CPHs in Victorian mental health services
The “Cultural Diversity Plan for Victoria’s Specialist Mental Health Services 2006-2010” provides a framework for improving the specialist mental health services available in Victoria for CALD communities [1]. Among several recommendations, this document sets out the requirement that every mental health service in Victoria appoint a CPH to support the implementation of the Plan [1]. CPHs are the service-based human resource suggested in the Plan to be the key players in mental health services to generate service improvement activities for CALD consumers and carers. Their importance is restated in the document “Because mental health matters: Victorian mental health reform strategy 2009 – 2019” [3]. The overall responsibility of CPHs is to assist their service to promote culturally sensitive practice and to facilitate service access by members of CALD communities [1] [3].The VTPU has been supporting CPHs in several ways; through providing education and training, coordinating a state-wide network and assisting with the implementation of service and community development initiatives within organisations.
Why do we need CPHs in mental health services?
| Victoria is home to people from more than 200 nations, speaking more than 230 languages and dialects and following more than 120 faiths. More information about Victoria and multiculturalism can be found here. |
| The preamble to the Victorian Charter of Human Rights and Responsibilities declares that “human rights belong to all people without discrimination and the diversity of the people of Victoria enhances our community”. Click here to download the Victorian Charter of Human Rights and Responsibilities document. |
| The Victorian Mental health Act includes among its objectives “to establish, develop, promote, assist and encourage mental health services which – take into account the age-related, gender-related, religious, cultural, language and other special needs of people with a mental disorder” (cited in Minas 2009/08) |
And yet…
A recent investigation of mental health service use by members of Victoria’s ethnic communities found that while people from non-English-speaking countries (NESC) comprise 20% of Victoria’s population, those from NESC comprise only 13% of community clients and 15 % of inpatients. People from NESP present late in the course of a disorder; there were more diagnoses of psychoses, more frequent contacts, inpatient admissions were more likely, more involuntary admissions and longer inpatient stays. People with non-psychotic disorders are, it seems, less inclined to seek treatment (Stolk, Minas, Klimidis 2008). Click here to download a copy of the Access Report.
The VTPU’s mission is to “strengthen the capacity of Victoria’s mental health system to provide effective, equitable and cultural appropriate services to Victoria’s CALD population”. To this end, we are committed to forming partnerships with mental health services and community organisations and working with CPHs.
What is the role of CPHs?
A culturally competent health system disseminates information on cultural competence and assists the mental health workforce to achieve culturally competent practice [2]. CPHs have the potential to contribute to this mission. At an organisational level, CPHs can participate in the development of policies that are culturally responsive and provide input into decisions regarding allocation of resources. They can play a role in educating the mental health workforce by conducting cultural competence training, disseminating information or influencing practice through a range of informal means. They can also facilitate partnerships within and outside the service in order to meet the needs of a diverse community. This research emerged from the need to further investigate the contributions of CPHs as agents of change in developing a systematic approach to cultural responsiveness.
There is no one way to describe the role of a CPH. Services are encouraged to develop their own role descriptions that reflect their particular programs and organisational structures. Most CPHs are enhancing the care and management of individual CALD consumers, their family members and carers, and participating in broader service and community development initiatives.
Gathering information and knowledge about the mental health needs of local CALD communities, assisting fellow team members to develop skills in cross-cultural work, agitating for improvements in the use of language services, developing linkages and partnerships with a range of organisations – these are just some of the tasks in which CPHs are engaged.
CPHs are “champions”; they are seeking creative and innovative ways to address the needs of our diverse and ever changing multicultural community and helping to develop more responsive, flexible service models. They need mentoring, sponsorship, and management support. For a brief, irreverent summary of what engaging the change champions within your service could mean click here.
A number of CPHs have been working in these roles for some time. Here are some of outcomes they are seeking and some suggestions, for CPHs who may be just getting started, about what to do.
1. Victorian Government Department of Human Services, Cultural diversity plan for Victoria’s specialist mental health services 2006–2010. 2006, Metropolitan Health and Aged Care Services Division, Department of Human Services, Victorian Government: Melbourne.
2. Australian Government National Health and Medical Research Council, Cultural competency in health: a guide for policy, partnerships and participation. 2006, Commonwealth of Australia: Canberra.
3. Victorian Government Department of Human Services, Because mental health matters: Victorian Mental Health Reform Strategy 2009 -2019. 2009, Mental Health and Drugs Division, Department of Human Services, Victorian Government: Melbourne.
Getting and keeping CALD issues on the organisation’s agenda
Find some allies within the organisation – who else is passionate about this issue? Find people with relevant expertise and experience – bilingual staff, researchers, educators, consumer and carer advocates and partner organisations.
Developing structures within the organisation that support and assist their work
Form a cultural diversity working group with links to decision-making structures within the organisation. Try to get representation from a really wide range of disciplines and teams.
Develop a process for decision making and communicating with senior management, team leaders, quality managers and staff at all levels.
Identify the key stake holders or a critical reference group for this work. Find ways to ensure CALD consumers and carers participate. Find ways to bring in and reach out to the community.
Seek mentoring, sponsorship and management support for the role. Develop an agreed description of the role. Develop links with other CPHs.
Understanding the community context, the cultural groups, the socioeconomic issues faced
Get an understanding of who is in your local community. Find out about the data and reports related to your local community which are available from various sources. Click here to link to the VTPU's data information.
Make connections with key ethno-specific or multicultural associations.
Find out about cross-sector multicultural networks in the local area. People with mental health issues may be seeking support from migrant services, the local council or religious leaders.
Identifying the main issues and priorities for the organisation and the local community
Get familiar with the relevant mental health workforce standards in relation to cultural diversity.
Click here to view the contents of the National Practice Standards for the Mental Health Workforce (2002) and Standards for Psychiatric Disability Rehabilitation and Support Services (2004) and links to the documents.
Review how CALD consumers and carers are experiencing the service (click here).
Review how the organisation's infrastructure is impacting on its capacity to respond to a culturally diverse community (click here)
Helping to devise an organisational cultural diversity plan and start working on some goals
Keeping records of activities, review their effectiveness and evaluate progress
2011 VTPU/ CPH activities
In 2011, the VTPU organised quarterly meetings with CPHs. These meetings were well attended and provided CPHs with an opportunity to meet other CPHs and VTPU staff, share information/ resources/ ideas, develop networks, and discuss a topic of interest in detail.
Topics covered include:
• An overview of the web-based social networking site NING
• An update on the VTPU study ‘development of a consensus among CPHs’
• Brainstorming session on ‘orientating new staff to cultural diversity’
• Participating in the national project- Mental Health in Multicultural Australia (MHiMA)
CPHs were also invited to participate in a series of on-line surveys as part of a VTPU project, seeking their views on mental health service provision and the CPH role. The VTPU is currently developing a report based on these findings.
CPHs are often asked for their input from VTPU staff, especially feedback on CALD programs, activities and resources, examples of good practice, gaps within their service, etc.
CPHs are also encouraged to attend VTPU education and training activities which include cultural responsiveness training sessions, seminar series/ case reviews, and journal club sessions.
The VTPU website is a great resource for CPHs and other mental health staff interested in cultural diversity in the workplace http://www.vtpu.org.au