As Australia’s cultural diversity continues to grow, mental health services need to understand and respond to changes in the local communities they serve. These changes include the arrival of immigrants and refugees whose values, norms, traditions, religious beliefs and social structures may vary from those of the broader Australian culture.

Cultural beliefs about what constitutes mental illness and how to respond to it will affect how immigrants and refugees seek help and whether or not they will choose to access services. Understanding mental illness as a health problem that requires medical treatment is a western concept that can seem strange or even threatening to some people from culturally and linguistically diverse (CALD) backgrounds.

To respond to the needs of their culturally diverse communities mental health services need to firstly understand who their CALD communities are, and then engage with them in partnership to deliver mental health services that are culturally responsive.

People from CALD backgrounds are more likely to receive poorer quality care than the general population, which may be partly due to language barriers and cultural differences between health care providers and consumers. These differences can result in miscommunication and misunderstanding leading to errors and incidents with potentially serious clinical consequences, sometimes even death.

Racism and discrimination from health care providers (intended or otherwise) also contributes to negative experiences for CALD consumers and can result in consumer mistrust and dissatisfaction with mental health services. This can lead to lack of compliance with treatment, disengagement from care and reduced willingness to access services in the future. All these factors can contribute to poor mental health outcomes.

When mental health services have good partnerships with the culturally diverse communities they serve, have addressed access issues by reducing barriers and improve equity of service delivery, they become more culturally responsive.

A culturally responsive mental health service can deliver:

• Better health outcomes for CALD consumers, carers and their families
• Greater access and equity for CALD consumers, carers and their families
• Quality and safety, and reduced rates of adverse incidents
• Better communication and understanding resulting in clearer expectations and improved compliance with treatment
• Higher consumer mental health literacy leading to appropriate help-seeking behaviour
• Greater consumer satisfaction and increased levels of trust, attendance and re-admission rates
• More efficient use of resources leading to cost savings
• Compliance with national standards and accreditation requirements
• Improved public perceptions of the mental health service

The evolution of a more culturally responsive mental health service requires organisational commitment and leadership, as well as an acknowledgement that it is an ongoing process. It cannot be viewed as a simple completion of a compliance activity with a fixed end point.

The Framework for Mental Health in Multicultural Australia: Towards culturally inclusive service delivery (the Framework) is a national Framework that has been specifically designed for Australian mental health services under the current policy context.

The purpose of the Framework is to improve service delivery for consumers and carers from CALD backgrounds, ensuring equitable outcomes in access and quality of care. The Framework supports local continuous improvement practices and enables services to respond to the changing population demographics in their local catchment areas. Implementation of the Framework will not only assist services to fulfil current accreditation requirements, it will also facilitate safer and better quality services.