The Consumer Perspective

Aloma Lane is 23 years old. She is half Samoan and half Australian and migrated to Australia from Christchurch, NZ six months ago. She is an aspiring singer/songwriter/guitarist. Aloma is recovering from schizoaffective disorder.

Q. What does recovery mean to you?

A. It means getting well. You have to have an opportunity to spend time with people your own age and socialise and have fun.

Q. What is important to you for your own recovery?

A. Having things to do during the day and night so you don’t get lonely and bored. You need to be around people all the time. You need to feel like you are achieving something. You need role models. Being able to extend myself by spending time with people. Working on my social skills – that is the thing I am most passionate about and then music after that.

Q. What is the best thing a mental health service can do to support the recovery process for consumers from culturally diverse backgrounds?

A. I go to a group that runs most days of the week – they do day trips like sailing, go to Wet n Wild and Dream World. The trips are subsidised. It gives you a chance to have fun and feel valued because people spend time with you. We need more of these programs; they must be run at night-time as well because that is when you get really lonely. Samoan parents can be quite bossy and domineering, but my Mum is quite modern and she really listens to me and cares about my needs. I feel supported because I am able to debrief all the time.

Q. What message can you give to other culturally diverse consumers about their recovery journeys?

A. You’ve got to be open, you have to listen to people and be open to new ideas. Loneliness is a really strong feeling that people have, but everyone goes through that and you just have to try and reach out to people, whether you are the lonely person or those reaching out. You have to let people know that they are not alone. Lonely people have to be open and active in forming new friendships. You have to take action.

Q. What message would you give to the general community about recovery from a mental illness?

A. You have to be respectful of something that you don’t understand. There are many types of people in the world and you have to be respectful to other people’s needs and differences.

The Carer Perspective

Elisapeta is Aloma’s mother and her carer. She is from Samoa and migrated to Australia in January 1998.

Q. What does recovery mean to you?

A. The way I see it in one word is freedom. For me personally it is the freedom to do what I would like to do. If Aloma is well, I could find a job and travel, go to social events. In my community I get invited to a lot of things and I was involved in a lot of volunteer activities, but I can’t go because she needs me here. If I do go, I may get a call to say she is feeling down. I was accepted to do a traineeship but I couldn’t do it, because family comes first. So, maybe next year.

Q. What do you believe are important ingredients to a recovery journey for someone who has a mental illness?

A. Having social support. Educating the family and the community at large so that they will be able to provide support to those who have mental illness. We all know that there is a stigma attached to people and the family with a mental illness. I feel in my family, some of the children don’t want to associate with Aloma and she feels left out. My heart goes out to my daughter in this situation. The older ones, they can communicate better. This is my assumption, but I feel that they don’t want to approach her in case they say the wrong thing.

Q. What is important for you in supporting your daughter in her recovery?

A. Having a lot of patience because at times I can be impatient. That has been really really hard. To really need to listen to key words, and to be able to help and not irritate her. Sometimes it takes me a little while to give an answer to what she asks or to a situation. I need her to clarify what she means in her mind. She needs to have someone to ring a lot of the time and the phone bill has been enormous. But she needs to call these people to establish contact so she can cope. My nieces that Aloma grew up with are great; they help her and talk to her about her illness. They clarify things for her and reduce the stress. Sometimes when it is all getting too much for me, I take off to my sister’s house and I talk about things totally different. When I come back home, I feel 100% better, usually because I am in a better frame of mind. My sister has been a godsend. I have been told to go to a support group, I would love to go to these groups, but I can’t find the time. I think this would be great to talk to some people in the same situation.

Q. What message would you give to other carers of culturally diverse mental health consumers?

A. In my own community, to understand and to be more open in talking about the problems they have with their family member. They feel ashamed because people say, ‘Do you know that person has a child with a mental illness?’ This is stigma. I want to say to them, talk openly and come forward because we might be able to help others. There are people out there who don’t know where to go for help. I know there are a lot of people with mental health problems but they haven’t been diagnosed because their families are ashamed.

Q. What do you need from your community to support you caring for your daughter?

A. I would like to set up a support group for the Samoan community who have mental illness, who experience domestic violence or whatever. There is no support because they think they get support from their church gatherings. These are good events, but this is a misunderstanding...they go to the church to eat, socialise and laugh about things, but we don’t talk about the issues, nothing gets done. The Samoan support group could run workshops to educate the people on mental illness.

The Clinican Perspective

Polly Nip is a social worker and Coordinator of Clinical Consultation at Queensland Transcultural Mental Health Centre. She is Chinese from Hong Kong and has been in living in Australia since 1995. Transcultural psychiatry is a particular professional interest.

Q. What does recovery mean to you?

A. To me it is a journey. It is about consumers learning to adjust and getting back to things that they enjoy. Sometimes people have chronic issues that they may not recover from medically, however, they can still recover socially and manage the illness through proper treatment and manage a life that they prefer and of their choice. It is an ongoing process, they will feel the ups and downs.

Q. What are some of the barriers you see culturally diverse consumers facing when managing their recovery journeys?

A. There are two main issues: access to services and recognition of cultural rituals. Even if people have high levels of English or have been here for a long time, that does not mean that they have been acculturated. A lot of people from diverse backgrounds with mental health issues receive very limited amounts of services. This is mainly because of language barriers, which is worsened by mental health services not using interpreters on a regular basis. The other barrier is people assuming that everyone will go through the same recovery journey. There may be religious or cultural recovery journeys that may include spiritual healing processes, issues or rituals and access to these is important. There is a strong psychological component in believing that you are able to get better. Some people believe that only through certain rituals can they be recovered. These concepts are quite different from the Western model, they need to be understood and targeted.

Q. How can mental health workers support culturally diverse consumers in their recovery?

A. Cultural sensitivity. Although breaking down the language barrier is difficult at times, it is really important to have interpreter intervention. Mental health professionals need also to seek cultural advice. They need to be able to provide information to clients in a culturally sensitive way and through the cultural concepts the clients have. Mental health professionals need to tap into cultural consultations to understand what clients’ recovery needs are. This needs to be personal because individuals may not follow strictly to traditions.

Q. How can mental health professionals not currently working within a recovery framework bring it into their service and practice?

A. Everyone can do it if they are willing. It is not hard; you don’t have to understand every culture. Seeking cultural knowledge and wanting to bring it into their work is the biggest issue. There may be a few more phone calls to make initially, however it will save time and confusion in the long run. Mental health professionals need to be asking more questions such as, ‘What does it mean to you to fully recover?’ How is this treated in your home country? How would your own culture call what is happening? Is there a word? Is there a way of treating the illness from your own culture? Are there certain rituals that you need to do?

Sometimes mental health professionals think that we know it all; we know what they mean without asking the questions. Only by asking questions can we understand expectations and then we can work on meeting those expectations.

Q. What message would you give to the general community about the recovery journey for culturally diverse mental health consumers?

A. Mental health problems can be treated and managed. I would say to the culturally diverse consumers, you need to let the professionals know what you need, what is important to them. You need to open up and tell them. Can you find a close friend to help you explain further what you are going through and what is important to you? At the end of the day the mental health professionals are there to promote your recovery journey. It is about the partnership. The consumers need to talk about what is important to them and the professionals need to listen.