MHIMA - FRAMEWORK FOR MENTAL HEALTH IN MULTICULTURAL AUSTRALIA: TOWARDS CULTURALLY INCLUSIVE SERVICE DELIVERY

ORGANISATIONS - IMPLEMENTATION GUIDE - Consumer, carer, and family participation

Consumer and carer participation is a central tenet in mental health policies and plans. Set standards and benchmarks are outlined in the National Standards for Mental Health Services 2010. Participation encompasses a range of processes in which consumers, carers and family members are engaged to have their say at both individual and system levels and in the planning, development, delivery and evaluation of services.

CALD consumer and carer participation varies across jurisdictions, and generally lags behind mainstream achievements in participation. There are important factors to consider and acknowledge when working with CALD consumers and carers as participation may be understood differently by diverse cultural groups.

• CALD communities don’t typically consider users of mental health services as "consumer" with the associated rights of choice and self determination
• The notion of “participation” implies non-universal concepts such as individual rights and self-advocacy
• The variety of mechanisms generally used to facilitate consumer and carer participation may not be the most appropriate mechanisms to engage CALD consumers, carers and their families.

The key cultural factors impacting participation levels are known to be:

• Familiarity with the concept of consumer participation
• Familiarity with, and acceptance of concepts of participation and advocacy
• Unrealistic expectations
• Mechanisms (e.g. committees, voluntary/ paid advocates) which are linked to cultural values
• Diverse and varied understandings of mental health and mental illness which may impede group processes.

KEY OUTCOME AREA 1: CONSUMER, CARER AND FAMILY PARTICIPATION

CALD consumers & carers effectively participate at all levels of mental health service planning, delivery and evaluation

• Outcome Indicator 1.1 CALD consumers & carers are represented on Committees and mechanisms in relation to service development, planning, service delivery, implementation, evaluation and policy development.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the importance of CALD consumer & carer participation and establishes contact with CALD consumers and carers and multicultural organisations.		NSMHS: 3.1, 3.2, 5.3, 6.7, 7.2, 7.10, 7.11, 7.12, 7.14, NSQHSS: 1.1, 1.2, 2.1, 2.2, 2.3, 2.5, 2.6, 2.9, 6.5
  Developing	The organisation works in collaboration with CALD consumers and carers and multicultural organisations to ensure their input in service development, planning, delivery, implementation etc.
  Advanced	The organisation employs CALD consumers and carers to ensure culturally tailored mechanisms to facilitate their input in service development, planning, delivery, implementation, evaluation, policy development and committee representation.

• Outcome Indicator 1.2 Training and support for CALD consumers & carers is provided, including mentoring and supervision

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the need for training and support, including mentoring and supervision of CALD consumers and carers in formal mental health advocacy and support roles.		NSMHS: 3.3, 3.5, 3.6, 6.18, 7.15, 7.16 NSQHSS: 2.3, 2.6,
  Developing	The organisation works in collaboration with CALD consumers and carers to ensure their input in the development of appropriate training and support programs and structures.
  Advanced	The organisation provides, evaluates and improves culturally inclusive training and support to CALD consumers and carers, including mentoring and supervison.

• Outcome Indicator 1.3 Culturally responsive approaches are incorporated into person-centred and recovery- oriented care.

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the need for client-centered and recovery-oriented care to be incorporated into its service framework.		NSMHS: 10.1, 10.5
  Developing	The organisation has processes in place to ensure CALD carers' and consumers' input and needs are central and client-centered care is being provided.
  Advanced	The organisation has processes in place to ensure ongoing evaluation and improvement of culturally inclusive services based on client satisfaction.

• Outcome Indicator 1.4 Working relationships with CALD community leaders and multicultural organisations are developed and maintained

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the need for CALD community engagement and for the development of effective working relationships with CALD community leaders and organisations.		NSMHS: 4.4
  Developing	The organisation has established working relationships with CALD community leaders and organisations.
  Advanced	The organisation has established effective working relationships with CALD community leaders and organisations and has processes in place for continuing evaluation and improvement.

• Outcome Indicator 1.5 CALD specific approaches are incorporated in peer support models

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the need to incorporate CALD specific approaches in their peer support models and assesses the specific needs of CALD groups in their catchment area.
  Developing	The organisation incorporates CALD specific approaches in their peer support models.
  Advanced	The organisation incorporates effective CALD specific approaches in their peer support models and routinely evaluates and improves these.

• Outcome Indicator 1.6 CALD consumers are provided information, including their rights, in an appropriate language and format

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects that CALD consumers have a right to be provided with suitable information in their preferred language.		NSMHS: 6.1, 6.2, 6.3, 6.4, 6.5, 6.10, 6.11, 6.14, 6.16 NSQHSS: 2.4
  Developing	The organisation has strategies in place to ensure that CALD consumers are provided with suitable oral and written information in a language they understand.
  Advanced	The organisation routinely provides information to CALD consumers in their preferred language and evaluates and improves these services.

• Outcome Indicator 1.7 CALD carers are provided information, including their rights, in an appropriate language and format

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects the importance of providing appropriate information to CALD carers in their preferred language.		NSMHS: 7.1, 7.3, 7.4, 7.7, 7.8, 7.9, 7.17 NSQHSS: 1.18, 2.5
  Developing	The organisation has strategies in place to ensure CALD carers are provided with information in their preferred language to enable them to support the well being and recovery of CALD mental health consumers.
  Advanced	The organisation routinely provides information to CALD mental health carers in their preferred language, so they can support CALD consumers more effectively.

• Outcome Indicator 1.8 CALD consumers are provided with culturally appropriate mental health care

  Level	Strategy	Good Practice Examples	Referencing
  Entry	The organisation accepts and respects that CALD consumers have the right to culturally appropriate mental health care tailored to their individual needs.		NSMHS: 4.3 NSQHSS: 2.5
  Developing	The organisation supports the provision of culturally appropriate care tailored to the individual need of CALD consumers and works in collaboration with specialist multicultural services.
  Advanced	The organisation utilises a range of internal and external resources to deliver culturally appropriate mental health care tailored to individual CALD consumer needs.