.aspx
Multicultural Mental Health Australia http://www.dhi.gov.au/Multicultural-Mental-HealthAustralia/home/default.aspx
References
Aboriginal Mental Health First Aid Training and Research Program. Cultural Considerations & Communication Techniques : Guidelines for providing
Mental Health First Aid to an Aboriginal or Torres Strait Islander Person. Melbourne: Orygen Youth Health Research Centre, University of
Melbourne and beyondblue, the national depression initiative; 2008.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) Washington
DC: American Psychiatric Association
Arsenault-Lapierre G, Kim C, Turecki G. Psychiatric diagnosies in 3275 suicides: a meta analysis. BMC Psychiatry 2004; 4:37
Australian Bureau of Statistics. 2007 National Survey of Mental Health and Wellbeing: Summary of Results. (Document 4326.0) Canberra: ABS 2008
Hunt, D. (2000), Refugee Adaptation in the Resettlement Process. In The National Alliance for Multicultural Mental Health. Lessons from the Field:
Issues and Resources in Refugee Mental Health. (pp. 17-20).
Kelly CM, Kitchener BA, Jorm AF (2010). Youth Mental Health First Aid: a manual for adults assisting young people. 2nd ed. Orygen Youth Health
Research Centre, Melbourne, Australia
Wickramage, K., Versha, A., Gurrum, D., Sankoh, F., Bah, S., Verma, N. (2008) “Un(settled) voices” Project: Perceptions and experiences
of young refugees on re-settlement in Western Sydney