Culturally and linguistically diverse communities

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Australia has a culturally and linguistically diverse (CALD) population, including refugee and humanitarian entrants, and other permanent migrant Australians.1

  • Around 7.3 million migrants live in Australia.2
  • Each multicultural community is unique and has diverse experiences and cultural practices.
  • CALD communities and refugees are identified as priority populations under the National Mental Health and Suicide Prevention Agreement. People from these communities experience higher levels of psychological distress compared with other Australians.3
  • In 2007–2020, refugees and asylum seekers in Australia experienced 1.7 times the rate of suicide compared with other permanent migrants.4

Risk factors and challenges

People from CALD communities may be exposed to additional risk factors for suicide, which can also affect access to aftercare services. These may include:

  • adjusting to a new culture
  • religious and cultural beliefs of mental health and suicide supports
  • experiences of stigma and discrimination
  • changes in social and family support networks
  • communication and language barriers
  • increased social isolation
  • navigating different cultural identities, particularly among young people.

Refugees or humanitarian entrants may also experience trauma from:

  • persecution or human rights abuses within their country of origin
  • exposure to war, violence or atrocities
  • separation from family and friends
  • asylum-seeking or migration process
  • time spent in immigration detention or processing centres
  • difficulty accessing services and supports, including the National Disability Insurance Scheme (NDIS) and Medicare
  • difficulty with employment; particularly for refugees who had professional qualifications that aren’t recognised in Australia.5

More about delivering healthcare to refugees in regional NSW.

Considerations

Cultural considerations

  • Be curious – connect meaningfully by taking the time to learn about the person’s culture and background. The community mental health profiles from the Transcultural Mental Health Centre can be helpful.
  • Cultural practices or beliefs around gender and age, e.g. is it appropriate for males to support female consumers, and vice versa; or is it appropriate for a younger staff member to support an older consumer, and vice versa?
  • Cultural and religious beliefs about mental ill health and suicide – are there ways to discuss wellbeing and illness that avoid issues of stigma, shame or taboos?
  • Recognise their family, carers, friends and kin structure may look different to others. This may be a large, multigenerational support network, or they may have experienced separation from family during migration or the asylum process.

Communication considerations

  • Check in with the consumer – ask how they would like to communicate and work together.
  • Provide written information in the person’s language.
  • Ensure translators are available, and check with the consumer if they would like to have a translator available. For small community cultural groups, there may also be issues in finding a translator that is unknown to the person.
  • Do not rely on family members, carers, friends and kin to be translators. They are there as supports. It can be distressing or burdensome for them to translate, and information and nuances may get lost in translation back to the consumer.
  • Do not use machine translation (such as Google translate) to provide information. Again, information may get lost in translation.
  • Reach out to the relevant support services below.

Recommended resources

Blue Knot: resources supporting recovery from trauma
Provides resources to support people affected by complex trauma, and help professionals and organisations to promote trauma-informed care and recovery.
Source: National Centre of Excellence for Complex Trauma

Discussing suicide with culturally and linguistically diverse communities
Practical resources for discussing suicide with individuals, families and communities from CALD backgrounds.
Source: Conversations Matter

Embrace Multicultural Mental Health
A website focused on mental health and suicide prevention for people from CALD backgrounds. Information is available in many languages, in a culturally accessible format.
Source: Mental Health Australia

NSW Refugee Health Service
Statewide service providing a range of clinical services and medical assessments for recently arrived refugees and asylum seekers.
Source: South Western Sydney Local Health District

NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTSS)
A service providing culturally relevant psychological support and community interventions to support refugees who have experienced trauma.
Source: NSW Health

Transcultural Mental Health Centre
A statewide service working with people from CALD communities, health professionals and partner organisations across NSW to support good mental health. Helpline: 1800 648 911
Source: Western Sydney Local Health District

References

  1. Suicide Among Refugee and Humanitarian Entrants and Other Permanent Migrants. Canberra (AU): Australian Institute of Health and Welfare; 2023 [cited 25 Sept 2024].
  2. Pham TTL, Berecki-Gisolf J, Clapperton A, et al. Definitions of Culturally and Linguistically Diverse (CALD): A Literature Review of Epidemiological Research in Australia. Int J Environ Res Public Health. 2021 Jan 16;18(2):737. DOI: 10.3390/ijerph18020737. PMID: 33467144; PMCID: PMC7830035.
  3. Stats and Facts: CALD Communities. Sydney (AU): Suicide Prevention Australia; 2023 [cited 25 Sept 2024].
  4. Refugee And Humanitarian Entrant Health. Canberra (AU): Australian Institute of Health and Welfare; 2023 [cited 25 Sept 2024].
  5. Never Turning Away: Australia’s World-Leading Program of Assistance To Survivors Of Torture And Trauma. Sydney (AU): Forum of Australian Services for Survivors of Torture and Trauma (FASSTT); 2018 [cited 25 Sept 2024].
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