I arrived in Australia from Vietnam when I was 22 years old. After four years of training in Social Work, I eventually started working at the Canterbury Community Mental Health Centre in Sydney. I have been at the centre for more than 6 years, where I have learned a lot about life, especially from working directly with Vietnamese people who have experienced or still suffer from a mental health problem.

My main tasks at the Centre include assisting consumers and carers with accessing mental health services relevant to their needs (such as providing assessment, acute service, case work and group work). I’m also responsible for providing counselling, support, treatment, education and assistance to Vietnamese families and their social networks. In addition to this, I also liaise closely with psychiatric inpatient services and provide education, consultation and collaboration with local GPs, psychiatrists and counsellors.

In terms of Vietnamese consumers and their attitudes, beliefs and understanding of mental illness, I see that there is a lack of knowledge about mental health problems. I also believe there is a lack of understanding of how to access the variety of health services that are provided.

From my experience as a Social Worker, I have found that many Vietnamese consumers and carers do not have the skills to seek appropriate help. Therefore, when they do access mental health services, it is at a later stage of their illness where they are often hospitalised as involuntary patients and require longer admission.

The majority of consumers and carers I work with are not familiar with the mental health system and do not sufficiency understand the role of mental health services. For example, in the case of major depression, some carers may bring the consumer to an emergency ward or even delay the medical treatment because they believe the person is suffering from a physical illness, rather than a mental one. Families are often very reluctant to seek early intervention because they think psychiatric units are like ‘prisons’ where consumers will be locked up.

Some consumers also prefer to rely on the traditional network of support from their families or even traditional herbal medicine or their own belief of ‘karma’ instead of relying on mental health services. For example, they may blame their mental illness on something bad that they did in their previous life. Some Vietnamese people believe that their mental illness is some kind of retribution and may prefer to seek help from a spiritual healer rather than undergo early medical intervention.

For example there was one consumer who suffered from schizophrenia and delusions, but their carer insisted that having ‘hypnosis’ would work, rather than seeking help from a professional mental health service. 

In addition to these beliefs, there is great stigma attached to mental illness in the Vietnamese community. Most consumers and carers say they feel ashamed to be associated with a person living with a mental illness. Many are unfamiliar with the term ‘counselling’ simply because this word doesn’t exist in the Vietnamese vocabulary. Some Vietnamese people believe that medication is the only thing that can fix an illness. They do not believe that expressing your feelings and talking about your problems can help. More than likely they will say: “I feel uncomfortable to go to the mental health counselling centre, because they think that I am crazy.”

In my opinion, I think these examples illustrate how important it is to be culturally competent when working with people from CALD communities with mental health concerns. I believe this can only help to:

* reduce delays for Vietnamese consumers to seek health care and treatment

* improve consumer health ‘literacy’

* improve access and equity for consumers

* improve communication and understanding between mental health consumers and health workers; and go towards providing better compliance and recommended treatment

* build trust between consumers and carers with service providers and mental health workers

* improve consumer attendance at ‘follow up’ appointments to help maintain the best service and ensure the consumer’s wellbeing in the community.

From the last edition of Synergy, Sarah Stewart from the Diversity Health Service wrote in her article how “cultural competency (is) just a newer version of cultural awareness or cultural sensitivity, cultural competency is the notion of reciprocity”.

I believe this is very true. From my work, I can see how developing cultural competency involves a two-way learning process between health service providers and consumers. I have recognised this through my work and practise it everyday as a Social Worker helping people from CALD backgrounds living with a mental illness.
 
Moreover, cultural competency adds an important skills component to the domains of knowledge and awareness. Yes, it is definitely true that the more I know about a consumer’s background, the more confidant I am in providing the support they need.

I definitely see cultural competency as a ‘power tool’ to help build rapport and trust with consumers and their carers and health providers. It simply does make a huge difference when dealing with people from CALD communities with mental health concerns.