Young mental health consumers from CALD backgrounds living in Western Australia experience a number of stressors that impact on their mental health, such as building relationships with their peers, social integration, learning English, establishing a sense of self and fulfilling demands of their traditional customs and family expectations. A significant number of young people from CALD backgrounds are unaware of general mental health issues and do not have the means to access information that is relevant to some of the problems they are experiencing.

Many are living with significant levels of emotional disturbances, however feel the need to remain silent due to the fear of bringing shame to their families. Others remain silent because they feel that they have no other options and do not know where to turn to for help.

Some share their emotional concerns and problems with their parents, however some parents dismiss these as they do not seem to them as real problems or simply fail to know what to do or even keep it as a family secret.

Other young people from CALD backgrounds express their problems at school, however schools have a limited number of resources to deal with such complex issues and lack the knowledge, experience and skills to effectively recognise behavioural and emotional indicators that reflect a mental health problem in children from CALD backgrounds. Therefore, appropriate referrals are not being made and in turn the actual services that specifically target CALD mental health are not being effectively used. I believe the best way to resolve this would be to better resource teachers with cultural competency training.

Doctors (GPs) should also offer family-focused treatments to CALD families as well as cognitive behavioural interventions to treat mental problems like childhood depression. I receive a number of referrals from GPs requesting some mental health intervention for CALD children experiencing depressive symptoms. In one case, the doctor’s care plan involved prescribing anti-depressants. However, after a clinical assessment it was discovered that the young person only presented slight depressive symptoms that were attributed by their resettlement experience. In this case it may have been more appropriate to have prescribed the child with supportive counselling rather than medication.

Luckily there are some services that acknowledge the needs of young people from CALD backgrounds that also encompass social integration, recognition of past and present trauma, and recreation. However, there is a lack of appropriate services that can provide general counselling targeted to young mental health consumers from CALD backgrounds.

Currently service providers in Western Australia who assist young people from CALD backgrounds with resettlement issues, education, trauma and torture and recreation are doing a commendable job, however the utilisation of mainstream services is poor. With funding a constant hurdle for many of these not-for-profit services, the links between ethno and multicultural-specific services and mainstream government and non-government services need to be improved.

The notion that only migrant-specific providers are the one-stop-shop for CALD communities needs to be deconstructed. The danger of having a top-heavy migrant service provision, especially in relation to child and adolescent mental health, is that these services are not funded to employ qualified mental health professionals. Some workers also lack experience, understanding and knowledge in managing severe mental health problems; and are not qualified to help at this level. This can often leave children and their families with a very limited understanding of their mental health and very limited options for further assistance.

After identifying the lack of mental health expertise in the field of young CALD people, the North Metro Area Child and Adolescent Mental Health Service (NMA CAMHS) in Perth created a Cross-Cultural Psychologist position. This position provides a cultural bridge between the staff at NMA CAMHS and CALD families. It also provides assessment inventories that are culturally valid to the client group, as well as adapting mainstream psychological interventions to suit cultural norms and sensitivities.

NMA CAMHS has successfully recognised the changing trend and increase in diversity amongst young people living in Perth. This position has formulated an effective means to promote CALD child and adolescent mental health among service providers, educational facilities and relevant mainstream agencies to help improve young CALD people and their families to better access appropriate mental health services.