1. Multicultural Mental Health Forum Recognising and responding to Mental health concerns in young people from multicultural backgrounds By David Keegan

2. 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 What is a mental illness?

3. PERCENTAGE OF AUSTRALIANS WITH A MENTAL ILLNESS IN ONE YEAR % MALE% FEMALE% TOTAL 16-2416-8516-2416-8516-2416-85 Any Anxiety Disorder 11.018.014.4 Any Depressive Disorder 5.37.16.2 Any Substance Use Disorder 7.03.35.1 Any Common Mental Disorder 18.022.020.0 15.5 22.8 4.3 9.3 9.8 30.1 8.4 21.7 12.7 26.4 6.3 15.4 Australian Bureau of Statistics. 2007 National Survey of Mental Health and Wellbeing: Summary of Results. (Document 4326.0) Canberra: ABS 2008

4. 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

5. 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

6. 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.

7. Risk Factors

9. 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).

10. 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

11. 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

12. 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

13. 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)

14. 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

15. Further info Mental Health First Aid Guidelines - http://www.mhfa.com.au/Guidelines.shtml http://www.mhfa.com.au/Guidelines.shtml Youth Beyond Blue – http://www.ybblue.com.auhttp://www.ybblue.com.au Transcultural Mental Health - http://www.dhi.gov.au/Transcultural- Mental-Health-Centre/Transcultural-Mental-Health-Centre- Home/default.aspxhttp://www.dhi.gov.au/Transcultural- Mental-Health-Centre/Transcultural-Mental-Health-Centre- Home/default.aspx Multicultural Mental Health Australia - http://www.dhi.gov.au/Multicultural-Mental-Health- Australia/home/default.aspx http://www.dhi.gov.au/Multicultural-Mental-Health- Australia/home/default.aspx

16. 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. 2 nd 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