Guest Editorial

Moving multicultural mental health into the mainstream: Building capacity and facilitating partnerships

Meg Griffiths
National Program Manager, Multicultural Mental Health Australia, Parramatta NSW

PP: 090 - 093

Keywords

multicultural mental health, culturally and linguistically diverse backgrounds, mental health policy, capacity building, partnerships

Article Text

In 2004 the Australian Government Department of Health and Aged Care produced the Framework for the Implementation of the National Mental Health Plan 2003-2008 in Multicultural Australia (Commonwealth of Australia, 2004) under the logo of the National Mental Health Strategy. Auspiced by the Australian Health Ministers' Advisory Council National Mental Health Working Group the Framework marks a high point for multicultural mental health policy. Fitting within a national policy context it describes a broad national approach to the mental health and wellbeing of people from culturally and linguistically diverse (CALD) backgrounds. It focuses on the specific needs of Australia's multicultural community and addresses the challenges of diversity - developing culturally inclusive public policy, ensuring equity and access, planning and delivering culturally competent and appropriate services, and developing and maintaining a culturally competent work force.

In the context of national mental health policy, and to meet nationally accepted standards of service delivery and workforce practice, the provision of culturally competent and appropriate services is the responsibility of all mental health service providers. The Framework provides a sound basis for awareness raising, capacity building and service development in multicultural mental health that is well connected to the National Mental Health Plan. Where it has been used to inform service development at State and Territory level it is regarded as a sound platform for the development of implementation or action plans.

If the Framework is to be effective in driving change, it is essential now to concentrate on the service development, capacity building and infrastructure requirements needed to ensure that its vision of multicultural mental health becomes a reality across Australia. However, the goals of the Framework will not be achieved by jurisdictions operating in isolation or by the mental health sector operating separately from general health services and in isolation from other sectors. To achieve the changes recommended by the Framework, action will be required across a range of sectors and at all levels of government, in partnership with individuals from CALD backgrounds, their families, communities and organisations.

As Multicultural Mental Health Australia (MMHA) moves into the next phase of its operation, from 2006 to 2008, its role has been enhanced and extended to give it a wide reaching brief to drive the implementation of the Framework. This editorial describes MMHA's role in relation to the Framework, specifically to promote and coordinate national activities that address the Framework's key Action Areas and priorities:

• A population health approach to mental health for people from CALD backgrounds;
• Improving service responsiveness to cultural diversity;
• Strengthening quality; and
• Fostering culturally inclusive research, innovation and sustainability.

Practically, this means that MMHA will focus on collaborative work with consumers and carers, policy and program development, information and awareness, workforce development and training and the development of effective practice in multicultural mental health.

To facilitate Framework implementation at State and Territory level MMHA will develop links with State and Territory mental health services and promote collaborations across sectors. This will mean establishing a formal mechanism to ensure all States and Territories have an opportunity to contribute to priority setting within MMHA and to the development of MMHA's national program and work plan, particularly where MMHA has responsibility for driving or facilitating national action on the service responsiveness elements of the Framework. This mechanism will also act as a forum to review priority issues for Framework implementation and multicultural mental health reform in each jurisdiction.

MMHA will continue its role in facilitating policy and program development to progress the Framework by providing information, consultancy services and advice on policy and program development to the States and Territories and through a range of activities that will promote the Framework and its goals to mental health professionals and multicultural communities in each State and Territory. It will also build practical partnerships between the mental health sector and CALD communities by facilitating joint projects and structured activities designed to support the needs of CALD consumers, carers, professionals and community workers and by promoting research and development activities in multicultural mental health.

Collaborating with and supporting CALD consumers and carers

A commitment to the concept of consumers and carers as partners in care and to providing recovery focused care must lie at the heart of any discussion of service appropriateness and service development. Working in partnership with CALD consumers at the level of individual care planning, in service development, and in systemic change, requires that commitment to be reflected in policy and procedures and to be backed by the appropriate allocation of resources to treat consumers and carers as equal partners in capacity building. Resources are required for training and support for consumers and carers, and for the development of responsive service models that build the capacity of existing organisations and services to facilitate participation. Increased community education, in partnership with CALD communities, is essential to the provision of effective, recovery focused rehabilitation and relapse prevention services.

MMHA will work with consumers and carers as partners in initiatives designed to understand needs and work to meet them. Via its relationship with the Australian Mental Health Consumer Network (AMHCN), MMHA will continue to support the AMHCN CALD Consumer Subcommittee and Interest Group to work with CALD consumers and carers to develop the skills to represent their own needs at the public and policy level. This means providing training, support and mentoring for a group of CALD consumer and carer spokespersons and policy commentators. MMHA will also work closely with existing consumer and carer workers around Australia to develop a national network of people concerned with supporting CALD consumers and carers operating at service level, to share information and skills in a critically under-resourced and under-valued area.

MMHA will continue to develop communications strategies to link consumers and carers and to develop targeted information, applied research projects and resources, like Reality Check (Multicultural Mental Health Australia, 2004a), In Their Own Right (Multicultural Mental Health Australia, 2004b), and Beyond Words (Multicultural Mental Health Australia, 2005), which have helped the voices of CALD consumers be heard within mental health sectors.

Community capacity building and stigma reduction

MMHA will continue to focus on provision of information and raising community and professional awareness in the field of multicultural mental health via an extended role in producing generic and tailored awareness campaigns, information and resources on mental health and mental illness that are targeted to and developed with CALD consumers, carers and communities and include a focus on prevention, early intervention, treatment, recovery and rights and responsibilities.

Of major significance is the Community Capacity Building and Stigma Reduction Project, which will develop an integrated information and training package for use with CALD community agencies working locally to reduce stigma related to mental illness and to promote well being, and, where required, appropriate help seeking. This project will involve national and local partnerships and will focus on developing a model of sustainable skills development and mentoring at the local level.

MMHA will also continue to promote and support national programs and mainstream services to provide culturally appropriate information and programs for CALD communities and consumers through joint ventures and partnering activities.

National programs of relevance to CALD service delivery include the Better Outcomes in Mental Health Care Initiative, implementation of the National Practice Standards for the Mental Health Workforce, and appropriate National Mental Health Data Collection for CALD communities. Projects and organisations like Auseinet, beyondblue, SANE and the Mindframe Mental Health Project have already moved to include multicultural issues in their activities in collaboration with MMHA. In this phase MMHA will continue to work with these and other national initiatives to expand services and information to be inclusive of the whole Australian community.

As well, MMHA will maintain and expand its core Information and Communication Services including the MMHA website, Synergy magazine, the E-Bulletin and Information Service (see www.mmha.org.au).

Workforce development and training

MMHA will continue to contribute to building a skilled and culturally responsive workforce by continuing to organise and sponsor conferences, workshops and training programs focusing on the skills required to meet the needs of people from diverse backgrounds, for health professionals and community workers. Additionally, where possible, all MMHA projects will include skills transfer programs.

Of major need is the coordination of a national process to scope, develop, document and disseminate core cultural competencies in multicultural mental health for health professionals in all relevant disciplines and for personnel working in the community and non-government sector. This is a major project outside the scope of MMHA's current funding, and would be designed to provide expertise and guidance for education authorities, professional bodies and employers to implement effective training and workforce development in multicultural mental health. In the short term, MMHA will also work with National initiatives to develop practice tools and standards for use by mental health and multicultural services.

MMHA will develop a national specific interest network of transcultural mental health educators and trainers, with a specific brief for action. In the first instance, this network will focus on a national scoping of issues related to the effective use of interpreters in mental health service delivery.

What about the future?

We know that, while the development of plans at the national level is effective in raising awareness of issues in the short term, for continued progress towards jurisdictions achieving the outcomes described in such a document it is essential that they be complemented by a capacity building approach to facilitate implementation (Parham & Rickwood, 2003). Long term structural development requires action to build and test models of care with national relevance, sustainability strategies to ensure that they are integrated into mainstream practice and monitoring systems using agreed specific and measurable indicators to inform progress in meeting the needs of CALD communities in all jurisdictions. Reporting on and monitoring of agreed performance indicators to measure outcomes and effectiveness of services and programs for people from CALD backgrounds must be an integral part of this process. This requires a capacity building process to facilitate development and consolidation of infrastructure to support the implementation of the Framework at the State and Territory level and the development of national partnerships to promote effective sharing of skills, experience and resources. It is with this goal that MMHA moves into its next phase.

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