Background: Chinese-language speakers comprise the largest non-English speaking population in Australia but they have among the lowest rates of mental health services utilisation.
Material: A bilingual (Mandarin/English) researcher conducted in-depth interviews with China-born mental health patients and members of the general community, and mental health service providers.
Discussion: Participants identified several factors that limit access to mental healthcare as well as the quality of care received: mental health literacy, communication difficulties, stigma, confidentiality concerns, service constraints and discrimination. Cross-cultural communication was not just a matter of hearing individual words but also appreciating idioms and cultural and social references.
Conclusion: Findings have implications for the prevention and treatment of mental disorders among migrants from China, and caution against assuming heterogeneity within ethnic groups. Mental health services must become more culturally competent in their attempts to engage the target group and to deliver both acute and continuing care.
Bhugra, D. & Mastrogianni, A. (2004) Globalisation and mental disorders. Overview with relation to depression. British Journal of Psychiatry, 184, 10—20.
2.
Chan, B. & Parker, G. (2004) Some recommendations to assess depression in Chinese people in Australasia. Australian and New Zealand Journal of Psychiatry, 38, 141—147.
3.
Chan, Y.F. & Quine, S. (1997) Utilisation of Australian health care services by ethnic Chinese. Australian Health Review, 20, 64—77.
4.
Chiu, M.L.-Y., Wei, G.F.-W. & Lee, S. (2006) Personal tragedy or system failure: A qualitative analysis of narratives of caregivers of people with severe mental illness in Hong Kong and Taiwan. International Journal of Social Psychiatry , 52(5), 413—423.
5.
Choy, R.Y.L. (2003) The mental health of Hong Kong Chinese migrants in Australia. In Untangling the Threads: Perspectives on Mental Health in Chinese Communities (eds. W.O. Phoon & I. Macindoe) (pp. 243—280). Sydney: Transcultural Mental Health Centre.
6.
Eisenbruch, M. (1990) Classification of Natural and Supernatural Causes of Mental Distress. Journal of Nervous and Mental Disease , 178, 712—719.
7.
Eisenbruch, M., Chan, B. & Parker, G. (2005) The meaning of suffering — A Chinese explanatory model tool for depressive episode (Abstract). Australian and New Zealand Journal of Psychiatry, 39(S2), A51.
8.
Federation of Ethnic Communities Councils of Australia. (n.d.) Birthplace of selected ancestry groups — Australia: 2001 Census.
9.
Fossey, E., Harvey, C., Mcdermott, F. & Davidson, L. (2002) Understanding and evaluating qualitative research . Australian and New Zealand Journal of Psychiatry, 36(6), 717—732.
10.
Gifford, S. (1998) Analysis of non-numerical research. In Handbook of Public Health Research Methods (eds C. Kerr, R. Taylor & G. Heard) (pp. 543—553). Sydney: McGraw Hill.
11.
Hsiao, F.-H., Klimidis, S., Minas, H. & Tan, E.-S. (2006) Cultural attribution of mental health suffering in Chinese societies: The views of Chinese patients with mental illness and their caregivers. Journal of Clinical Nursing, 15, 998—1006.
12.
Jorm, A.F. (2000) Mental health literacy. Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396—401.
13.
Jupp, J. ed. (2001) The Australian People: An Encyclopaedia of the Nation, its People and their Origins. Cambridge: Cambridge University Press.
14.
Khoo, S.-E. (2003) A greater diversity of origins. In The Transformation of Australia's Population, 1970 to 2030 (eds S.-E. Khoo & P. McDonald P) (pp. 154—184). Sydney: UNSW Press.
15.
Knipscheer J.W. & Kleber R.J. (2005) Help-seeking behaviour regarding mental health problems of Mediterranean migrants in the Netherlands: Familiarity with care, consultation attitude and use of services. International Journal of Social Psychiatry, 51(4), 372—382.
16.
Levkoff, S.E., Macarthur, I.W. & Bucknall, J. (1995) Elderly mental health in the developing world. Social Science and Medicine, 41, 983—1003.
17.
McDonald, R. & Steel, Z. (1997) Immigrants and Mental Health: An Epidemiological Analysis. Sydney: Transcultural Mental Health Centre.
18.
Minas, I.H., Lambert, T.J.R., Kostov, S. & Boranga, G. (1996) Mental Health Services for NESB Immigrants: Transforming Policy into Practice. Bureau of Immigration Multicultural and Population Research , Canberra: Australian Government Publishing Service.
19.
National Health Strategy. (1993) Removing Cultural and Language Barriers to Health. National Health Strategy Issues Paper No. 6. Melbourne: NHS.
20.
Ng, T.P., Fones, C.S.L. & Kua, E.H. (2003) Preference, need and utilisation of mental health services, Singapore National Mental Health Survey. Australian and New Zealand Journal of Psychiatry, 37, 613—619.
21.
Parker, G., Chan, B., Tully, L. & Eisenbruch, M. (2005) Depression in the Chinese: The impact of acculturation. Psychological Medicine, 35, 1474—1483.
22.
Parker, G., Gladstone, G. & Chee, K.T. (2001) Depression in the planet's largest ethnic group: The Chinese. American Journal of Psychiatry, 158, 857—864.
23.
Pirkis, J., Burgess, P., Meadows, G. & Dunt, D. (2001) Access to Australian mental health care by people from non-English speaking backgrounds. Australian and New Zealand Journal of Psychiatry, 35, 174—182.
24.
Snowdon, L.R. & Yamada, A.-M. (2005) Cultural differences in access to health care. Annual Review of Clinical Psychology, 1, 143—166.
25.
Steel, Z., McDonald, R., Silove, D., Bauman, A., Sandford, P., Herron, J. & Minas, H. (2006) Pathways to first contact with specialist mental health care. Australian and New Zealand Journal of Psychiatry , 40, 347—354.
26.
Tabora, B.L. & Flaskerud, J.H. (1997) Mental health beliefs, practices and knowledge of Chinese American immigrant women. Issues in Mental Health Nursing, 18, 173—189.
27.
Wikipedia. People's Republic of China, (online). Available http://en.wikipedia.org/wiki/People%27s_Republic_of_China ( 2007, August 27).
28.
Wong, Y.-L.R., Cheng, S., Choi, S.-Y., Ky, K., Leba, S., Tsang, K. & Yoo, L. (2003) Deconstructing culture in cultural competence: Dissenting voices from Asian-Canadian practitioners. Canadian Social Work Review, 20(2), 149—167.
29.
Yeo, S.S. & Meiser, B. (2003) Cross-cultural cognitive therapy for the treatment of depressive symptoms in Chinese clients: Integrating the belief systems of Confucianism, Buddhism and Taoism. In Untangling the Threads: Perspectives on Mental Health in Chinese Communities (eds. W.O. Phoon & I. Macindoe ) (pp. 300—317). Sydney: Transcultural Mental Health Centre.
30.
Yip, K.-S. (2004) Taoism and its impact on mental health of the Chinese communities. International Journal of Social Psychiatry, 50(1), 25—42.
31.
Yip, K.-S. (2005) An historical review of the mental health services in the People's Republic of China. International Journal of Social Psychiatry, 51(2), 106—118.
32.
Zheng, Y.P., Xu, L.Y. & Shen, Q.J. (1986) Styles of verbal expression of emotional and physical experiences: a study of depressed patients and normal controls in China. Culture, Medicine & Psychiatry, 10, 231—243.
33.
Ziguras. S., Klimidis, S., Lewis, J. & Stuart, G. (2003) Ethnic matching of clients and clinicians and use of mental health services by ethnic minority clients. Psychiatric Services, 54(4), 535—541.
