1. HARD CALD EVIDENCE The ‘Westernising’ of mental health evidence

2. Angel Carrasco Assistant Director of Social Work (Mental Health &ATODS) Gold Coast Health Service District

5. * Greek, Arabic and Italian speakers had the largest proportions of Australian-born speakers, reflecting the fact that these languages were mainly brought to Australia now more than 20 years ago and have been maintained among the children of those migrants. (ABS, 2006) * The 2006 ABS Census found almost three-quarters (73%) of people born overseas who had been resident in Australia for two years or more were Australian citizens

7. * Suicide rates for CALD people aged 65 and over are 65% higher for males and 117% higher for females than the Australian born population aged 65 and over. (C of A, 2004). * “Numerous reports in the past four decades have indicated that substantial cross-ethnic differences exist in the dosage requirement and side-effect profiles of various psychotropic drugs.” (Keh-Ming, Poland & Anderson, 1995)

8. YET……….. YET……….. Australian research dealing with CALD populations accounted for only 2.2 per cent of published articles and attracted only 1.5 per cent of competitive research grant funding (C of A, 2004).

11. Comparative analysis of multistage population surveys Sample Mekong Delta of Vietnam: n= 3039 Vietnamese immigrants (NSW) n= 1161 Australian born population n= 7961 Psychometric survey tools: * International Diagnostic Interview (CIDI) 2.0 – Western survey * Phan Vietnamese Psychiatric Scale (PVPS) – Indigenous survey Results: Cultural factors in the expression of mental distress and research tools may influence the prevalence rates of mental disorders across countries Population GroupCIDIPVPS Mekong Delta1.8%8.8% Aust. Vietnamese6.1%11.7% Australians16.7%*****

12. Some Methodological issues in CALD Research have included:

13. “Existing research into the specific issues surrounding mental illness in people from CALD backgrounds is often scant or unconvincing and many issues require additional and rigorous research. “ Multicultural Mental Health Framework, C of A, 2004:p15

14. “Clearly more effectiveness studies are needed to address these basic questions of generalizability before these empirically supported treatments can be considered as “best practice” interventions with minority (sic CALD) clientele. “ (p.797) Zane, Hall et al 2004 “Research on Psychotherapy with Culturally Diverse Populations” in Michael Lambert (Editor), Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change (5 th Edition)

15. Current development of AASW cross cultural curriculum accreditation standards for social work qualifying programs Awareness of underlying western bias in mental health research and evidence. Further development of education and training for current Australian social workers in cultural competency Use interpreters and community cultural groups appropriately Need for more CALD research as a fundamental social justice issue.

16. APA, A. P. A. (2000). Diagnostic and statistical manual of mental disorders ( Fourth Edition, Text Revision ed.). Washington: American Psychiatric Association. Australia, C. o. (2004). Framework for the implementation of the National Mental Health Plan 2003- 2008 in Multicultural Australia. Retrieved. from www.mentalhealth.gov.auwww.mentalhealth.gov.au Bhugra, D. (2002). Ethnic factors and service utilization. Social Psychiatry, 15, 201-204. Carrasco,A. (2009) Topic 12: Mental Health and people from culturally diverse backgrounds. Master of Mental Health Pratice Module. Griffith University. Citizenship, D. o. I. a. (2009). Australian Multiculturalism for a New Century: Towards Inclusiveness. Retrieved 17th June, 2009, from http://www.immi.gov.au/media/publications/multicultural/nmac/chapt_2a.htm http://www.immi.gov.au/media/publications/multicultural/nmac/chapt_2a.htm Commission, A. P. S. (1998). Charter of Public Service in a Culturally Diverse Society. from www.apsc.gov.au/foundations/charterpublicservice.htm www.apsc.gov.au/foundations/charterpublicservice.htm Draguns, J. G., & Tanaka-Matsumi, J. (2003). Assessment of psychopathology across and within cultures: Issues and findings. Behaviour Research and Therapy, 41, 755-776. National Health and Medical Research Council (2006). Cultural Competency in Health: A Guide for Policy, Partnerships and Participation. Canberra: NHMRC. www.nhmrc.gov.au/publications/_files/hp19.pdf NHMRC, N. H. a. M. R. C. (2005). Cultural competence in Health: A guide for policy, partnerships and participation. Retrieved. from http://www.participateinhealth.org.au/clearinghouse/Docs/culturalcompetency.pdf. http://www.participateinhealth.org.au/clearinghouse/Docs/culturalcompetency.pdf Proctor, N. G. (2006). "They first killed his heart (then) he took his own life": Reaching out, connecting and responding as key enablers for mental halth service provision to multicultural Australia. Australian e-Journal for the Advancement of Mental Health, 5(2), 1-5. Queensland, G. (2005). Review of transcultural mental health services in Queensland. Retrieved. from. Silove, D. (2002). The asylum debacle in Australia: A channlage for psychiatry. Journal of Psychiatry, 36, 290-296. Stolk, Y. (2009). Approaches to the influence of culture and language on cognitive assessment instruments: The Australian context. Australian Psychologist, 44(1), 1-5.

17. Contact Details: Angel_Carrasco@health.qld.gov.au