What is culturally informed counselling and why is it important for people seeking help for mental health issues?

By Ann Khorany, ABC news

National Mental Health Week from October 5 to 12 provides an opportunity for a national discussion about mental health issues. (ABC News: Luke Bowden)

When Arati was 11 years old she began to struggle with her mental health and decided to seek help.

But she says the counselling she received did more harm than good. 

Arati’s family had settled in Melbourne’s western suburbs after moving from rural India but she said the counsellor did not have any cultural sensitivity or awareness.

“They kind of made me hate my culture more for the longest time,” she said.

“They give you verses from the Bible and [tell you] this is what you should be following, don’t think about the other things.”

When Arati first sought help for her mental health at age 11, she was told to go read a bible. (Supplied)

Other professionals Arati went to weren’t much better, she said.

“The first couple of counsellors I met, they immediately trashed on my family from the first session,” she said.

It was not until she met a culturally informed counsellor that she felt understood.

“It makes a huge difference when there’s someone that understands and doesn’t demonise your household.”

Arati, who is now studying at university to become a culturally informed psychologist, wants to work with neurodiverse kids.

“That’s where I wish I had that support as a child,” she said.

Geetha Chetty struggled to find a culturally sensitive counsellor, so became one herself.  (Supplied)

‘I was like an experiment’

After Geetha Chetty also found her attempts to seek mental health support were being undermined by her counsellors’ lack of cultural awareness, she opened her own mental health practice.

“I was like an experiment,” she said.

“I would waste half my session trying to explain to them the cultural context and why I think a certain way and that was most of the session gone.”

Ms Chetty now runs Enlightened Mind in Williams Landing, in Melbourne’s west. 

Her practice provides culturally informed counselling for her clients, 90 per cent of whom come from a culturally and linguistically diverse (CALD) background.

Ms Chetty said cultural awareness was about acknowledging the similarities and differences among CALD groups whereas cultural sensitivity focused on how the counsellor’s personal beliefs, values and lived experiences might impact the support they provide to clients.

Cultural barriers to mental health help

Research has shown that people from CALD communities are also less likely to seek mental health support in the first place.

Ms Chetty said access to culturally informed counselling could “normalise” mental health treatment and make people from CALD communities feel more comfortable about seeking help. 

Dr Queenie Wu specialises in providing diverse therapies and culturally sensitive counselling to CALD communities.(Supplied)

Dr Queenie Wu, a Melbourne clinical psychologist who specialises in providing culturally sensitive care, said that “maintaining face” was a significant barrier that prevented some people from Asian backgrounds from seeking mental health support.

“Maintaining face” involved preserving one’s reputation or dignity, she said.

“So, mental health issues could be perceived as a loss of face for not just the individual, but for the family as well [and] as a result, that individual would avoid seeking help to not bring shame, or embarrassment upon their families,” Dr Wu said.

She added that people from Asian communities — which place a high value on social and familial collectivism — would often suppress their mental health struggles to avoid “disruptions” to family harmony.

Dr Wu said culturally informed counselling played a crucial role in dispelling these kind of stigmas around seeking help and helped make clients feel safe opening up about their mental health struggles.

“By tailoring the counselling approach to align with the cultural norms and values of the diverse groups, the individuals are more likely to feel understood and respected,” Dr Wu said.

Carolyn Nikoloski says financial issues can be a barrier to CALD people seeking help for their mental health. (Supplied)

Mental Health Australia chief executive Carolyn Nikoloski said there were also other factors that could impact CALD people’s access to mental health services.

“We know that there are many financial barriers to accessing care and that’s particularly pronounced at the moment with the cost-of-living crisis that we’re all living and working through,” Ms Nikoloski said.

New national data released by Mental Health Australia show that people in more affluent socio-economic areas access mental health support services at twice the rate of lower socio-economic areas like Western Sydney.

This is despite higher estimated rates of mental health conditions in lower socio-economic areas.

Ms Nikoloski said the distribution and availability of mental health care providers was likely a factor. 

She added that Mental Health Australia had been working with CALD communities through the Embrace Multicultural Mental Health project to help multicultural groups learn more about mental health and available resources.

The federal government-funded project also assisted mental health organisations in providing CALD groups culturally appropriate advice.

“We think this is a really important part of the solution in terms of how we improve mental health in CALD communities and also overcome some of those barriers to getting help, like stigma,” she said.

While access to culturally informed counselling still needed to improve, Dr Wu said attitudes to mental health assistance in CALD communities were clearly changing.

“I don’t think my clients from the CALD groups even made it to 1 per cent … in the beginning on my career,” Dr Wu said.

“I’m happy to report now that around 99 per cent of our clients are from Asian backgrounds.”

Posted 15 Oct 202315 Oct 2023, updated 17 Oct 2023