CDW Final Report s1

MULTICULTURAL COMMUNITY
DEVELOPMENT IN MENTAL HEALTH PROJECT
STAGE ONE REPORT
Queensland Transcultural Mental Health Centre

Multicultural Centre for Mental Health and
Wellbeing Inc.
July 2003
Multicultural Centre for

Mental Health and Wellbeing
Report Stage One
Explanation of graphic on report cover: This graphic was designed by the bilingual community
development workers to illustrate how mental health is conceptualised by the project staff team. The tree
represents the cycle of life and the dynamic nature of mental health. Mental health is at the nucleus of
everybody's life where wellbeing, harmony and hope are the key factors. Mental health facilitates
empowerment which sustains one's ability to achieve goals, love ourselves and others, cope with and
enjoy life regardless of being exposed to either bright (sun) or dark (cloud) times.
The Multicultural Community Development in Mental Health Project involves

the following communities:
Arabic-speaking community
Bosnian community
Farsi-speaking community
Filipino community
Samoan community
Spanish-speaking community
Vietnamese community
Published by:

PO Box 169
Annerley Qld 4103
Ph: (07) 3240-2833
Fax: (07) 3240-2282
Website: www.health.qld.gov.au/pahospital/mentalhealth/qtmhc_index.htm
Multicultural Centre for Mental Health and Wellbeing Inc.

87 Juliette Street
Greenslopes Qld 4120
Ph: (07) 3891-7911
Fax: (07) 3891-7922
© 2003 Queensland Transcultural Mental Health Centre and Multicultural Centre for Mental Health and
Wellbeing Inc.
Multicultural Community Development in Mental Health Project 2

Report Stage One
ACKNOWLEDGMENTS
This report is the result of significant contributions from:
Members of the participating culturally and linguistically diverse communities who provided their expertise
on mental health issues and shared their opinions, beliefs and experiences aiming to benefit their
communities and the Australian society at large.
The bilingual community development workers, who actively participated in the planning and development
of stage one, promoted the project and established a constructive dialogue within their communities.
All members from the project management team and the project reference and advisory groups who
always encouraged the bilingual workforce and provided their valuable and prompt advice.

Report Stage One
TABLE OF CONTENTS
ACKNOWLEDGMENTS 3
INTRODUCTION 7
EXECUTIVE SUMMARY 8
PROJECT OVERVIEW 10
BACKGROUND 11
CONCEPTUAL FRAMEWORK 12
o Community and consumer participation
o Community development
o Expert communities
o Reciprocity in Education approach
PROJECT STRUCTURE 14
PROJECT MANAGEMENT 16
PROJECT PROCESSES AND FINDINGS 20
RECRUITMENT AND SELECTION PROCESS 20

o Bilingual Community Development Worker
o Project Coordinator
TRAINING PROGRAM 20
o Overview of the project
o Project rationale and conceptual framework
o The Queensland mental health system
o Mental health issues for migrants and refugees
o Community development tools
BILINGUAL WORKFORCES’ CONCEPTUALISATION OF MENTAL HEALTH 21
BCDW’s PRELIMINARY ‘SWOT’ ANALYSIS OF THE PROJECT 22
DEVELOPMENT OF PROJECT TOOLS 23
o Community session evaluation form
o Community session report form
COMMUNITY SESSIONS 25
ARABIC-SPEAKING COMMUNITY 25
o Community profile
o Process
o Findings: beliefs, understanding and experiences of mental health
o Feedback
BOSNIAN COMMUNITY 27
o Community profile
o Process
o Feedback
FARSI-SPEAKING COMMUNITY 29
o Community profile
o Process
o Feedback
FILIPINO COMMUNITY 30
o Community profile
o Process
o Feedback

Report Stage One
SAMOAN COMMUNITY 33
o Community profile
o Process
o Feedback
SPANISH-SPEAKING COMMUNITY 35
o Community profile
o Process
o Feedback
VIETNAMESE COMMUNITY 38
o Community profile
o Process
o Feedback
TEMPORARY PROTECTION VISA HOLDERS COMMUNITY 41
SUMMARY OF KEY ISSUES IDENTIFIED BY COMMUNITY 42
PROJECT CONSULTATION AND INPUT PROCESSES 44
PROJECT REFERENCE GROUP 44
o Process
o Main issues identified
PROJECT ADVISORY GROUP 44
DISCUSSION 46
FUTURE DIRECTIONS 48
REFERENCES 49
ATTACHMENTS 51
o Project flyer
o Handout for BCDWs with the spectrum of interventions for mental health and services
available
o Participant’s assessment form
o Community Session Feedback Form
o A graphic on Samoan view of health
o Summary: Arabic-speaking community
o Summary: Bosnian community
o Summary: Farsi-speaking community
o Summary: Filipino community
o Summary: Samoan community
o Summary: Spanish-speaking community
o Summary: Vietnamese community
o Translated project summaries

Report Stage One
FIGURES
Fig 1. Commonalities in the conceptualisation of mental health, mental health problems and mental illness
across the participating communities.
Fig 2. A graphic description of the mental health concept agreed by the project staff team.
TABLES
Table 1. Project Structure

Table 2. Project Management
Table 3. Outcomes of SWOT Analysis
Table 4. Arabic-speaking community – age categories
Table 5. Tagalog / Filipino community – age categories
Table 6. Samoan community – age categories
Table 7. Spanish-speaking community – age categories
Table 8. Vietnamese community – age categories

Report Stage One
INTRODUCTION
This report documents Stage One of the Multicultural Community Development in Mental Health Project.
The project is a joint initiative of the Queensland Transcultural Mental Health Centre and the Multicultural
Centre for Mental Health and Wellbeing Inc, in partnership with culturally and linguistically diverse (CALD)
communities.
This report is divided into five sections. The first section provides a summary of the report. Section two
presents an overview of the project with a particular focus on its rationale, theoretical framework and
structure. Section three outlines the project’s human resources and management. In section four, the
processes and findings obtained during the first stage of the project are presented. This section comprises
several areas: the recruitment and selection of the bilingual workforce; the training program undertaken by
the bilingual community development workers (BCDWs) and the project coordinator; their
conceptualisation of mental health; an introductory ‘SWOT’ analysis of the project; the development of
project tools and the findings obtained from the community sessions in relation to their perceptions about
mental health, mental health problems and mental illness; their determinants; and the manner in which
they prefer to see these issues addressed. Finally, the processes and findings of Stage One of the project
are discussed in section five. A summary of the findings for each participating community is included in the
attachments as well as translations of summaries of the report in each of the languages of the
participating communities.

Report Stage One
EXECUTIVE SUMMARY
The Multicultural Community Development in Mental Health Project is a three-stage project aimed at
developing a best practice model for the participation of culturally and linguistically diverse (CALD)
communities in the planning, implementation and evaluation of mental health services and related
activities. The project is a joint effort between the Queensland Transcultural Mental Health Centre, the
Multicultural Centre for Mental Health and Wellbeing and CALD communities. At this stage the project is
focused on working with the following communities: Arabic-speaking, Bosnian, Farsi-speaking, Filipino,
Samoan, Spanish-speaking, Vietnamese and people on Temporary Protection Visas.
The concepts of community and consumer participation, community development, expert communities
and reciprocity in education constitute the project’s theoretical framework. Mental health consumers have
been defined within the population-based approach to include both those who have used “any aspect of a
mental health service [and] those people who have not yet needed to experience the traditional mental
health system” (Stacey and Herron, 2002).
Stage one of the project, which is the focus of the present document, includes the following:
• the recruitment, selection and training of eight bilingual community development workers (BCDWs)
and the project coordinator; their conceptualisation of mental health; their preliminary analysis of the
strengths, weaknesses, opportunities and threats of the project;
• the development of project tools;
• the identification of the cultural context of how mental health, mental health problems and mental
illness are perceived and understood by the eight participating communities, their needs and the
manner in which these communities prefer to see them addressed;
• and the establishment of the project management team as a decision making forum for the progress
and evaluation of the project; the project reference group to provide community input into project
strategies, implementation and ongoing review, and the national advisory group to offer expert advice
and input from stakeholders working nationally in the areas of consumer and community participation
and/or transcultural mental health.
Emphasis has been made to value both processes and findings as relevant performance indicators.
During stage one, 42 community sessions took place representing seven of the participating CALD
communities and involving 299 community members, two reference group meetings and one
teleconference involving members of the advisory group.
The diversity in processes and findings across the participating communities has been demonstrated in
stage one and should be considered for the planning and implementation of future stages. Nevertheless,
some commonalities appeared.
For most BCDWs, their previous personal contact with community leaders and community members in
general facilitated the attendance and participation in the community sessions. Most sessions took place
at participants’ homes and were carried out in a very informal manner. Participants were happy to discuss
mental health issues and valued the significance of the sessions for the wellbeing of their communities.
Figure 1 illustrates the common ideas pointed out by participants in relation to the conceptualisation of
mental health, mental health problems and mental illness. The migration experience, and all aspects
associated with it, emerged across all communities as a significant factor that influences mental health
problems (as depicted in Figure 1). Insufficient English-language proficiency, lack of integration with the
wider Australian community, feelings of homesickness and isolation, discrimination and racism, frustration
due to unrecognized skills and unemployment, culture clash, family and intergenerational difficulties, lack
of trust in mental health services, lack of alternative or complementary interventions (including traditional
healing practices) to treat mental health problems and illnesses within the Australian mental health
system, and insufficient information on mental health issues and services, were commonly mentioned
across all communities.
Likewise, similarities appeared in relation to the strategies given by the communities to overcome the
problems and needs identified. Respected community leaders, especially spiritual and religious leaders in
most communities, were identified as a crucial resource when dealing with mental health issues. A
number of strategies were identified during the various community sessions, including:
• education sessions to promote mental health and prevent mental illness;
• the utilisation of bicultural/bilingual workers, including doctors, nurses, counsellors and community
development workers within mental health services;

Report Stage One
• promotion of multicultural awareness among mental health workers;
• the utilisation of mental health programs and services by organisations working with recently arrived
migrants;
• reforms to the overseas-acquired skills recognition process;
• improvement of employment networks; and
• working with the media in order to reduce discrimination and racism
Even though the project aimed to involve people on Temporary Protection Visas in the discussion of
mental health issues concerning their community, barriers were encountered which prevented members
of this community from widely participating in the project. As a mental health project focusing specifically
on the needs of refugees on temporary protection visas commenced around the same time of this project,
a decision was taken to change the aims and objectives of the work with this particular community which
will be described in further detail in this report
From the process perspective, future stages of the project should continue to enhance the expertise of the
bilingual workforce in the conceptualisation and practice of community and consumer participation,
community development, the concept of expert communities, the reciprocity in education approach and
the ‘team work’ character of the project. Vital to the project aims, is the shift from a ‘banking education’ to
a process of ‘conscientization, action and reflection’, and the development of a ‘dialogical education’
(Freire, 1994).
This document, which has included both processes and findings of stage one, aims to generate
discussion for the planning and implementation of future stages of the project. Primarily, it belongs to the
communities, which have provided their thoughts and expertise in relation to mental health issues. Any
decision-making process based on this report should include the communities and the personnel involved
in the project. The information contained here aims to stimulate reflection, generate ideas and strengthen
the development and participation of culturally and linguistically diverse communities.
Figure 1: Commonalities in the conceptualisation of mental health, mental health problems and mental
illness across the participating communities
Mental health
- Living a normal life

- Coping with everyday problems
- Happiness, enjoyment, satisfaction
- Well-being
- Having / achieving goals
- Harmony and balance (body, mind & spirit)
- Relating to others
- Trusting others
Mental health problems

Mental Illness
- Normal part of life / experienced by many
- Stress, anxiety - Being ‘crazy’
- Depression, sadness - Cannot function normally
- Difficulties interacting with other people/ - Having serious mental disorders
other cultures (schizophrenia, psychosis, suicidal
- Problems caused by migration experience tendency, addiction to drugs)
(loneliness, homesickness, discrimination, - Harming themselves and others
unemployment, low self-esteem) - Out of this world / loss of contact with
- Requires help from family and friends reality
- Respected community, spiritual and - Requires comprehensive treatment &
religious leaders identified as crucial support (family and friends, health
resources in dealing with mental health professionals, medication, hospitals,
problems traditional healers)

Report Stage One
PROJECT OVERVIEW
According to the Commonwealth Department of Health and Aged Care and the Australian Institute for
Health and Welfare (1999), most Australians, with the significant exception of Aboriginal people and
Torres Strait Islanders, have witnessed a remarkable improvement in their overall health and living
standards over the last century. Infant mortality has dropped considerably and life expectancy has risen,
along with material wealth and services.
However, this positive development in physical and material wellbeing has not automatically been
followed by improvements in mental and emotional wellbeing. The 1997 National Survey of Mental Health
and Wellbeing (Australian Bureau of Statistics, 1998) found that over one in six Australians had
experienced anxiety, affective or substance use disorders at some time during the previous year.
Whereas women were more likely to report anxiety and depression, men commonly reported substance
abuse disorders. The highest prevalence of mental disorders was found among young people aged 18 to
24 years.
Australia’s demographic diversity needs to be recognised. According to the Australian Bureau of Statistics
[Australian Bureau of Statistics, 2002 #23] 24% of the Australian population in 2000 was born overseas,
and 15% reported coming from a non-English speaking country. The 2001 Census of population and
Housing, shows that 17% of Queenslanders are overseas born and that 7% speak a language other than
English at home. Even though the experiences of migration and dislocation may be common amongst
these communities, this is not a homogeneous group in terms of their experiences prior to migration, their
language, culture, religion, socio-economic status and education (Queensland Health, 1995).
The literature does not have consistent findings of mental disorder rates within culturally and linguistically
diverse communities in Australia. The results of prevalence studies vary widely according to the disorder
studied, ethnic group and location of the study (Minas, 2001).
The 1997 Survey of Mental Health and Wellbeing (Commonwealth Department of Health and Aged Care
and Australian Institute of Health and Welfare, 1999) reported that migrants from non-English speaking
background (NESB) had a lower incidence of common mental disorders (14%) compared with migrants
from English-speaking countries (16%) and the Australian-born population (19%). However, there are two
important factors that need to be considered when interpreting these results. Firstly, the strict health
requirements that migrants have to fulfil during the application process may be responsible for common
mental disorders being under-represented, and secondly, the level of English language proficiency limited
the participation of members of culturally and linguistically diverse (CALD) communities in this type of
population-based survey.
Minas (2001) has commented that its not immigrant status in itself, that is associated with either a high or
low prevalence of mental disorder but that there are many factors that are part of the experience of many
migrants that may be associated with increased vulnerability. Such experiences include pre migration
experiences such as trauma and disrupted families and post migration experiences such as
unemployment, lack of skill recognition, social isolation, language barriers and lowered social status.
A number of Australian studies have also confirmed that people of CALD are less likely to receive
treatment for their mental health problems and have their mental disorders diagnosed later in onset. It has
also been established that people of CALD are less likely to receive treatment and care from specialist
mental health services in both hospital and community settings and that once they do gain access to such
services they have longer lengths of stay in hospital care, have higher rates of involuntary admission and
significantly lower rates of voluntary admission, have shorted face-to-face contacts in community settings
and are less likely to receive talking therapies than English speaking people. (McDonald and Steele 1997,
Stolk 1996, Balabil and Dolan 1992, Lloyd 1993 in Mihalopolous 1999).

Report Stage One
BACKGROUND
There is a commitment in Australia to increase community expertise in relation to mental health and to the
social support of individuals and community connectedness so that better mental health for all can be
achieved (Commonwealth Department of Health and Aged Care, 2000). This includes the participation of
consumers and carers from a range of communities in the planning, implementation and evaluation of
mental health services.
Even though most new arrivals to Australia eventually settle successfully, it is well documented that
people arriving to live in a country with a culture different than their own, experience many difficulties trying
to find their way around in a range of areas (Ferguson and Browne, 1991; Zalokar, 1994; Commonwealth
Department of Health and Aged Care, 2000). These include, among others, the ability to speak English;
racism and discrimination at individual, community and institutional level; homesickness; feelings of
isolation; and accessing resources of mainstream society such as recreation, social support, education,
employment, housing and health services. Access to mental health services is one of the health areas
where more obstacles are encountered. In addition, the understanding of what mental health, mental
health problems and mental illness are, often differ according to various cultural perspectives.
As previously described, experiences related to the migration process can impact on the mental health of
the individual. Migration is listed as one of the determinants of distress in many scales. The impact
depends on a number of variables such as the inner resources of the individual, the access to and the
quality of family and community support and the societal environment of the host country. Under these
considerations there is a need to address the mental health issues of CALD communities by the
communities themselves together with the organisations that provide services to them. Mental health
services are one of the key services. The active participation and the expertise of CALD communities, and
consumers within these communities, will assist mental health services in the provision of more accessible
and culturally appropriate services.
Despite some attempts to involve CALD communities and consumers in meaningful participation in the
planning of mental health services and projects, to date in Australia, no successful and sustainable model
has been achieved. Examples of these attempts include the Mental Health Consumer Participation in a
Culturally Diverse Society Project run by the NSW Transcultural Mental Health Centre where significant
participation was achieved. However, due to the amount of resources required, consumer involvement
was maintained only for a limited period of time.
In Queensland, the Qld Transcultural Mental Health Centre (QTMHC) in partnership with the Ethnic
Mental Health Program established a NESB Consumer Advisory Group, which was in operation between
1998 and 2001. For several years this group struggled to become a forum of meaningful participation for
the consumers and carers involved in this group. This group required a level of sustained input and
resources from the two participating organisations that were beyond the means of the organisations. More
importantly, however, the CAG model was found to be not an ideal model for a group of consumers and
carers who held different beliefs and ideas about mental illness according to the explanatory model within
their own culture and various levels of English language proficiency which made group communication
difficult. In Queensland, ethno specific CAG groups, which exist in states such as NSW are difficult to
organise due to smaller population groups, therefore a new approach was warranted.
However, the review of this experience provided the QTMHC and the Multicultural Centre for Mental
Health and Wellbeing with valuable feedback, which is now informing the present project. The lessons
learnt from these experiences highlight the importance of long-term groundwork and strong support when
working for sustained participation of CALD communities.

Report Stage One
CONCEPTUAL FRAMEWORK
Four main domains constitute the theoretical basis for the Multicultural Community Development in Mental
Health Project. All four domains are inter-related. These are:
• Community and consumer participation
Both empowerment and involvement are crucial characteristics of healthy communities. Empowerment
means community members taking control over their day-to-day issues; involvement implies people
feeling included and able not only to participate but also to influence the decisions that affect them (Health
Education Authority, 1998). Community and consumer participation is even more relevant in the CALD
communities’ context:
‘Community action is strengthened by enabling all sectors within the community - individuals,
groups and organizations - to participate in community decisions. It is particularly important
to incorporate those groups that may otherwise be disenfranchised, as there are barriers to
community participation for many people. Language can be a major barrier. Groups and
individuals that are not members of the dominant mainstream culture are also more likely to
be excluded from community action. Age, gender, disability and illness, social status, cultural
background and level of education can also exclude people from community participation’
(Commonwealth Department of Health and Aged Care, 2000:42)
Even though the National Mental Health Strategy over the last decade, has recognised and endorsed
consumer involvement in mental health policies and programs, the ‘Review of Mental Health Services in
Australia – 2003’ conducted by the Mental Health Council of Australia found that: “Whilst the principles of
consumer and carer participation in the development, implementation and evaluation of the mental health
system appear to be enshrined in National Mental Health Policy and Plan, there appears to be a lack of
genuine consumer and carer involvement in mental health care or reform at the jurisdictional, regional and
local level” (Groom & Hickey, 2003, p. 30). The review also found that there is substantial need for
improvement in regard to consumer and carer involvement in individual treatment decisions, and that
carer involvement in particular was lacking. The evaluation of the Second National Mental health Plan
concluded that “… human rights issues remain and full participation of consumers and carers has not yet
been achieved” (Commonwealth Department of Health & Ageing, 2002:13).
Some of the barriers for appropriate community and consumer participation include: inadequate
education and training for the mental health workforce to implement new policies; illness-orientated (rather
than health driven) service design and practices; unclear conceptualisation of what ‘consumer’ means;
difficulties consumers face when struggling for sufficient and respectful recognition of their right to active
participation; lack of agreement on how communities, and consumers in particular, conceptualise mental
health (Stacey and Herron, 2002).
The Multicultural Community Development in Mental Health Project aims to address some of the above
barriers. It recognises that effective CALD community participation requires adequate support, knowledge,
skills and resources for both community members and mental health workers to engage in a constructive
‘dialogue’ (Freire, 1994) and work together searching for better mental health outcomes for the
communities involved.
The project aimed to create safe environments in which the communities involved would eventually start
naming the barriers to participation in mental health services, discuss their diverse concepts and
explanatory models of mental health and wellbeing and the ways in which they prefer to see their mental
health needs met. The project sought to develop a respectful environment to enable communities to
deepen their understanding and practices of what it means to be healthy and to gain confidence in
articulating their input into mental health services. Furthermore, the project aimed to define the most
effective practice for CALD communities to influence mental health services. In this regard, previous
attempts for meaningful consumer participation have failed, making it evident that effective CALD
consumer and carer participation primarily requires the participation of the community to which they
belong. Thus the concept of the mental health ‘consumer’ within this project is placed into the population-
based approach, where “those people who have not yet needed to experience the traditional mental
health system are also ‘consumers’” (Stacey and Herron, 2002).
By involving key members of the communities and mental health consumer organisations in the project
reference group, the project aimed to increase their understanding about community issues and the

Report Stage One
current status of consumer participation. Similarly, the involvement of individuals experienced in mental
health consumer participation from across the nation in the project advisory group provided a mechanism
for learning from the experiences of previous projects and other models.
• Community development
Communities are active entities, constantly facing challenges and responding to them. In the context of
this project, community development refers to the process of facilitating the community’s understanding of
the factors that affect its health and quality of life and eventually enabling empowerment within the
community through the development of the skills needed to take control over and improve those
conditions. It involves helping communities identify issues of concern and facilitating their efforts to bring
about change in these areas (Hawe, Degeling et al; 1990). Community development also takes into
account the protective forces already present within the communities and aims to stimulate them.
• Expert communities
Intrinsically linked to the community development domain is the concept of expert communities.
Traditional approaches to mental health have emphasised “professional expertise and control, diagnosis
of deficits, ‘symptom’ reduction, and life skills training” (Nelson et al, 2001). The limitations of these
professionally-controlled approaches have been increasingly noted (Nelson, et al; 2001). There is a need
for innovative approaches, which recognise that communities and consumers are the ones with the
expertise. Ultimately, they are the ones who experience and handle everyday mental health issues. This
knowledge and experience held by the communities and consumers may also be increased through
interaction with mental health services. Simultaneously, mental health service providers may enhance
their knowledge in relation to community’s beliefs and practices and improve their interaction with
communities and consumers.
• Reciprocity in Education approach
The traditional relationship between communities/consumers and mental health services, which has
focused on the model ‘provider (mental health services)/ passive recipient (communities and consumers)’,
has failed to deliver better mental health outcomes (Commonwealth Department of Health and Aged
Care, 2000). The model of interactive learning, known as the Reciprocity in Education approach
(Amirghiasvand, Eaton et al; 2001), aims to increase community expertise in mental health while
acknowledging the diversity of perceptions, values and beliefs held by the communities.
Community/consumers and mental health services engage in a dialogue, which will enable them to
develop common goals and better health outcomes.

Report Stage One
PROJECT STRUCTURE
The Multicultural Community Development in Mental Health Project is a three-stage project which plans to
develop a best practice model for the participation of those with mental illness and other members of
CALD communities in mental health services and related activities. At this stage the project has been
limited to work with the following communities: Arabic-speaking, Bosnian, Farsi-speaking, Filipino,
Samoan, Spanish-speaking, Vietnamese and Temporary Protection Visa Holders.
Table 1 illustrates the structure of the project, its stages, objectives, key performance indicators and time
frame.
Table 1: Project structure

STRATEGIES/
OBJECTIVES KEY PERFORMANCE INDICATORS TIME FRAME
STAGE ONE
1) To increase the capacity of the 9 Bilingual community development 9 June 2002

project bilingual workforce to: workers (BCDWs) and project
a. Attract people from their coordinator employed
own communities to a 9 Develop and implement a training 9 June 2002
mental health group program for the project bilingual
session workforce
b. Facilitate focus groups 9 Develop and implement a support 9 August 2002
c. Organise a response to mechanism to enable the BCDWs
mental health needs if to perform their role
required 9 Evaluation by the BCDWs of 9 November
training program and support 2002
mechanism
2) To consult with community 9 Establish a project reference group 9 September

organisations and mental with representatives of community 2002
health consumer advocacy organisations and mental health
representatives re: CALD consumer advocacy services
consumer/community
participation in the planning,
implementation and evaluation
of mental health services
3) To consult with mental health 9 Establish a project advisory group 9 October 2002
services re: CALD consumer/ made up of nationally recognised
community participation in the authorities in the field of consumer
planning, implementation and and community participation in
evaluation of mental health mental health.
services
4) To identify the perceptions of 9 Plan and conduct six community 9 November

the selected communities, sessions or focus groups in each 2002
including consumers, about of the selected communities
mental health, mental health 9 Document the information 9 December
problems, mental illness, their gathered in the community 2002
determinants and the manner in sessions
which they prefer to see these 9 Develop tools to effectively gather 9 December
issues addressed. data from the communities 2002
5) To plan the next stage of the 9 Plan Stage Two of the project 9 February
project informed by Stage One using the information gathered 2003
during Stage One by the project
team and management groups

Report Stage One
Cont……..
Table 1: Project structure
STRATEGIES/
OBJECTIVES KEY PERFORMANCE INDICATORS TIME FRAME
STAGE TWO
1.To increase mental health 9 Participants in the project have 9 July 2003-
literacy within the selected increased their mental health literacy June 2004
CALD communities (i.e. the
ability to maximise personal,
family and community mental
health; knowledge of both risk
and protective factors;
knowledge of how to seek
mental health information and
professional help; the ability to
recognise specific mental
health disorders and their early
signs)
2. To develop community
networks within each
participating community to
support mental health
consumers and carers.
STAGE THREE
1. To develop an effective and 9 A best practice model that involves 9 July 2004 –
sustainable CALD CALD communities and consumers in June 2005
community and consumer the planning, implementation and
participation in mental evaluation of mental health services
health services model developed.
2. To facilitate linkages with
consumer and carer
participation mechanisms
and strategies in
mainstream mental health
services.

Report Stage One
PROJECT MANAGEMENT
The Multicultural Community Development in Mental Health Project is managed by the QTMHC in
partnership with the Multicultural Centre for Mental Health and Wellbeing, through the project
management team. Table 2 illustrates the roles and responsibilities of the project members.
Table 2: Project human resources: roles and responsibilities
Project role Name/s Responsibilities
Bilingual • Benny Behzadpour (Farsi-speaking • Engage with members from their own
community community) communities in the discussion of
development • Beth Guanzon (Filipino community) mental health issues through
workers • Lejla Cisic (Bosnian community) community sessions, liaison and
(BCDWs) • Odette Tewfik (Arabic-speaking networking.
community) • To collect the information obtained
• Ofelia Rivera (Spanish-speaking from the community sessions in
community) relation to the participants’
• Tusi Luafutu (Samoan Community) perceptions about mental health,
• Quoi Phan (Vietnamese community) mental health problems, mental
• Saad Al-Obeidy (Temporary illness, their determinants and the
protection visa holders community) manner in which they prefer to see
them addressed (Stage One)
Project Elvia Ramirez, QTMHC • Convene project management team
manager
Project Ignacio Correa-Velez • Coordinate the activities of the

Coordinator BCDWs
• Work collaboratively with the BCDWs
to develop and implement outreach
strategies to engage with their
communities in the discussion of
mental health issues
• Ensure a consistent approach is
undertaken in terms of information
provision, collection and
documentation
• Develop and implement networking
strategies for community input into the
project
• Convene project reference group
• To work in close collaboration with the
project management team, reference
and advisory groups, focusing on the
development and implementation of
effective strategies and outcomes
• To maintain up to date project
documentation and other relevant
information

Report Stage One
Cont……
Project QTMHC: • Prepare and continually review the

management • Rita Prasad-Ildes project plan
team • Elvia Ramirez • Make decisions about operational
• Greg Turner aspects of the project
• Simone Bell
Multicultural Centre for Mental Health
& Wellbeing Inc:
• Gail Hyslop
• Ignacio Correa-Velez
(Following stages of the project will

involve reps from other mental health
services)
Project • Nadia Beer (Consumer advocate • Overview the progress of the project
Reference – The Park) providing guidance on strategies to
Group • Marina Castellanos (Centre for prevent and overcome possible
(Following Multicultural Pastoral Care) difficulties
stages of the • Ivan Choy (Access Inc, Logan & • Define the role of consumer advocacy
project will Beenleigh Migrant Resource groups, community organisations and
involve reps Centre) networks to support the project
from other • Taher Forotan (QPASTT) • Provide local advice on effective
mental health • Lindsay Irons (Queensland community consumer participation
services) Alliance)
• Mitra Kakhbaz (Multicultural
Development Association)
• Phillip Luafutu (Police Liaison
Officer – Samoan Community)
• Phuong Nguyen (Vietnamese
Interpreter – Mater Hospital)
• Ruth Palmani (Access Inc, Logan
& Beenleigh Migrant Resource
Centre)
• Denise Ryan (Consumer
consultant – Princess Alexandra
Hospital)
• QTMHC & Multicultural Centre for
Mental Health and Wellbeing staff

Report Stage One
Cont……
Project Name/s Responsibilities

role
Project • Chris Alliston (AUSEINET, Consumer • Provide broader (interstate,
Advisory Project Officer, SA) international) advice to the project on the
Group • Lisa Anderson (Consumer and Carer theoretical frameworks underpinning the
Project Officer, MHU, Qld Health, project and look for further funding
Qld) opportunities
• Merinda Epstein (National Resource
Centre for Consumer Participation in
Health, VIC)
• Helen Dyer (Executive assistant,
QCAG)
• Meg Griffiths (National coordinator
Multicultural Mental Health Australia)
• Vicki Katsifis (prominent NESB
consumer consultant, NSW)
• Lou-Anne Lind (Coordinator, National
Ethnic Disability Alliance, NSW)
• A/Prof Nicholas Proctor (Flinders
University, SA)
• Andrew Sozemenou (Researcher,
Western Sydney Area Health
Service, NSW)
• Carlos Suarez (Consumer
consultant, TMHC NSW)
• Greg Turner (Education and
development coordinator, QTMHC)
• Neil Wildman (CDP, Mental Health
Council of Australia, ACT)
The project team has established links with a diverse group of community members and community
organisations:
• Partners/clients: At this stage, the project has worked with members and organisations of the
Arabic-speaking, Bosnian, Farsi-speaking, Filipino, Samoan, Spanish-speaking, Vietnamese
and Temporary Protection Visa Holders’ communities in Brisbane, Ipswich and Logan.
• Other stakeholders which support the project through their participation in the Reference
Group, their advice and feedback on the progress of the project, the provision of venues for
meetings of community groups and the access to relevant networks:
o Queensland Program of Assistance to Survivors of Torture and Trauma

(QPASTT)
o Queensland Consumer Advisory Group (QCAG)
o Mental health consumer consultants, Princess Alexandra Hospital
o Mental health consumer consultant, The Park
o Centre for Multicultural Pastoral Care
o Multicultural Development Association
o The Romero Centre
o Australian Red Cross
o Radio 4EB
o Islamic Women’s Association of Queensland
o Tofa Mamao Samoan Community Advisory Council
o Logan and Beenleigh Migrant Resource Centre (Access Inc)

Report Stage One
o Logan City Multicultural Neighbourhood Centre
o The Peace Centre, Goodna
o Vietnamese Association of Australia, Queensland Chapter
o Kinections (Multicultural Counselling and Education Services)

Report Stage One
PROJECT PROCESSES AND FINDINGS
The following section focuses on the processes and findings of Stage One of the Multicultural Community
Development in Mental Health Project. Eight areas are discussed: the selection and recruitment process
developed for the BCDWs and the project coordinator, the training program undertaken by the bilingual
workforce, their conceptualisation of mental health, the BCDW’s preliminary ‘SWOT’ analysis of the
project, the development of some project tools, the planning, implementation and findings of the
community sessions facilitated by the BCDWs, the work developed with Temporary Protection Visa
holders, and the establishment of the project Reference and Advisory groups.
RECRUITMENT AND SELECTION PROCESS
• Bilingual Community Development Worker
The recruitment and selection of the team of Bilingual Community Development Workers (BCDWs)
followed the standard process for staff employed at the Qld Transcultural Mental Health Centre. A position
description was widely disseminated through multicultural sector networks.
Applicants were invited to complete a written application that explored knowledge and understanding of
community work, the community they were to work with, and the community issues related to mental
health.
A total of 28 written applications were received. Fifteen applicants were selected and invited to attend an
interview. The selection panel was composed of three representatives from the Multicultural Centre for
Mental Health and Wellbeing and the Queensland Transcultural Mental Health Centre.
The successful applicants were employed on a sessional basis for 100 hours each starting in early
June 2002 through to the beginning of 2003.
• Project Coordinator
The project coordinator was employed by the Multicultural Centre for Mental Health and Wellbeing for 12
hours a week for 12 months.
TRAINING PROGRAM
Between the 11th and the 19th of June 2002, the BCDWs and the project coordinator undertook 18 hours
of training. Considerable planning went into the development of process and content facets of the
training program. In order to provide mental health education to their communities the BCDWs and the
coordinator needed to acquire content knowledge of the Queensland mental health system and its
explanatory model, including all facets of mental health literacy. In regard to process, BCDWs were
exposed to community development approaches.
However, it was vitally important that BCDWs applied this process knowledge in culturally appropriate
ways according to the needs and characteristics of their own communities. Considerable care was taken
in the development of the training program not to erode or invalidate traditional ‘community development’
approaches utilised by each of the ethnic communities represented in the project. It was important to
stress that it was not about ‘competing’ explanatory models, but rather it was about understanding and
negotiating explanatory models to come up with the best outcomes. In this way BCDWs were encouraged
to utilise community development process mechanisms that were culturally appropriate to their own
specific communities whilst ensuring that the project goals were being met at the various stages.
The training program was developed and facilitated by QTMHC staff. Five main areas were covered in the
training module. Firstly, an overview of the project focusing on the population health approach and the
levels of intervention in mental health was presented. The second area reviewed the project rationale and
its conceptual framework, emphasizing community participation and development, and the reciprocity in
education approach. The third module conceptualised mental health and mental illness from a western
perspective and overviewed the Queensland mental health system. The fourth area included in the
training program reviewed significant issues relevant to migrant and refugees in the context of mental
health. Finally, the project workforce discussed some community development tools, strategies and
practices.

Report Stage One
• Overview of the project
This unit placed the project into the population health approach context in which health and illness are
considered the result of the complex interaction of biological, psychological, social, environmental (family
and community connectedness), and economic factors at the personal, local and global levels. The
spectrum of levels of intervention in mental health (promotion, prevention, treatment and continuing care)
was also reviewed. The three stages of the project were identified followed by a discussion of the role of
the BCDWs in stage one of the project.
• Project rationale and conceptual framework
The second unit focused on the rationale behind the project and its conceptual framework. The objectives
of the project were discussed in the context of community participation, including consumers and carers,
the development of trust and constructive dialogue between CALD communities and mental health
services, and the importance of acknowledging the community explanatory models and the community
expertise in mental health issues. An overview of the concepts of ‘community development’ and
‘reciprocity in education approach’ was followed by discussions on particular issues such as CALD
consumer participation, mental health service utilisation, status of mental health among CALD
communities, and barriers to mental health service access by people from non-English speaking
backgrounds (NESB). At the macro level, the National Standards for Mental Health Services and the
Queensland NESB Mental Health Policy Statement (1995) were also reviewed.
• The Queensland mental health system
In the third section of the training module, the aetiology, clinical characteristics, classification, assessment
and treatment of mental illness from a western perspective were explored. Among the mental disorders
discussed were schizophrenia, major depression, bipolar disorder, obsessive-compulsive disorder, panic
disorder, post-traumatic stress disorder and personality disorders. The Queensland Mental Health Act and
the structure of mental health service delivery were also discussed.
• Mental health issues for migrants and refugees
Important issues for migrants and refugees in the context of mental health were reviewed. Both risk and
protective factors were analysed in particular groups (men, women, children and youth, elderly and the
family unit). Issues such as the stressors of migration, acculturation, second language acquisition,
intergenerational conflicts, cultural identity, schooling issues for CALD children and adolescents, and
issues of stigma and shame were included in this unit. Diverse cultural explanatory models of mental
health and illness, particularly those from collectivist cultures, were also explored. Participants were
invited to share the explanatory models of mental health and illness, and ‘treatments’ from their own
culture.
• Community development tools
The last part of the training focused on some tools and strategies useful for community development
processes. The ‘SWOT’ (Strengths, Weaknesses, Opportunities and Threats) methodology was reviewed
and applied by the BCDWs in the context of the project itself. Similarly, the project’s bilingual workforce
conceptualised mental health by using the ‘tree methodology’ (i.e. giving concepts related to mental health
and locating them on the roots, trunk or branches of an imaginary tree). Finally, some participatory
techniques were used to progress understanding on how to invite community members to be part of
community sessions in the first stage of the project.
BILINGUAL WORKFORCE’S CONCEPTUALISATION OF MENTAL HEALTH
Acknowledging that project staff are also members of their communities, the eight BCDWs, the project
coordinator and the project manager decided to explore in more detail their own conceptualisation of
mental health. As a result of this, the logo for the project was born. Figure 2 illustrates the project
team’s conceptual model of mental health. The symbol of the tree represents the cycle of life and the
dynamic nature of mental health. According to this conceptual model, mental health is at the very
nucleus of life. It represents a sense of wellbeing, happiness, balance, harmony and inner peace that

Report Stage One
allow us to empower ourselves and be aware of our strengths and limitations. This feeling of
empowerment leads us to love ourselves and others, achieve goals, cope and enjoy everyday life.
This workshop also aimed to provide the BCDWs with some tools and resources to be used for the
planning and implementation of community meetings.
Figure 2: Project’s Team’s conceptual model of mental health
BCDW’s PRELIMINARY ‘SWOT’ ANALYSIS OF THE PROJECT
Prior to their work in the field with the communities, the BCDWs carried out a ‘SWOT’ analysis of the
project. The ‘SWOT’ analysis involves those factors intrinsic to the project (strengths and weaknesses)
and those external to it (opportunities and threats). These factors may, in one way or another,
influence the process and achievement of the project objectives.
Following a short introduction of the ‘SWOT’ methodology given by the project manager and the
project coordinator, the BCDWs were asked to write down what each of them perceived as strengths,
weaknesses, opportunities and threats to the project. All BCDWs actively participated in this activity.
Finally, a discussion on the findings focused on four levels: community, bilingual team, the project
itself, and the mental health system and services. This workshop aimed to help the team of BCDWs
express their feelings and worries about the project, to gain confidence in relation to their role, and to
design strategies to overcome potential weaknesses and threats.

Report Stage One
The main findings of this analysis are shown in Table 3.
Table 3: BCDW’s ‘SWOT’ analysis of the project
STRENGTHS WEAKNESSES OPPORTUNITIES THREATS
• Project aims • Lack of time and • Enable empowerment • Create high

• Focus on promotion and resources (‘only 100 among CALD expectations within the
prevention hours for stage one’; ‘not communities communities
• Focus on community enough training’; • Increase expertise of • Inability to fulfill all
development and ‘access to venues for CALD communities in expectations
community participation community sessions’) mental health issues • Communities’ lack of
• Bilingual workforce • Develop trust between trust towards mental
• Remuneration to CALD communities and health services &
BCDWs mental health services previous community
• The project may projects
positively influence other • Confidentiality issues
community projects (e.g. (i.e. ‘mental health is a
family programs) sensitive issue’)
• Communities may • Sense of competition

realize that other that other community
communities share organisations may
similar problems and perceive in relation to
issues their ongoing projects
• Community members • Competition with other
may socialize with projects (e.g. Brisbane
others City Council and
• BCDWs may share Centrelink pay those
knowledge & who attend their
experiences with their community sessions)
communities • Stigma attached to
• Increase BCDWs’ mental health and
professional mental illness
development • Disagreements between
different religious groups
within the communities
• Potential conflict
between roles of
BCDWs (i.e. role in this
project and other
occupations)
• High expectations from
project management
team towards BCDWs
DEVELOPMENT OF PROJECT TOOLS
Two instruments were developed by the project bilingual workforce to evaluate both processes and
outcomes of the community sessions for stage one of the project. The BCDWs, the project
coordinator, and the project manager participated in the discussion and design of these tools. Two
groups were formed: one designed the ‘community session evaluation form’ and the other group
developed the ‘community meeting report form’. A representative of each group presented these tools
to the whole group and a general discussion was held. Other members of the project management
team were also consulted in relation to these forms.
Following is a short description of these instruments:

Report Stage One
• Community session evaluation form
The community session evaluation form (see Attachments) was designed to obtain feedback from the
participants who attended the community sessions. It contains eight items, five of them use a
categorical scale ranging from ‘strongly agree’ to ‘strongly disagree’. The other three items are open-
ended questions, including one for additional comments. The group considered that this structure,
including both quantitative and qualitative information, would encourage people to fill in the form. This
tool aimed to help the BCDWs increase their expertise in the facilitation of community sessions.
• Community session report form
The development of the community session report form (see Attachments) had two main objectives.
Firstly, to give an overview of the objectives and expected outcomes of the community sessions,
according to the aims of stage one, so that the BCDWs could plan their session activities around these
objectives, and secondly, to facilitate the documentation of the information obtained through the
sessions. The report form did not aim to establish a rigid structure to the meetings but to give
coherence to the process of stage one. Creativity and flexibility among the BCDWs in the development
of the workshops were constantly encouraged. The report form included: the objectives of the session;
invitation strategies; activities undertaken; participant’s conceptualisation of mental health, mental
health problems, and mental illness; problems and needs identified; suggestions to address those
needs; feedback given by participants in relation to the community session; strengths and difficulties
perceived by the facilitator; and other comments or issues raised during the meeting.
The two forms were to be piloted during stage one of the project in order to define their
appropriateness for the consecutive stages.

Report Stage One
COMMUNITY SESSIONS
The information presented in the following section has been obtained from two sources. Firstly, the
workshop report forms provided by the BCDWs after the community sessions took place, and
secondly, the meetings held between the BCDWs and the project coordinator. In these meetings, both
the processes and the findings of the community sessions were discussed.
The present report gives an overview of the results of the sessions for each of the communities
involved. This section has been divided into four core areas: a brief community profile, the process (i.e.
venue, invitation strategies and activities undertaken), the findings (i.e. beliefs, understanding and
experiences of mental health) and the feedback (i.e. participants and BCDW’s evaluation of the
session).
The community profiles below have been derived from the Australian Bureau of Statistics 2001 Census of
Population and Housing1. When referring to the ancestry of the community, please note that people were
asked to consider the ancestry with which they identified. People could provide more than one response.
Therefore, it is important to be careful when interpreting or making a comparison between the number of
people born in a country, language spoken at home and ancestry.
ARABIC-SPEAKING COMMUNITY
• Community profile
The Arabic-speaking population in Queensland is composed of a total of 4,817 persons. Of these, 2,697
are males and 2,120 are females. The level of proficiency in the English language of this community is
unknown. The age breakdown of the Arabic-speaking community is as follows:
Table 4: Arabic-speaking community – age categories
Age (years) No. People
0–9 706
10 – 19 801
20 – 44 2,203
45 – 64 846
65 and older 261
TOTAL 4,817
People who speak Arabic have been born or have an ancestry from 22 countries. These include: Egypt,
Lebanon, Iraq, Sudan, Syria, United Arab Emirates, Somalia, Algeria, Saudi Arabia, Morocco, Kuwait,
Jordan, Libya, Eritrea, Bahrain, Oman, Tunisia, Yemen and Qatar.
• Process
A total of six sessions involving 39 adult participants were conducted within the Arabic-speaking
community. Twenty-five were women and 14 were men. People from Iraq, Egypt, Lebanon, Sudan and
Southern Africa were represented, including seven participants on Temporary Protection Visas
(TPVs). Both Islamic and Christian religious backgrounds were represented.
Three of the sessions took place at participant’s homes, including one at a priest’s home. The other
three were conducted at community venues (i.e. neighbourhood centre, churches).
A variety of invitation strategies were used including: inviting friends; approaching people through the
church; attending cultural and religious celebrations within the community; inviting people through
community leaders; and contacting potential participants by phone. In general, participants were
invited to talk about ‘mental health’, ‘settlement in Australia’ or ‘wellbeing’ depending on the
characteristics of particular groups.
1
The data has been prepared by the Office of Statistics and Economic Research and the West Moreton Public Health Unit.

Report Stage One
Icebreaking activities and introductions were carried out when needed. In two of the sessions the
meeting started by listening to music and talking about food and cultural issues. Participants were
encouraged to share their experiences in relation to mental health, their settlement process in
Australia, their problems and needs and how they prefer to see these issues addressed. Overall, most
participants expressed their opinions. At the end of the sessions the BCDW gave an overview of the
mental health system in Queensland and details about transcultural mental health services available.
• Findings: beliefs, understanding and experiences of mental health
The conceptualisation of mental health varied across the sessions depending on the participant’s
educational background. For those with formal education, mental health was defined as ‘wellbeing’,
whereas mental health problems were described as ‘stress’, ‘depression’, ‘anxiety about the future’
and ‘difficulties in the interaction with other cultures’. Mental illness was defined as ‘being crazy’. On
the other hand, for those with no formal education, it was difficult to differentiate between mental
health, mental health problems and mental illness. In this group, all of these terms were associated
with ‘being crazy’. Concepts such as stress, depression, sadness, annoyance and low self-esteem
were not identified by this group of people as mental health problems or illnesses, but were considered
part of everyday ‘normal’ life.
Issues such as homesickness, loneliness, lack of extended family support, communication problems
(language barrier), finding it hard to integrate with the wider community, unmet expectations in relation
to life in Australia, unemployment (due to skills not being recognised in Australia, language barrier,
mature age, discrimination in workplace, lack of money to buy a car), cultural clash (law supports
women against the ‘Middle Eastern culture’; men lose power and self-esteem; Centrelink system
encourages couples to separate due to ‘individual accounts’; intergenerational difficulties such as sex
before marriage which is against parents’ culture, and lack of respect towards adults), discrimination
and racism, financial issues (two-year period without Centrelink benefits; loan from Centrelink to help
in settlement is not enough; limited financial resources for single mothers; low income for those who
stay home caring for children), and the lack of trust towards mental health services were some of the
problems and needs commonly identified across the sessions.
Some other issues were raised by specific groups of participants. For TPV holders, the temporary visa
itself is the most significant issue that affects their life as a whole. Due to their limited access to
entitlements and benefits available to the wider community and the uncertainty towards the future,
feelings of stress, isolation, depression, anger and rejection were common in this group.
Unemployment, poor English language skills, family separation, financial difficulties, discrimination and
racism (especially after the events of September 11, 2001) have had a negative impact on their mental
health according to participants.
In general, when members of the Arabic-speaking community have any emotional or personal
problems, they prefer to talk to their spiritual leader or other community leaders.
Several ideas were expressed by participants to address the main problems and needs identified.
These ideas were: improving both cultural awareness among mental health workers and the cultural
assessment approaches used by mental health services; establishing multicultural outdoor activities or
‘social club’ for people with mental health problems (i.e. ‘stress’, ‘depression’, ‘isolation’) and
communities in general to improve their support networks and prevent the development of more
serious problems; employing ‘multicultural or bilingual counsellors/mental health workers within the
mental health system (their role would be to work with members of CALD communities in primary
mental health care, i.e. ‘promotion and prevention’, ‘helping them to integrate within the wider
community’, ‘mental health education’, ‘recognition of the positive things of migration and of life in
Australia’); improving the ‘referral to services system’ for members of CALD communities; facilitating
meetings among people with mental health problems and mental illness to talk about their experiences
within the mental health system (‘this may improve the trust between service providers and clients’);
changing the name of mental health services may reduce the stigma attached to mental health and
increase access to those services (i.e. wellbeing); advocating to the Immigration Department to
increase and facilitate family reunion programs; advocating to Centrelink to increase financial
assistance (especially for mothers who are looking after children) or make loan repayments more
affordable; and reconsidering the impact of the two-year period without entitlements for new
immigrants.

Report Stage One
Other suggestions given were: increasing the number of hours for English-language programs;
organising information sessions in the home country for prospective immigrants to Australia to give a
full and clear picture about life in Australia (to prevent over-expectation); special training for
interpreters in the mental health field; include mental health programs and services in different
institutions and organisations (i.e. TAFE) which are in contact with recently arrived migrants;
establishing programs to strengthen couple and family relationships; involving the media in the
dissemination of mental health information in different languages; promoting media awareness of
CALD communities’ ‘sensitive issues’; improving the way the media portrays other cultures.
Three main ideas came out of the meeting with TPV holders: improving employment networks;
extending their entitlement to services that have an impact on their mental health; and guaranteeing
confidentiality to promote trust between their community and service providers.
• Feedback
∗ Participant’s feedback
Overall, participants were satisfied with the way the objectives and activities of the sessions were
explained and the opportunity they had to express their ideas and needs. All participants considered
the sessions interesting and useful.
∗ BCDW’s feedback
People from the Arabic-speaking community expressed their preference to attend sessions at familiar
places (e.g. friend’s home, church, neighbourhood centre). The BCDW is well known within the
community and already had an established community network in place which facilitated the planning
and implementation of the sessions. Due to gender, culture and confidentiality issues, the meeting with
TPV holders required two separate sessions for men and women.
The BCDW considered the following issues as strengths during the sessions: having separate
meetings with specific groups (i.e. men, women, specific religious denominations, TPV holders)
facilitated participation; participation and discussion were enriched when participants knew each other.
No major difficulties appeared during the sessions. Most of the participants in these sessions
expressed concern about the use of the term ‘mental health’ because of the stigma attached to it and
its association with ‘being crazy’. Other names suggested were wellbeing or good health. There were
also concerns about what the project and the mental health services can and cannot do to address the
needs and issues mentioned.
BOSNIAN COMMUNITY
According to the Australian Bureau of Statistics 2001 Census of Population and Housing, 2,923 people
(1,494 males and 1,429 females) who were born in Bosnia and Herzegovina are living in Queensland. Of
these, 2,428 Queensland residents identify themselves as having Bosnian ancestry, 1,221 are males and
1,207 are females. There is no current data available on the level of proficiency in English and on the age-
breakdown of this community. Anecdotal information indicates that most Bosnian people live in Brisbane
and the Gold Coast.
• Process
In the Bosnian community, six sessions involving 36 participants (18 women and 18 men) were carried
out. Members from both Muslim and Christian backgrounds participated. People with low and high
levels of English-language proficiency were represented. The six sessions were conducted at
participant’s homes.
Members of the Bosnian community were invited to discuss their beliefs and needs in relation to
‘emotional stability’, ‘inner balance’ and ‘spiritual satisfaction’.

Report Stage One
The objectives of the project were explained to participants, followed by a discussion of the topic.
Throughout the session, participants were invited to express their opinions and share their
experiences. Self-disclosure and indirect questioning were occasionally used by the facilitator as
strategies to promote participation. The atmosphere was informal and friendly.
When defining mental health, participants identified the notions of ‘living’, ‘having a normal life’ (having
a safe and decent job with the potential to progress, financial stability, loving family, safety, freedom,
broad range of friends, good opportunities to socialize), ‘being fully accepted by the host society’,
‘having good health’, ‘trusting other people’, ‘feeling safe’, ‘happiness’, ‘living in peace’, ‘having the
opportunity to laugh, relax and enjoy everyday life’, ‘having and pursuing goals’, ‘achieving inner
balance and spiritual satisfaction’ (‘uspostavljanje unutarnjeg mira, duhovne ravnoteze I opsteg
emotivnog zadovoljstva”) (spirituality for the Bosnian community is not necessarily connected with
religion or God, but with the ‘immaterial, intellectual and inner self, and with individual harmony’;
spirituality is understood more as a philosophical concept), ‘setting and achieving goals’, ‘having hope
and positive attitudes’. Family and social networks were mentioned as significant components of
wellbeing and mental health (‘just having coffee with a friend can be enough to make someone
happy’).
Mental health problems were defined as: ‘problems experienced by many people’ such as
‘frustrations’, ‘fears’, ‘inability to cope with everyday life and its challenges’, ‘being depressed and
anxious’, ‘feeling of hopelessness’, ‘having no goals’, ‘low self-confidence’, ‘feeling nostalgic’, ‘worrying
about the future’, ‘having problems due to the war experience’. People with mental health problems
are normal people who have experienced difficulties; these problems can be solved with help from
family and friends and only eventually may require professional intervention, but ‘without the use of
medication’. Some participants suggested that what is considered a mental health problem in
Australia, is a ‘normal part of life’ in Bosnia (‘mental health problems make you stronger’). Some
participants complained because, in Australia, mental health problems are treated like mental illness,
‘doctors use only medication’.
On the other hand, mental illness was perceived as ‘having something serious, like schizophrenia,
psychosis, mood disorders’. Mentally ill people ‘are dependent on others’, ‘they may harm themselves
or others’, ‘they cannot function normally’, and therefore ‘require comprehensive treatment including
medication, psychotherapy and even hospitalization’; ‘support from family and friends may not be
enough’. Usually all family members are affected if there is someone with mental illness in their family.
The main problems and needs identified by community members were: ‘inadequate English-language
skills’, ‘feelings of isolation and loneliness’, ‘opportunities to socialize with other people from the
community’, ‘improving harmony and understanding within the family’, ‘having more people they can
trust and get help from during periods of crisis’, ‘inability to adjust to Australian life’, ‘not being
accepted by the general community because of their background, accent, different customs and
culture’, ‘being treated as people with no culture because they do not belong to the English-speaking
culture’. Participants complained about the lack of culturally appropriate help when accessing health
services in general (including services provided by GPs, psychologists, psychiatrists). One important
reason for this is the lack of mental health professionals from the Bosnian community working in
Australian mental health services (the issue of language and the difficulty of having interpreters during
their contact with health professionals was a common concern). Another issue was the common
practice of prescribing medication for mental health problems and not providing additional counselling
or psychotherapy. Teenagers emphasized their need to socialize and make new friends.
Among the suggestions given by participants were: organizing the Bosnian community and bringing
together diverse groups of the community; professionals from the former Yugoslavia with expertise in
health in general, and mental health in particular, should be employed in schools, counselling services
and other settings to support the Bosnian community; establishing a Bosnian centre or club which may
offer information, education, recreation, counselling services for the Bosnian community; outdoor
activities; helping community members to adapt to and understand the Australian culture (‘individuals
should be able to find patience and hope in themselves’, ‘trying to socialize more with Australians’);
campaigning for a more open Australian society where people from other backgrounds are
appreciated, respected and not perceived as strangers. The two teenagers suggested establishing a
Bosnian youth club as a good strategy to socialize.

Report Stage One
• Feedback
Participants considered that the objectives and activities of the sessions were clearly explained, they
had the opportunity to express their ideas and opinions, and that the meetings were interesting and
useful.
It was not possible to organise more formal sessions with a greater number of participants due mainly
to the lack of trust and support from some community leaders. After some attempts, the BCDW
decided to invite a small group of people to informal sessions at ‘a friend’s home’, and the community
responded positively. The BCDW considers that the use of specific wording such as emotional
stability, inner balance and spiritual satisfaction helped motivate people to attend the sessions and
discuss these issues.
Most community members, including those with mental health problems and illnesses openly shared
their experiences. Participants with different levels of English-language skills identified similar needs
and problems in relation to the impact that communication has on their everyday life.
Because it is difficult to translate mental health terminology into the Bosnian language, some
participants struggled to understand these concepts and express their opinions. They considered that
‘it was too obvious what is needed to achieve mental health’. Some were skeptical about the real
achievements of the project and expressed lack of trust due to previous experiences in similar projects
that ‘did not give any benefit to the community’. A feeling of pessimism among participants in relation
to the project was perceived by the BCDW.
FARSI-SPEAKING COMMUNITY
According to the Australian Bureau of Statistics 2001 Census of Population and Housing, the Farsi-
speaking population in Queensland is about 4,752 persons. Of these, 2,668 are males and 2,084 are
females. The level of proficiency in the English language of this community and its age-breakdown is
unknown. People who speak Farsi are largely from Afghanistan and Iran.
• Process
Six community sessions involving 44 members of the Farsi-speaking community were conducted (21
women and 23 men). Fourteen of these participants were aged 21 or younger. One of the sessions
was specifically planned for youths. Members from both Islamic and Bahai’ religious backgrounds
attended the sessions. Three TPV holders participated in one of the sessions. Four meetings were
held at participant’s homes. The other two were conducted at community centres (one of them at a
religious centre).
The BCDW from the Farsi-speaking community invited people to talk about ‘mental health problems
and services’. The main strategies used were: contacting members of the community by phone,
presenting the project through their community program at Radio 4EB and inviting people to the
sessions, and visiting them.
Icebreaking activities and introductions were applied when needed. Usually the session started by
talking about ‘general matters’ before focusing on the objectives of the meeting and on mental health
issues and services. In half of the sessions, participants asked the BCDW about mental health
services for the community.

Report Stage One
Participants defined mental health as ‘being happy’, ‘satisfied’, ‘enjoying life’ or ‘when the community is
thoroughly satisfied’. The terms ‘stress’, ‘depression’, ‘anxiety’, ‘confusion’, ‘hopelessness’,
‘pessimism’, ‘sleeplessness’, ‘afraid of associating with other people’, ‘loneliness’ and ‘homesickness’
were used to define mental health problems. On the other hand, participants associated mental illness
with ‘addiction to drugs’, ‘schizophrenia’, ‘Downs Syndrome’ and ‘being crazy’.
Common problems and needs identified by the community were: drug abuse (especially among young
people); embarrassment and fear of exposing their problems to other members of the community;
intergenerational difficulties due to the clash of cultures (youths preferred not to talk about their
problems when their parents were present); isolation; no family support; homesickness; lack of
language skills (scared of answering the phone or when people talk to them in the street); difficulties
integrating into society (especially for older people); loss of status after migration; discrimination (which
has increased after the September 11, 2001 events). Youths expressed the need to receive more
support at school to achieve a higher ‘OP’ because of the language barrier (this also applies at the
university level).
When facing personal, family or emotional problems, members of the Farsi-speaking community turn
to prayer, meditation, spiritual leaders or medical practitioners from their own community. According to
the BCDW there is an excellent relationship between members of different religious affiliations within
the Farsi-speaking community.
Participants suggested some strategies to address their needs: having someone (they can trust) from
the community or the mental health services who can visit them in their homes ‘just to talk’, ‘feeling
that somebody cares’; mental health workers able to visit people with drug and alcohol problems and
psychiatric disabilities. Some youths mentioned the importance of improving communication with
parents to tackle intergenerational difficulties, and more tutorial assistance to cope with school and
university.
• Feedback
Most participants were satisfied with the sessions, considering them a great opportunity to express
their feelings and concerns. Some felt that there was not enough time to talk about other important
issues.
The BCDW from the Farsi-speaking community used her well-established community network to invite
people to participate. The community’s response was positive. Participants’ willingness to talk and
express their needs and feelings was considered as the main strength of the sessions. No major
difficulties were perceived. However, there is a need to define what the project can and cannot offer to
the community and to clarify the role of the BCDWs.
FILIPINO COMMUNITY
According to the Australian Bureau of Statistics 2001 Census of Population and Housing, 15,405 people
living in Queensland have been born in the Philippines. Of these, 3,671 are males and 11,734 are
females. The population with Filipino ancestry in Queensland totals about 19,631 persons. Of these, 6,137
are males and 13,494 are females. There is no data available on the level of proficiency in the English
language; however, anecdotal information indicates that most people speak English well or very well.

Report Stage One
The age breakdown of the Tagalog-speaking community is as follows:
Table 5: Tagalog-speaking community – age categories
0–9 547
10 – 19 961
20 – 44 4,879
45 – 64 2,528
65 or older 400
TOTAL 9,315
• Process
Six sessions involving 40 members of the Filipino community were conducted. Fourteen were men and
26 were women. Nine participants were 21 years old or younger (one session was specifically planned
for youths). In one of the sessions, most participants were women who came from the Philippines to
marry older Australian men. Different Christian religious groups were represented. Two sessions were
conducted in English as participants felt more comfortable speaking in English.
Three sessions took place at participant’s homes, one at a community centre (church centre), one at
the BCDW’s workplace, and the other one at a park. For one of the sessions, the BCDW invited other
members of the Filipino community working in her workplace (Department of Employment and
Training) at lunchtime to talk about mental health. Other strategies used were attending other
community meetings (i.e. Filipino University Alumni Association, parent’s meeting at school, Filipino
women’s group, a church meeting, and a community party). On two occasions, the BCDW approached
leaders of the community (e.g. church minister, social worker) who introduced her to other members of
the community. Participants were invited to talk about ‘mental health’.
The sessions were conducted in a relaxed and informal atmosphere where sharing food and
storytelling were common. The objectives of the sessions were briefly explained by the BCDW. Open
questions and brainstorming were used to explore participant’s opinions and beliefs. Occasionally, the
facilitator opened the discussion asking participants about their experiences in Australia.
Mental health was defined as: ‘the health of the mind as against physical health’, ‘a normal person
coping with daily life’, ‘a healthy attitude about life’, ‘the state of mind of a person’, ‘the way the mind
works’, ‘our response to the environment’, ‘psychological wellbeing of a person’, ‘being aware of the
services offered by counsellors’, ‘physical and emotional embodiment of a person’, ‘general health of a
person’s emotions and use of mind’. In two of the sessions participants could not differentiate between
mental health and mental illness (‘the word mental means crazy’).
Several terms were used to describe mental health problems. Some participants defined them as part
of normal life that people have to cope with, ‘common problems encountered in daily living, such as
depression, sadness, anger, frustration, neurotic behaviour, suspicious, doubtful, distant, laziness’;
‘behaviours that do not impede the normal functioning’; ‘rough situations from time to time’; ‘minor set
backs in life’; ‘feeling emotionally troubled and depressed due to unfortunate circumstances’;
‘problems that cause anxiety’; ‘nervous and emotional breakdown due to stress’; ‘problems caused by
social and environmental factors’. Others mentioned ‘people with problems that could not cope on their
own, so they need help from other people’ or ‘emotional problems due to environmental factors,
diseases of the aged like Alzheimer’s’.
Mental illness, on the other hand, was defined as ‘more extreme behaviours’ that ‘affect people’s
functioning in society’. In these circumstances, ‘medical and professional help is needed’. Other terms
used were: ‘people who are out of this world’, ‘people who need confinement in hospitals or clinics’,
‘people with mental disabilities like schizophrenia, severe depression, obsessive-compulsive
disorders’, ‘people with suicidal tendency’, ‘clinical illness brought about by genetics, drugs, etc.’,
‘medical occurrences that can be controlled by medication’.

Report Stage One
Some common problems and needs identified by participants were: family members tend to deny
mental health problems because they are afraid of the stigma attached to them (‘keep it secret’, ‘try to
hide the person or make excuses for them’, ‘individuals and families refuse to seek help or recognize
the problem’). In the case of women who are married to Australian men ‘they avoid talking about their
problems (e.g. domestic violence) or going to mental health services for fear that they will be labelled
as mentally ill or crazy, and this will jeopardise their permanent residence status or Australian
citizenship’. This causes a feeling of ‘hopelessness and resignation’.
Other issues mentioned were: lack of knowledge and experience on mental health issues (i.e. lack of
information about activities and services offered by mental health services); misconceptions of mental
health by most people; misdiagnosis and incompetence of health professionals, and the lack of more
effective strategies and treatments to deal with mental health problems (e.g. ‘alternative treatments’);
lack of funding (‘it’s not the main priority of the government’); lack of support and help from society in
general outside the Filipino community; lack of communication with other communities in relation to
mental health issues; increasing drug abuse and mental disability caused by it; family conflicts that
contribute to mental health problems (e.g. conflict between couples due to change of roles in a new
country); depression among the youth due to unemployment and conflict with parents (‘culture conflict
between youth and parents’); lack of integration with mainstream community (especially for older
people). Some participants considered that Filipino people have ‘crab mentality’ (i.e. ‘putting their own
countrymen down especially when that person is progressing).
In order to address the needs identified, several suggestions were given. Filipino women who came to
marry Australian men suggested an increase in information about what mental health services
provided, to employ caring and compassionate Filipino social workers to work with the community in
the mental health area, screening psychological and emotional make-up of Australian men and
involving them in mental health workshops.
Other participants also suggested: conducting mental health counselling programs for medical
professionals (‘because they only know how to cure illness, not the everyday problems people face’);
activating mental health awareness programs; making changes in lifestyle (‘relax more, live in a good
environment, go to church, be active in the community, talk to friends, help others’); counselling
services for youth (communication, interaction, let the youth be heard, listen to their problems and
concerns, bridging the gap between parents and children, addressing drug abuse and unemployment;
as one participant said: “mental health starts with the youth”); family workshops to address family
issues (intergenerational difficulties, motherhood and parenthood); extension of services to rural areas
where the incidence of suicide is higher; more research on mental health; more government funding;
alternative approaches, not only drugs, to address mental illness (“think outside the box”); more
individualised treatments (‘each person is unique’). Participants considered that the Filipino community
initially seeks help within the community, they rely on priests or other religious leaders and therefore,
these leaders should have proper training to deal with mental health issues.
• Feedback
Overall, participants perceived the sessions as very useful, informative and a good opportunity to
share experiences with others. They highlighted the importance of having someone to talk to about
mental health issues. The duration of the sessions (2 hours) was considered positive. Particular
religious groups expressed interest in continuing their participation in the project.
There were no difficulties inviting members of the Filipino community to attend and participate in the
sessions. The strategies designed, such as contacting workmates and community leaders and
attending other community meetings, worked well. Most participants were expressive, articulate and
had a previous understanding of mental health issues; being able to talk in their own language is an
advantage; the significant bonding in some religious groups has made it possible to offer mental health
assistance and support to their members.

Report Stage One
When the sessions were held in participant’s homes, the host person could not participate fully
because she/he was trying to make sure everyone was okay. Some participants were shy at the
beginning and needed time to feel more confident in the group. For those women who had problems
with their husbands, there were lots of unexpressed emotions and feelings. They need time and the
right environment to talk about these issues. Sometimes the environment of the session (e.g. park)
may distract the participants and make the meeting more difficult to facilitate.
SAMOAN COMMUNITY
According to the Australian Bureau of Statistics 2001 Census, 4,046 people (1,888 males and 2,158
females) living in Queensland were born in Samoa and 56 in Western Samoa. There are a total of
7,195 people who speak Samoan in Queensland - 3,414 males and 3,781 females. However, 8,988
people (4,427 males and 4,561 females) self-identified themselves as having Samoan ancestry. The
age breakdown of the Samoan-speaking population in Qld is as follows:
Table 6: Samoan-speaking community – age categories
0–9 1,557
10 – 19 1,599
20 – 44 2,810
45 – 64 1,045
65 or older 225
TOTAL 7,236
The catchment area of the Logan and Beaudesert Health Service District (HSD) is the home of 2,224
persons who speak Samoan at home. This is the largest (0.8%) population who speak a language other
than English in the HSD. The Samoan population who live in the West Moreton Health Service District is
again the largest non-English speaking background population in the HSD with 1,630 or 1.0% of the HSD
population.
• Process
Forty-four participants, 31 of them women, attended six community sessions. Different religious
denominations were represented. Two sessions took place at the BCDW’s house, and the others at a
community neighbourhood centre.
The BCDW from the Samoan community personally invited, either verbally or in writing, potential
participants to meet and share their knowledge about mental wellbeing and mental health problems.
Established community groups, such as a rugby club committee, were invited. Participants were
previously informed about the objectives, venue, time and duration of the sessions, and that a morning
or afternoon tea would be provided.
Personal introductions and icebreaking activities were conducted. People talked about themselves,
their villages of origin in Samoa, their migration experience, and their life in Australia. According to the
facilitator, ‘it was like an extended family’. These activities made it easier to discuss mental and
emotional health issues freely. In some sessions, participants were asked to write down on a piece of
paper how they were emotionally affected leaving their relatives and friends behind. ‘This exercise was
like rewinding back a clock; there were some unresolved issues with some participants’. In other
sessions, after discussing mental health issues, the BCDW showed a diagram of a ‘Meeting house’ or
‘Fale Fono’. This diagram (see Attachments) represents the Samoan people’s view of health.

Report Stage One
The Samoan community does not have a precise translation for the word ‘mental’ as this is part of the
overall wellbeing of the body, mind and soul. Participants could not separate this concept from the
holistic notion of an individual’s health. In this context, it was difficult to define mental health. Some
community members voiced their disappointment because the project focused ‘only on mental health
and not on general health…unemployment, housing… and the impact of these issues on overall poor
health’.
Mental health problems were perceived as a ‘normal part of life’, ‘something that we have to cope
with’. However, it is understood that mental health problems need to be taken care of earlier
(‘prevention is better for everyone’). Community and family support were perceived as crucial when
coping with mental health problems and illnesses. The language barrier and the lack of understanding
of the Samoan culture by the Australian community at large (including orthodox medical practitioners)
were considered to influence mental health problems. They believe that transition from life in the
Islands to life in Australia brings a variety of new economic, psychological and social stressors that
affect their mental health (e.g. employment, housing, getting enough income to meet needs). Youth in
Samoa are told that ‘the path to peace is service, but when that path is blocked, frustration occurs that
prompts violence’.
According to some participants, particularly those born in Samoa, mental illness is caused by the
following:
Ma’i Aitu: Aitu means spirits that may cause people to become bad tempered, impulsive and use foul
language or manifest bad behaviours.
Ma’i fasia: Various geographical areas in Samoa are under the custody of a fasia or guardian spirit. If
people visit such areas and do something against the traditional law (e.g. laughing), they might be
punished with hallucinations that may be long lasting. There have been cases where people have
come to Australia to escape the fasia.
Ma’i valea: The ‘emotional sickness’ considered to be caused by contact with some object that
belonged to a deceased person. Christian Samoans, however, consider Ma’i valea to relate to
disobeying the wishes of the father or family chief, breaking the Ten Commandments or lapsing from
certain Samoan traditions that are acceptable to the group.
Another term mentioned by some participants was ‘vale’, which is commonly used to describe a
person who is ‘crazy’.
Some Samoans believe that their traditional healers and medicines are the only treatment for mental
illness. According to the BCDW, these views may differ among younger Samoans who have been
educated in Australia, but are still prevalent within the community.
Participants identified three main issues. Firstly, the difficulties understanding the way mental health
problems and illnesses are interpreted and treated in the western culture. Because Samoan beliefs
are different, people prefer to use traditional healing practices and are reluctant to attend mental
health services. Lack of adequate communication between the mental health services and the
relatives of people with mental illness was also identified. Secondly, the stigma attached to mental
illness, the family’s denial to recognize the problem, and the fear of talking about it openly. Some
participants expressed the need to conceive mental illness like any other illness and not like a
punishment or a possession by spirits. The stressors involved in the migration experience (e.g. the
feeling of isolation and the lack of support of the extended family and/or friends, the new culture,
economic stressors, racism and discrimination, etc) as the third issue identified.
Several suggestions were given to address the needs and problems identified:
¾ Mental health promotion: participants stated that the best opportunities to promote mental
health were found within the Samoan community, such as churches and other community
organisations. Community leaders should be encouraged to discuss mental health issues
with the community in a more open manner.

Report Stage One
¾ Increase community participation in educational activities related to mental health. These
activities should be developed in a culturally appropriate manner acknowledging the
community’s beliefs and practices.
¾ Training of mental health workers from the Samoan community to work in mental health
services, to assist Samoan families, and to visit members of the community who are in
need.
¾ Encouraging family and community involvement, with prior consent of the clients, into the
planning, implementation and review of the care program.
¾ Cultural advocacy through community networks, Church groups and probably the
establishment of a National Advisory Council in Mental Health for Pacific Islanders, will
increase the understanding of the Samoan culture within the Australian community,
reduce discrimination and improve mental health services.
• Feedback
The group enjoyed the activities, felt comfortable expressing their views and recognized the
importance of discussing mental health issues within the Samoan community. Some expressed their
interest in participating in future sessions. The duration of the sessions (2 hours) was not considered
long enough to discuss an issue of such relevance. Some participants recommended that, in order to
increase participation, the sessions ‘might be done in a way that participants get something from it, like
a payment’.
The BCDW is well known within the Samoan community and has had previous experiences working in
the community development field. The strategies implemented to promote attendance and participation
were well received by the community. The discussion of the session objectives when inviting potential
participants helped the group to think about or look into mental heath issues beforehand. This
facilitated the discussion during the sessions. The BCDW valued the sense of humour of some
participants during the meetings, which allowed people to have fun while discussing a serious matter.
Participants recognized the right to have culturally appropriate health services. After the sessions,
members of the Samoan community recommended that a national mental health advisory council be
established along with a cultural advocacy service.
In one of the workshops, a participant who was not previously invited made negative comments
throughout the meeting, telling people that they were wasting their time, and interrupting the activities
planned by the BCDW. However, the rest of the group expressed their support of the BCDW’s role and
the project itself.
SPANISH-SPEAKING COMMUNITY
According to the Australian Bureau of Statistics 2001 Census of Population and Housing, 9,542 or 0.3% of
the Queensland population speak Spanish at home. Of these, 4,625 are males and 4,917 are females.
Their level of proficiency in the English language is unknown.

Report Stage One
The age breakdown of the Spanish-speaking population in Queensland is as follows:
Table 7: Spanish-speaking community – age categories
0–9 919
10 – 19 1,347
20 – 44 4,189
45 – 64 2,429
65 or older 672
TOTAL 9,556
People who speak Spanish in Queensland have arrived from, or have an ancestry mainly from the
following countries: El Salvador, Spain, Chile, Argentina, Colombia, Uruguay, Peru, Mexico,
Nicaragua, Cuba, Guatemala and Costa Rica.
• Process
More than 100 invitations to members of the community were made. The sessions were also
announced through 4EB radio. Six sessions involving 79 participants took place. The majority (60)
were women. One of the sessions involved 15 teenagers (10 to 14 years old). Some participants
belonged to previously established Spanish-speaking community groups (e.g. Acacia Ridge Spanish-
speaking Group, Spanish-speaking Women’s Support Group). One session was conducted with
mental health consumers and another with human services workers from the Latin-American
community. All sessions took place at community venues.
The BCDW contacted the centre or group coordinator, when applicable, and negotiated access to
group members (e.g. negotiations with the Catholic Church took place in order to deliver the session
with the community at the church hall). Parents of teenagers were sent a letter and gave consent for
their children to participate. The objectives of the sessions were explained to potential participants and
personal/written invitations were made. Participants were invited to “share ideas, knowledge and
experiences on how people from the Spanish-speaking community perceive and develop emotional
wellbeing”. Additionally, the invitation stated that their participation and contribution would serve to
plan activities for the benefit of the community. Special care was taken to assure confidentiality when
inviting mental health consumers.
Personal introductions and explanation of session objectives were conducted. In the first two sessions,
the BCDW gave a brief definition of mental health, mental/emotional health problems and
mental/emotional illness. For the other sessions it was agreed to conduct this activity at the end of the
meeting. A poster with an adaptation of the mental health spectrum was then used to invite
participants to share their cultural knowledge on how they perceive and understand these three
concepts. Participants were given three cards to write down their answers to three questions: 1) what
is the image that we have of an emotionally healthy person? 2) How do we notice when somebody has
emotional problems? 3) How do we know or take notice that somebody is emotionally sick? After
writing their answers, participants pinned their cards on the respective section of the poster. The
answers were then discussed by the group; nobody knew whose answer was being discussed. In
some meetings, the main ideas were grouped.
A small break took place. Participants were asked to form pairs, find something in common with the
other person and share it with the whole group.
For the second part of the session, another poster with the mental health intervention spectrum was
used to address participant’s knowledge and experiences about the mental health system. Three
cards containing three questions were provided: 1) What would help to improve our emotional
wellbeing? 2) How do you believe people with emotional problems should be treated? 3) How do you
believe people with mental illness should be treated? Answers were also pinned up and a group
discussion followed.

Report Stage One
At the end of the sessions a brochure titled, “What is Mental Health” was provided. An evaluation of
the activities was undertaken and contact details from participants were collected.
Some of the terms used to define mental health were: ‘being positive and realistic’, ‘able to relate to
others’, ‘capable of solving own problems’, ‘able to recognize own problems and look for help if
necessary’, ‘a person with great physical, psychological and emotional capacity to cope with
problems’, ‘handling stress and keeping calm even in crisis’, ‘having goals’, ‘able to have fun’, ‘having
a good sense of humour’, ‘helping other people’, ‘being emotionally balanced’, ‘being self-confident’,
‘stable and content with self’, ‘being able to combine personal and social life’, ‘constant need to
improve self and the community where one lives’, ‘balancing personal with community wellbeing’,
‘ability to love oneself and others’, ‘able to express ideas and emotions’, ‘a person that smiles, talks
and acts freely’, ‘sleeping well’, ‘having interest in work, sports, etc’.
The young people described emotionally healthy people are ‘happy’, ‘excited’, ‘laughing and talking’,
‘active’, ‘go to places and have heaps of friends’, ‘take care of themselves’, ‘are nice, joyful and
helpful’.
Mental health problems were defined as: ‘not relating positively with other people’, ‘avoiding people’,
‘not showing interest for others’, ‘acting with prejudice’, ‘blaming others for own lack of success’,
‘lacking concentration and not sleeping well’, ‘feeling tired, low mood’, ‘not facing problems’, ‘finding
life difficult’, ‘denying own problems’, ‘temporary inability to face problems as they come’, ‘thinking
about suicide’, ‘being negative’, ‘difficulty in solving own problems’, ‘being emotionally unstable,
irritable, anxious and nervous’, ‘expressing emotions aggressively’, ‘unable to control oneself’, ‘low
emotional energy levels’, ‘looking sad, not talking to others, feeling isolated’, ‘being depressed’, ‘crying
easily’, ‘lacking the willingness to improve self-esteem’, ‘feeling sad and angry’, ‘acting emotionally to
make decisions’.
The young people defined people with mental health problems as: ‘they don’t know where they are’,
‘sad, suicidal, with no friends and angry’, ‘moody’, ‘confused’, ‘unhappy and with very bad problems’,
‘looking insecure’, ‘not looking normal’.
On the other hand, mental illness was described as: ‘inability to communicate and relate to other
people’, ‘socially violent’, ‘lacking self-control’, ‘isolation from the world’, ‘inability to solve own
problems’, ‘not acknowledging when one needs help’, ‘needing external help to keep living’, ‘drug
abuse or addictions’, ‘disproportioned vision of reality’, ‘loss of touch with reality and self-identity’,
‘cognitively impaired’, ‘suicidal ideas’, ‘unable to reason’, ‘lacking self-confidence and self-respect’,
‘hopelessness’, ‘behaviour not in accordance to the circumstances’, ‘incoherent and inadequate
emotional responses’, ‘clinically diagnosed with moderate or severe psychiatric conditions’, ‘requires
psychological treatment, medication and therapy’, ‘lack of sleep and crying easily’, ‘imagine and hear
things that are not real’, ‘having double personality’.
Teenagers described mentally ill people as ‘looking sad, crying and getting really depressed’, ‘they do
not want to take part in anything’, ‘looking sick’, ‘being suicidal and homicidal’, ‘being paranoid’,
‘having negative emotions’.
The following were the main problems and needs identified during the meetings: lack of information
and/or services concerning mental health issues (e.g. culturally appropriate mental health services,
cross-cultural training for doctors, support groups, information translated into Spanish, not enough
culturally appropriate venues for group therapy and treatments, lack of entertainment programs,
personal development activities, including spiritual growth, and programs addressing family issues).
Discrimination and lack of respect for immigrants and their culture, lack of adequate employment in
accordance with previous skills and the recognition that barriers to employment and education affect
emotional wellbeing, need for more community participation and development programs, were also
mentioned.
Mental health consumers specifically mentioned the need for support from family, friends and
workmates, more culturally adequate support groups and centres with staff from own culture and
language and the need to be actively involved with community activities.

Report Stage One
Several ideas were suggested by participants to address the needs identified: programs supporting
the family and providing information about family issues; more holistic and culturally appropriate
mental health treatments, services and support groups (own language); counsellors and other health
professionals from own culture (changes in process of skills recognition for migrants); promoting
mental health awareness; promoting respect for immigrants and people from other races and cultures,
promoting cultural identity and pride, researching and implementing other alternatives to treat mental
health problems and mental illness (e.g. yoga, meditation, exercise, dancing - not only medication),
promotion of community models rather than institutional models to treat mentally ill people.
Participants emphasised that people with emotional problems should be treated with cultural
sensitivity.
Mental health consumers gave some ideas to address their needs: reducing bureaucracy in mental
health services, treating people with mental disability in the same way as other people with no
disabilities are treated (respect, understanding, support, tolerance, without discrimination, giving them
time to trust others and express their needs), mental health awareness programs in workplaces,
training of mental health workers from their own communities to work in mental health services.
• Feedback
The vast majority of participants were very satisfied with the objectives and activities of the sessions
and were willing to participate in future meetings. They enjoyed interacting and sharing ideas with
other people. A significant number of participants considered that the length of the sessions (2.5
hours) was not enough.
The high level of attendance, participation and interest showed in the sessions reflected the success
of the strategies planned and was perceived as the main strength by the BCDW. Most people
expressed a willingness to attend future activities. The session with consumers was characterized by
their openness and willingness to talk about their experiences of the mental health system. Even
though one of the sessions took place in the corner of a noisy hall where more than 100 people were
eating after Mass, those who attended actively participated.
The two-hour session was not long enough to conduct all planned activities, including those required
prior and after the meetings (e.g. setting up chairs, etc). The second part of the sessions had to be
done faster. Some of the teenagers were too young to understand and participate in the discussion of
mental health issues. Keeping their interest and attention during the two-hour session was a huge
challenge. Some of the meetings were conducted at lunchtime and the BCDW provided cool drinks
and light meals in addition to the coffee, tea, and biscuits supplied.
VIETNAMESE COMMUNITY
According to the Australian Bureau of Statistics 2001 Census of Population and Housing, in Queensland
11,758 persons have been born in Vietnam. Of these, 5,701 are males and 6,057 are females. The
number of people who speak Vietnamese at home is 14,367 (7,172 males and 7,195 females). The
Vietnamese community’s level of proficiency in the English language is unknown.
People who speak the Vietnamese language at home have been born in Vietnam or have Vietnamese
ancestry although they may have been born in other countries such as Cambodia and Laos.
The largest part of the Vietnamese community in Queensland lives in the southern area of Brisbane.

Report Stage One
The age breakdown of the Vietnamese-speaking community in Queensland is as follows:
Table 8: Vietnamese-speaking community – age categories
0–9 2,283
10 – 19 2,430
20 – 44 6,397
45 – 64 2,435
65 or older 769
TOTAL 14,314
• Process
Six sessions involving 17 adult participants were conducted - 12 of the participants were men. The
vast majority arrived in Australia more than 10 years ago. Three of the sessions took place at
Vietnamese restaurants. The other three were conducted at participant’s homes.
The BCDW told participants he was involved in a government mental health project and invited them
to talk about mental health issues (‘to talk about strategies that would help Vietnamese people deal
with mental health problems’). All participants were previously known to the BCDW. The sessions
were conducted in a very informal manner while having lunch, dinner or a cup of tea. Like a ‘friends
talk’ as described by the BCDW.
Mental health was defined by participants as ‘feeling happy’, ‘living a normal life’, ‘learning from hard
past experiences and being strong to cope with everyday life’, ‘the capacity of individuals to react with
the environment’, ‘achieving what you want’, ‘having normal mental abilities’, ‘intelligence’, ‘being
stable’, ‘when body and mind work in harmony’, ‘when the nervous system runs well’.
In the Vietnamese culture, there are two terms that relate to mental health:
TÂM THAN (‘heart & brain’) is used in a more medical context. It means to “create ideas to keep your
wellbeing”, “emotion and intelligence together”. Most people relate this term to mental illness.
TINH THAN (‘spirit & brain’) is used in a more religious or spiritual context to describe ‘something
invisible, an energy, a superior intelligence’ that helps to cope with life. People consider this term as
less threatening.
Mental problems were described as: ‘fatigue’, ‘not wellbeing’, ‘troubled brain that creates problems’,
‘being mentally unstable’, ‘when the nervous system does not run well’, ‘stress’, ‘depression’, ‘being
bored’, ‘feeling tired’, ‘doing something funny without thinking’, ‘worrying too much’, ‘not a happy life’,
‘consequence of the loss of balance in life’. For most participants, mental health problems are not
severe, do not affect life seriously and can be kept under control by taking medication, etc.
Mental illness, on the other hand, was perceived as ‘being crazy’, ‘hearing voices’, ‘strange
behaviours’, ‘mentally unstable’, ‘chaotic’, ‘when body and brain don’t work together’, ‘when something
is wrong with the whole system’. For many, mental illness forces people to go to hospital because ‘it’s
out of control’. Only a few participants saw mental health as ‘punishment from wrong doings’ either in
this life or in past lives, or as a punishment for what the ancestors did. When people believe that they
are possessed by the devil, they go to the ‘palm reader’, ‘who knows how to fix the problem’. Similarly,
some people attribute ‘hearing voices’ to ‘paranormal powers’ or ‘a sixth sense’; for others, hearing
voices definitely means ‘being crazy’.

Report Stage One
People with mental problems or mental illness and their families feel ashamed and try to hide the
problem and keep it within the family. When they look for help, they ask close friends, traditional
healers, palm readers, religious leaders, teachers or ‘academic people’.
Members of the Vietnamese community identified a variety of problems and needs: distress caused by
‘worrying too much about money and material things’, ‘thinking too much’, ‘doing many things at the
same time’; family conflicts (between husband and wife and between parents and children) are
exacerbated by the cultural clash. As some of the participants mentioned ‘men want to keep power,
women want to have more power’, ‘parents want children to work harder at school’, ‘older people lose
status’. The conflict between parents and children seems to be exacerbated by differences in the
education system: ‘in Vietnam kids are asked to study and work hard because the whole family will
feel proud and will improve the social status’, but in Australia the system works ‘enjoy first and study
only if you want’. Domestic violence, gambling and drug abuse (especially among youth) were
perceived as prevalent within the community.
The feelings of isolation and low self-esteem, which are exacerbated by the lack of English-language
skills (especially amongst older people), and the need to accept reality (‘if you don’t have more money
just accept it’) and adapt to this society were also identified. According to the participants, racism and
discrimination are common in society, ‘but people prefer not to talk about it’, ‘it’s part of life and we
have to face it’, ‘people are afraid of government and police, we don’t trust them’. Lack of information
about mental health issues and lack of appropriate peer support to cope with difficulties of life were
also mentioned.
In order to address the community needs, several strategies were formulated: increasing the number
of community groups where people can have the opportunity to meet and talk to others, travel, learn
new things, attend religious activities, etc.; having people from the community trained to help them
improve their wellbeing and ‘live in harmony’ (participants mentioned difficulties using interpreters
when consulting health services); involving community leaders in the promotion of mental health; using
other alternatives for stress control, such as Tai-Chi, meditation, prayer and herbs; studying and
researching to help solve social problems and people’s needs; programs to improve parent-children
relationships; promoting mental health through newspapers, radio, shops, posters, seminars, etc.
• Feedback
Participants talked freely about mental health issues. They appreciated the opportunity to give their
personal opinions and found the sessions helpful.
The BCDW felt good talking to people from his community about these issues. The duration and
informal character of the sessions were perceived as positive. He believes the project will help his
community.
Three main issues were perceived as difficulties by the BCDW: Firstly, it was not possible to meet and
obtain information from a greater number of people (competition with other organisations, which pay
for members participation in projects, was a possible cause). Secondly, it was difficult for some
participants to understand the term ‘mental health’ as it is used in western societies. Thirdly, the
BCDW found that the time to conduct the meetings (2 hours) was too long for busy people; the time
allocated to prepare a good meeting report (one hour), on the contrary, was not enough.

Report Stage One
TEMPORARY PROTECTION VISA HOLDERS COMMUNITY
The Temporary Protection Visa (TPV) holders’ community represents mainly Arabic, Farsi and Dari
speakers, but they were considered as a separate community because of the particular conditions and
needs related to the uncertainty of their status and lack of entitlements in the Australian community.
Even though the project aimed to involve people with TPVs, in the discussion of mental health issues
concerning their community, a number of barriers relating to members of the community being
overwhelmed with a range of settlement issues and the uncertainty of their visa status, made it difficult
to engage members of the community in the project. In addition, as a mental health project focusing
specifically on the needs of refugees on temporary protection visa holders commenced around the
same time as this project, it was decided to redirect the focus of the project with this community to
respond to more pressing issues faced by the community.
Leaders and members of this community had previously expressed their wish to have a place where
they can meet and carry out social and recreational activities. This issue seems to be perceived as a
very significant need by people on TPVs. Attempts to find a venue for this purpose are ongoing and
have been incorporated into the mental health project for refugees on TPVs.

Report Stage One
SUMMARY OF KEY ISSUES IDENTIFIED BY COMMUNITY
Issues Affecting Mental Health Community Identifying Issue
Denial of problem because stigma Arabic-speaking, Farsi-speaking, Filipino,

Samoan, Vietnamese
Lack of trust towards mental health Arabic-speaking, Bosnian, Vietnamese
services and government
Lack of knowledge about mental health Filipino, Samoan, Spanish-speaking, Vietnamese
issues/services
Difficulty understanding western notion of Bosnian, Samoan, Vietnamese
“mental health”
Misdiagnosis Filipino
Homesickness Arabic-speaking, Farsi-speaking
Loneliness Arabic-speaking, Bosnian, Vietnamese
Drug abuse Farsi-speaking, Filipino, Vietnamese
Domestic Violence Filipino, Vietnamese
Gambling Vietnamese
Torture/trauma Bosnian
Family Problems Arabic-speaking, Farsi-speaking, Filipino,
Vietnamese
Intergenerational Conflict Arabic-speaking, Farsi-speaking, Filipino,
Vietnamese
Gender role conflict Arabic-speaking, Filipino, Vietnamese
High educational expectations for youth Farsi-speaking, Vietnamese
Communication/Language Barriers Arabic-speaking, Bosnian, Farsi-speaking,
Samoan, Vietnamese
Social Isolation Arabic-speaking, Bosnian, Farsi-speaking,
Filipino, Samoan, Vietnamese
Discrimination/racism Arabic-speaking, Bosnian, Farsi-speaking,
Samoan, Spanish-speaking, Vietnamese
Unmet Expectations Arabic-speaking
Inability to adjust to Australian culture Arabic-speaking, Bosnian, Farsi-speaking,
Filipino, Samoan, Vietnamese
Unemployment/Financial Difficulties Arabic-speaking, Filipino, Samoan, Spanish-
speaking, Vietnamese
Loss of status after migration Farsi-speaking, Vietnamese
Uncertainty of future residency status Arabic-speaking, Filipino

Report Stage One
Suggestions to Improve Mental Health Community Identifying Issue

in Community
Employment of multicultural mental health Arabic-speaking, Bosnian, Filipino, Samoan,

workers Spanish-speaking, Vietnamese
Train community leaders and service Arabic-speaking, Bosnian, Filipino, Samoan,
providers about mental illness and cultural Spanish-speaking, Vietnamese
diversity
Outdoor activities programs/recreation Arabic-speaking, Bosnian
center
Community social clubs/socializing Arabic-speaking, Bosnian, Vietnamese
opportunities
Community-building programs Arabic-speaking, Bosnian, Filipino, Samoan,
Spanish-speaking, Vietnamese
Personal development programs Spanish-speaking
Improved referral system Arabic-speaking
Community counseling services Arabic-speaking, Bosnian, Farsi-speaking, Filipino,
Spanish-speaking, Vietnamese
Rename services to reduce stigma Arabic-speaking
Family reunion/relationship building Arabic-speaking, Bosnian, Farsi-speaking, Filipino,
programs Samoan, Spanish-speaking, Vietnamese
Financial assistance/greater entitlements Arabic-speaking
Info sessions about Australia and Arabic-speaking, Bosnian
Australian culture
More comprehensive English language Arabic-speaking, Farsi-speaking
programs/ tutorial assistance
Community education/promotion about Arabic-speaking, Bosnian, Filipino, Samoan
cultural diversity and mental health Spanish-speaking, Vietnamese
(engage media)
Mental health information in appropriate Spanish-speaking
language
Alternative (non-medicinal) treatment Bosnian, Filipino, Samoan, Spanish-speaking,
options for mental illness Vietnamese
Community participation in mental health Samoan, Spanish-speaking
education
Community-focused treatment Spanish-speaking
Government funding for mental health Filipino, Spanish-speaking, Vietnamese
services and research
Drug rehab programs Farsi-speaking, Filipino
Job placement assistance Arabic-speaking, Filipino
Services in rural areas Filipino

Report Stage One
PROJECT CONSULTATION AND INPUT PROCESSES
PROJECT REFERENCE GROUP
The Project Reference Group was established to act as a consulting forum aiming to overview the
progress of the project, facilitate cross-cultural community development work, effectively approach the
communities involved in the project, prevent potential difficulties and promote the project through
community networks. This section presents the process of establishing the group, the main issues
identified in the reference group meetings and the feedback given by the project coordinator.
• Process
Two meetings, at a two-month interval, were conducted during Stage One. Both took place at the
Multicultural Centre for Mental Health and Wellbeing.
A variety of multicultural and community-specific organisations, involving both CALD communities and
mental health consumer representatives, were contacted and invited to participate on the reference
group. The project coordinator visited some of these organisations and explained the project
objectives and the aims of the reference group in more detail. Some organisations expressed interest
in the project but could not attend the reference group meetings due to other commitments. Those
who agreed to attend were sent an invitation letter two weeks prior to the meeting and received the
minutes after each meeting.
The first meetings focused on the strengths, weaknesses, opportunities and threats of the project and
the second meeting, the process, rather than the outcomes, was the main subject of discussion.
• Main issues identified
∗ Meeting one (22 August 2002)
At the first reference group meeting, several strengths and opportunities were identified by
participants. Particular emphasis was put on the crucial role of the BCDWs as members of their
communities and the significance of their personal experiences of migration. Similarly, the theoretical
framework of community participation and empowerment, community development and reciprocity in
education approach, the experiences learned from previous projects and the opportunity of facilitating
a constructive dialogue between CALD communities and mental health services, were also mentioned.
On the other hand, the BCDW’s comfort level with community participation and development, the
danger of not perceiving the project as a team effort (and not eight mini-projects), the sessional basis
of their contract (100 hours in stage one), the unclear future funding of the project, the lack of trust of
communities in relation to previous experiences and projects, and the lack of consumer involvement,
at least at this stage of the project, were identified as potential weaknesses and threats.
∗ Meeting two (24 October 2002)
The second reference group meeting was conducted after 26 community meetings had taken place.
The discussion focused more on the process rather than the outcome. Some of the issues identified
were: the need to increase the expertise of BCDWs on community development and participation
rather than just provision of information; the clarification of their role as BCDWs and the use of
strategies to cope with the workload; the crucial role that the family unit has in CALD communities
should be taken into account for the next stages of the project; the significance of achieving a balance
between the project aims and the diversity of the participating communities; mental health services
should be involved and aware of the findings and outcomes of the project; and the opportunity of the
project to develop an expertise on the spiritual dimension of mental health.
PROJECT ADVISORY GROUP
A National Advisory Group (NAG) was established aimed at obtaining expert advice and input from
individual stakeholders working nationally and/or internationally in the areas of consumer and
community participation in mental health.

Report Stage One
Members of the Advisory Group participated in a teleconference conducted on the 2 October, 2002
and facilitated by the QTMHC Education and Development Coordinator. Some of the issues discussed
during the teleconference were: increasing consumer participation in future stages of the project;
considering remuneration to community members as a strategy to increase meeting participation (this
strategy is being implemented by other organisations); the significance of recording all information
concerning the project developments; and the need to involve other mental health services in the
project.
A major issue discussed by the NAG centred on the cross-cultural appropriateness of community
development processes such as focus groups, workshops, etc. It was agreed that ‘one singular
approach’ could not be applied across all participating communities. This is an important issue as it
underpins the training provided to community development workers, the processes they use to provide
and receive information, and the expectations placed on workers by both their communities and the
project management team. While it is important that workers are provided with consistent
standardised training, it is critical in this project that workers are empowered to utilise processes that
are appropriate to their community. The NAG validated the flexible approach being taken in the
project and the positive evaluations received from the various participating communities.
The NAG urged that attention be paid to the reporting of all components of the project, pointing out
that the value of the project to the wider community lies in the process of recording and reporting. This
advice has been taken on board and all efforts have been made to present the details in this report
The issue of sustainability of the project into an ongoing program whereby groups were empowered to
continue operating in their own way was raised by the NAG. It was suggested that partnerships be
developed with a broad range of service providers, government and non-government agencies and
participating community leaders. This will be addressed in Stages 2 and 3 of the project.
The NAG suggested that attention be given to developing ‘a product’; something that can be given
back to the participating communities. For example, it was suggested that participating communities
would value an easy-to-read guide on the mental health system in their own language, designed and
written by individual communities with service input. This advice will be considered by the project
management group, particularly in relation to Stage 3 of the project.
The Advisory Group endorsed the principles and processes underpinning the project and there was
agreement that it was on track in its aims to ultimately develop culturally appropriate consumer
participation mechanisms. The Advisory Group will continue to provide advice to the project as we
enter into Stage 2 of this project.

Report Stage One
DISCUSSION
This report of stage one of the Multicultural Community Development in Mental Health Project has
presented an overview of the project background, conceptual framework and structure, the project
management organisation and the processes and outcomes achieved during stage one. Among other
activities, training of the project bilingual workforce, development of project tools, 42 community
sessions representing seven of the participating CALD communities and involving 299 community
members, two reference group meetings and one teleconference involving members of the advisory
group took place during this stage.
The project places the mental health ‘consumer’ concept within the population-based approach,
targeting the whole community and not only those who have experienced the traditional mental health
system. The findings of stage one certainly confirm the relevance of this approach when working with
CALD communities.
The project recognises and values the diversity of the participating CALD communities and
simultaneously aims to maintain consistency of approaches within the community development
principles. The diversity of these communities has been reflected throughout, both processes and
findings of, stage one. The BCDWs planned and implemented a variety of strategies to promote
attendance and participation of members from their own communities in the community sessions.
These strategies were based on the knowledge and previous experiences that the BCDWs had
working with their communities.
Certainly, some of these strategies were more successful than others, and the attendance at the
community sessions varied across communities. Similarly, the venues used for the sessions and the
activities undertaken during these differed. Whereas some of the sessions were conducted in a more
formal structured way (i.e. focus groups or workshops in community venues), most communities
preferred to have the sessions at friend’s houses in a very informal manner. This diversity in processes
should be considered and encouraged throughout all stages of the project.
Even though each community identified particular problems and needs and formulated specific
strategies to overcome them (see previous section on community sessions) which should be taken into
account for the planning and implementation of future stages, some commonalities appeared. The
migration experience emerged across all communities as a significant factor that influences mental
health. At the individual level, feelings of isolation and homesickness, changes in gender roles after
migration, aging, low self-esteem and disruptions in professional development were frequently cited. At
the family level, participants across all communities expressed the lack of support from extended
family, the influence that changes in gender roles have on family relationships, and intergenerational
difficulties due to cultural clashes. At the social level, inadequate English-language skills and
consequently the lack of integration with the wider Australian community were commonly reported,
along with unemployment, unrecognized skills, loss of status after migration, discrimination and
racism, financial difficulties, lack of trust of mental health services (e.g. lack of cultural
inappropriateness), lack of alternative interventions and traditional healing practices to cope with
mental health problems and mental illness, and the lack of information on mental health issues and
services.
Likewise, similarities appeared in relation to the strategies given by the communities to overcome the
problems and needs identified. At the community level, all communities identified respected
community leaders as a crucial resource when dealing with mental health issues. In this context, all
communities but one mentioned spiritual and religious leaders. Education strategies such as mental
health awareness programs in workplaces, programs to strengthen couple and family relationships,
and promotion of changes in lifestyle through relaxation, physical activities, multicultural outdoor
activities and social clubs were also mentioned, along with support groups and the promotion of
cultural identity.
At the mental health service level, the availability of bicultural/bilingual workers, including doctors,
nurses, counsellors and community development workers among others within mental health services
was strongly supported by all communities. Most communities expressed the difficulties faced using
interpreters when accessing mental health services. Other strategies mentioned at this level included
promoting multicultural awareness among mental health workers, improving referrals to mental health
services and including mental health programs and services within other organizations working with
recently arrived migrants.

Report Stage One
At the government level, most communities agreed that reforming the overseas-acquired skills
recognition process, improving employment networks and extending English-language programs for
new migrants, may positively influence the mental health status of CALD communities.
At the media level, campaigning for a more open Australian society to reduce discrimination and
racism, promoting media awareness of CALD communities’ most sensitive issues and involving media
in dissemination of mental health issues were pointed out.
These findings only reflect the opinion of those community members who participated in the sessions.
Although efforts were made by the project team to involve participants from a wide range of religious,
social and educational backgrounds, this aim could not be entirely accomplished in all participating
communities.
Equally relevant to the progression of the project, was the process in which the bilingual workforce
engaged during stage one not only with the project but also their communities as they put their time,
effort and enthusiasm towards the issues the project was trying to address. Their recruitment and
selection, their training and active participation on the team’s conceptualisation of mental health, the
preliminary SWOT analysis of the project and the development of project tools, and their planning,
implementation and reporting of the community sessions were also valuable outcomes of stage one.
In this learning process, future stages of the project should continue to enhance the expertise of the
bilingual workforce in the conceptualisation and practice of community and consumer participation,
community development, the concept of expert communities and the reciprocity in education
approach. Vital to the project aims, is the shift from a ‘banking education’ to a process of
‘conscientization, action and reflection’, and the development of a ‘dialogical education’ (Freire, 1994).
Emphasis should also be placed on the team work approach ‘of the project where all personnel
involved learnt from each other, and the sharing of personal and professional experiences contributed
to the team’s growth.
This report aims to be a discussion document for the planning and implementation of future stages of
the project. Primarily, it belongs to the communities, which have provided their thoughts and expertise
in relation to mental health issues. Within the principles of community participation and community
development, any decision-making process based on this report should include the communities and
the personnel involved in the project. Both, processes and outcomes of stage one are equally
important for the future of the project. The information contained here aims to stimulate reflection,
generate ideas and strengthen the development and participation of culturally and linguistically diverse
communities.
This report was prepared by

Ignacio Correa-Velez
Project Coordinator – Stage One
(for the project team)

Report Stage One
FUTURE DIRECTIONS
Since completing stage one of the project and writing this report, the Queensland Transcultural Mental
Health Centre and the Centre for Multicultural Mental Health and Wellbeing have been successful in
obtaining funding from the Mental Health Unit, Queensland Health, to implement stages two and three of
the project.
In addition, the project has with financial support from Multicultural Affairs Queensland, incorporated two
additional communities into stage one of the project. Following the commencement of the stage one, the
project was approached by organisations working with the Horn of Africa communities in relation to mental
health concerns in those communities. It was decided to incorporate the Somali and Sudanese
communities into the project and with financial assistance from Multicultural Affairs Queensland this has
been possible.
In May 2003 Queensland Health endorsed an action plan called “Towards Consumer Centred Services –
Queensland Health Action Plan for Consumer and Carer Participation in Queensland Mental Health
Services” to guide further developments in consumer and carer participation.
The action plan acknowledges the specific considerations that need to be given to consumers and carers
from culturally and linguistically diverse backgrounds and provides mental health services with a number
of strategies for consideration.
The Multicultural Community Development in Mental Health Project is looking forward to commencing
stage two which will focus on increasing mental health literacy in ethnic communities and stage three
where it will pro-actively engage with mental health services to facilitate linkages between the project and
consumer and carer participation mechanisms in mental health services.

Report Stage One
REFERENCES
Amirghiasvand M, Eaton A, Engleheardt R, Moutakis A, Procter N. (2001). Uncovering Cultural
Healing: Interactive Learning Between Migrant Communities and Mainstream Mental Health.
Adelaide, The Migrant Health Service.
Australian Bureau of Statistics (1998). 1997 National Survey of Mental Health and Wellbeing: Adult
component. Canberra, ABS.
Commonwealth Department of Health and Aged Care (2002).Evaluation of the Second National
Mental Health Plan. Commonwealth of Australia:Canberra.
Commonwealth Department of Health and Aged Care (2000). National Action Plan for Promotion,
Prevention and Early Intervention for Mental Health 2000. Canberra, Mental Health and
Special Programs Branch, Commonwealth Department of Health and Aged Care.
Commonwealth Department of Health and Aged Care (2000). Promotion, Prevention and Early
Intervention for Mental Health - A Monograph. Canberra, Mental Health and Special Programs
Branch, Department of Health and Aged Care.
Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare
(1999). National Health Priority Areas - Mental Health 1998. Canberra, HEALTH and AIHW.
Commonwealth Department of Health and Aged Care and Australian Institute of Health and Welfare
(1999). National Health Priority Areas Report: Mental health 1998, A report focusing on
depression - Summary. Canberra, HEALTH and AIHW.
Ferguson B, Browne E. (1991). Health Care and Immigrants: A Guide for the Helping Professions.
Sydney, McLennan & Petty.
Freire P. (1994). Pedagogy of Hope: Reliving 'Pedagogy of the Oppressed'. New York, Continuum.
Groom, G. & Hickey, I. (2003). Out of Hospital, Out of Mind: A Review of Mental Health Services in
Australia - 2003. Mental Health Council of Australia: Canberra.
Hawe P, Degeling D, Hall J. (1990). Evaluating Health Promotion. A Workers' Guide. Sydney,
McLennan & Petty.
Health Education Authority (1998). Community Action for Mental Health. London, Health Education
Authority.
Mihalopolous C, Pirkis C, Naccarella L, Dunt D (1999) The role of General Practitioners and other
Primary Care Agencies in Transcultural Mental Health Care, ATMHN, Vic
Minas H, (2001) Service responses to cultural diversity in Thornicroft G and Szmukler G, Textbook of
Community Psychiatry, Oxford University Press
Nelson G, Lord J, Ochocka J. (2001). “Empowerment and Mental Health in Community: Narratives of
Psychiatric Consumer/Survivors.” Journal of Community & Applied Social Psychology 11: 125-
142.
Nelson G, Lord J, Ochocka J. (2001). Shifting the Paradigm in Community Mental Health: Towards
Empowerment and Community. Toronto, University of Toronto Press.
Queensland Health (1995). Mental Health Services in Queensland 1995 - Non-English Speaking
Background Queensland Mental Health Policy Statement. Brisbane, Mental Health Branch,
Queensland Health.
Stacey K, Herron S. (2002). “Enacting policy in mental health promotion and consumer participation.”
Australian e-Journal for the Advancement of Mental Health 1(1): 1-17.

Report Stage One
Zalokar J. (1994). Psychological and Psychopathological Problems of Immigrants and Refugees.
Radovijica, Didakta.

Report Stage One
ATTACHMENTS

Multicultural Community Development
in Mental Health Project
An initiative of:
Multicultural Centre for Mental Health and Wellbeing Inc
The Queensland Transcultural Mental Health Centre (QTMHC) in

partnership with the Multicultural Centre for Mental Health and Well-being
Inc. (formerly Ethnic Mental Health Program) are developing an innovative
project to engage with selected culturally and linguistically diverse (CALD) communities on issues
concerning mental health and wellbeing. The Multicultural Community Development in Mental Health
Project is a long term three-stage project which aims to develop a best practice model for the active
participation of CALD communities in mental health services. In order to achieve this, the project
recognises the significance of obtaining a greater understanding of the relationship and impact of culture
on mental health from the perspective of different ethnic communities.
For the first stage of the project, currently underway, bilingual community development workers from eight
communities have been employed on a sessional basis to engage with members of their ethnic/cultural
communities through community meetings, liaison and networking.
The second stage of the project will aim to increase the community mental health literacy and will be
informed by the findings from stage one.
A project Reference Group overviews the progress of the project, and provides advice on strategies to
prevent and overcome possible difficulties, and on the role of community organisations and networks to
support the project. A Project Advisory Group has just been established.
For more information contact:
Mr Ignacio Correa-Vélez Ms Elvia Ramírez

Project Coordinator Project Manager
Multicultural Centre for Queensland Transcultural Mental Health Centre
Mental Health and Wellbeing Ph: (07) 3240 2833
Ph: (07) 3891 7911 Elvia_Ramirez@health.qld.gov.au
emhp@optusnet.com.au
September 25, 2002

WHERE CAN WE GET HELP?
MENTAL HEALTH
PROBLEMS
Psychiatrists
∗ SELF – FAMILY – FRIENDS – TRUSTED COMMUNITY
LEADERS – SUPPORT GROUPS Psychiatric Hospitals
Rehabilitation Programs
MENTAL HEALTH MENTAL ILLNESSES
SPECTRUM OF MENTAL WELL-BEING

When you first contact a service, you may need to provide complex information over the phone. It
is then beneficial for you and the service to get a telephone interpreter. Ring TIS 131 450 to get an
interpreter in your language. TIS will phone the service you want to contact. The service would
decide to accept and pay for the interpreter. A three-way telephone conversation will then take
place.
QUEENSLAND TRANSCULTURAL MENTAL HEALTH CENTRE

Princess Alexandra Hospital, Psychiatric Unit, Third Floor
Ipswich Rd, Woolloongabba, Qld 4102
Telephone: (07) 3240 2833 Freecall: 1800 188 189 (Outside Metropolitan)
MULTICULTURAL CENTRE FOR MENTAL HEALTH AND WELL-BEING

87 Juliette Street, Greenslopes Qld 4120
Telephone: (07) 3891 7911
ADULT COMMUNITY MENTAL HEALTH SERVICES

Aspley: 776 Zillmere Rd (07) 3263 0888
Beenleigh: 10-18 Mt Warren Blvd Mt Warren Park (07) 3290 9855
Coorparoo: 263 Old Cleveland Rd. Ph: (07) 3847 0900
Fortitude Valley: 162 Alfred St. Ph: (07) 3834 1605
Gold Coast: 60 High St. Southport Ph: (07) 5537 0655
Goodna: 81 Queen St. Ph: (07) 3818 0030
Inala: Wirraway Pde. Ph: (07) 3275 5355
Ipswich: Bell St Health Plaza. Ph: (07) 3817 2555 / 24 Hour Help Line: (07) 3817 2577)
Logan Central: Wembley Rd (corner Ewing Rd). Ph: (07) 3808 1281
West End: 175 Melbourne St. Ph: (07) 3846 9400
Wynnum: New Lindum Rd. Ph: (07) 3893 8404
CHILD & YOUTH COMMUNITY MENTAL HEALTH SERVICES

Aspley: 776 Zillmere Rd (07) 3263 0888
Beenleigh: 10-18 Mt Warren Blvd Mt Warren Park (07) 3290 9866
Fortitude Valley: 162 Alfred St. Ph: (07) 3834 1605
Gold Coast: 60 High St ☎ (07) 5537 0655
Goodna: 81 Queen St. Ph: (07) 3818 0030
Inala: Wirraway Pde. Ph: (07) 3275 5355
Ipswich: Bell St Health Plaza. Ph: (07) 3817 2360
Logan Central (Child): 39 Wembley Rd. Ph: (07) 3208 7599
Logan Central (Youth): 91 Wembley Rd Ph: (07) 3290 0500
South Brisbane: Aubigny Place, Mater Hospital complex Ph: (07) 3840 1640
Wynnum: Florence St. Ph: (07) 3396 1823
COUNSELLING SERVICES:
Gambling Help Services: Springwood Plaza Chambers,Dennis Road
Immigrant Women’s Support Service (domestic violence, sexual abuse): Ph: (07) 3846 3490
Inala Youth Care Community: 12 Sitella St Ph: (07) 3372 2655
Kinections: 5 Reid Street, Woolloongabba 4012 Ph: (07) 3435 4300
Logan City Multicultural Centre: 38 Blackwood Rd, Logan Central Ph: (07) 3808 4463
Peace Centre: 15 Church St, Goodna 4300 Ph: (07) 3818 2622
Queensland Program of Assistance to Survivors of Torture & Trauma (QPASTT):
118 Park Rd, Woolloongabba Ph: (07) 3391 6677
ZigZag Young Women’s Resource Centre: 575 Old Cleveland Rd, Camp Hill Ph: 3843 1823
An initiative of:
Participant’s Assessment Form
Date: ______________________ Community: ____________________________
Topic: __________________________________________________________________
We sincerely value your participation and would like to know your opinions about this meeting.
Please take a few minutes to answer the following questions:
Strongly Agree Neither Disagree Strongly
agree agree/nor disagree
disagree
1. The objectives and activities of the
meeting were clearly explained.
2. I had the opportunity to express my
own ideas, experiences, and/or
needs.
3. I felt comfortable expressing my
own ideas, experiences, and/or
needs.
4. I believe the meeting was
interesting and useful.
5. I would be interested in attending
future meetings similar to this one.
6. What did you like most from the meeting?

_______________________________________________________________________________
_______________________________________________________________________________
__________________________________________________________
7. If there were things you did not like from the meeting, please let us know them:
_______________________________________________________________________________
_______________________________________________________________________________
__________________________________________________________
8. Other comments
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
___________________________________________________
Thank you very much for your time and help.

An initiative of:
WORKSHOP REPORT FORM
Community: _____________________________________
Date: ____________ Time: _______ Place:_____________________
No. Participants: ________Female _________Male
COMMUNITY PERCEPTIONS ON MENTAL HEALTH, MENTAL HEALTH PROBLEMS, AND

MENTAL ILLNESS
OBJECTIVES:
1. To find out how people in the community:
a. See mental well-being, mental health problems, and mental illness

b. Prefer to see the mental health of their individuals, families, and community
improved
c. Prefer to see the mental health problems addressed
d. Prefer to see the mental illness addressed
2. To provide verbal and written information on mental well-being (on the mental health system
in Queensland or any other topic believed to be relevant at the time)
INVITATION STRATEGIES: I invited people to…

ACTIVITIES: During the workshop we…
HOW DID THE COMMUNITY DEFINE
a) MENTAL HEALTH,
b) MENTAL HEALTH PROBLEMS, AND
c) MENTAL ILLNESS?
WHAT WERE THE MAIN PROBLEMS AND NEEDS IDENTIFIED BY THE PARTICIPANTS?
WHAT WERE THE SUGGESTIONS GIVEN BY THE PARTICIPANTS TO ADDRESS THE MAIN
PROBLEMS AND NEEDS IDENTIFIED?
WHAT WAS THE FEEDBACK GIVEN BY THE PARTICIPANTS IN RELATION TO THE

WORKSHOP? (Evaluation forms)
STRENGTHS AND DIFFICULTIES DURING THE WORKSHOP (as perceived by facilitator)
FACILITATOR’S COMMENTS/OTHER ISSUES:
CONCLUSIONS:
_______________________________
Community Development Worker
‘Fale Fono’ or ‘Meeting House’: Samoan view of health
Samoan people experience sickness differently from ‘Palagi’ (white people). In general, Samoan
people have a holistic view of health. Therefore, mental health is not simply seen as a separate
component but as an integrated aspect in the matrix of a person’s physical, psychological and
spiritual wellbeing.
‘Fale Fono’ or ‘Meeting house’ represents:

• Roof: Samoan people’s culture or shelter for life.
• Culture: it is the philosophical drive and attitudes. It can also include belief systems
related to traditional methods of healing.
• Foundation: the nucleus and extended family constitute the fundamental basis for social
organisations in Samoan culture. The extended family is an important source of strength
for Samoan people. It supports the four posts of ‘Fale Fono’ which are:
o Physical: the biological wellbeing of the body which can be measured by
the absence of illness and pain.
o Spiritual: the sense of wellbeing in the context of a belief system that may
be based on Christianity, traditional spiritual beliefs, or a combination of
both.
o Mental or psychological: the non-physical aspects of one’s health.
o Other.
SUMMARY: Arabic-speaking community
The Multicultural Community Development in Mental Health Project is a three-stage project which is
aiming to develop a best practice model for the participation of culturally and linguistically
diverse (CALD) communities in the planning, implementation and evaluation of mental health
services and related activities. The project is a joint effort between the Queensland Transcultural
Mental Health Centre, the Multicultural Centre for Mental Health and Wellbeing and several CALD
communities.
In stage one of the project, six sessions involving 39 adult participants were conducted within the
Arabic-speaking community. Twenty-five were women and 14 were men. Both Islamic and
Christian religious backgrounds were represented. Three of the sessions took place at
participants’ homes, including one at a priest’s home. The other three were conducted in
community venues (i.e. neighbourhood centre, churches).
Issues such as homesickness, loneliness, lack of extended family support, the language barrier
which makes it hard to integrate with the wider community, unmet expectations in relation to life in
Australia, unemployment (due to skills not being recognized in Australia, language barrier, mature
age, discrimination in workplace), culture clash, intergenerational difficulties between parents and
children, discrimination and racism (which have increased after the September 11, 2001 events),
and the lack of trust towards mental health services were some of the problems and needs
commonly identified across the sessions. In general, when members of the Arabic-speaking
community have any emotional or personal problem they prefer to talk to their spiritual leader or
to other community leaders.
Several ideas were expressed by participants to address the main problems and needs identified:
improving both cultural awareness among mental health workers and the cultural assessment
approaches used by mental health services; establishing multicultural outdoor activities;
employing ‘multicultural or bilingual counsellors/mental health workers’ within the mental health
system; improving the ‘referral to services system’ for members of CALD communities; and
facilitating meetings among people with mental health problems and mental illness to talk about
their experiences within the mental health system.
This document, which has included both processes and findings of stage one, primarily belongs
to the communities which have provided their thoughts and expertise in relation to mental health
issues. Any decision-making process based on this report will include the communities and the
personnel involved in the project. The information contained here aims to stimulate reflection,
generate ideas and strengthen the development and participation of culturally and linguistically
diverse communities.
SUMMARY: Bosnian community
communities.
In stage one of the project, six sessions involving 36 participants (18 women and 18 men) from
the Bosnian community took place. Members from both Muslim and Christian backgrounds
participated. People with low and high levels of English-language proficiency were represented.
The six sessions were conducted at participants’ homes.
The main problems and needs identified were: insufficient English-language skills, isolation and
loneliness, lack of opportunities to socialize with other people from the community, improving
understanding within the family, inability to adjust to Australian life, not being accepted by the
general community because of their different culture. Participants complained about the lack of
culturally appropriate health services in general (the issue of language and the difficulty of having
interpreters during their contact with health professionals was a common concern). Another issue
was the common practice of prescribing only medication for mental health problems and not
providing additional counselling or psychotherapy.
Among the suggestions given by participants to address their needs were: organizing and
bringing together diverse groups of the community; establishing a Bosnian centre or club which
may offer information, education, recreation, counselling services for the Bosnian community;
employing professionals from the former Yugoslavia with expertise in health in general, and
mental health in particular, within schools, counselling services and other settings to support the
Bosnian community; outdoor activities; helping community members adapt to and understand the
Australian culture; campaigning for a more open Australian society where people from other
backgrounds are appreciated, respected and not perceived as strangers.
SUMMARY: Farsi-speaking community
communities.
In stage one of the project, six community sessions involving 44 members of the Farsi-speaking
community were conducted (21 women and 23 men). Fourteen of those participants were aged
21 or younger. One of the sessions was specifically planned for youths. Members from both
Islamic and Bahai' religious backgrounds attended the sessions. Three TPV holders participated
in one of the sessions. Four meetings were held at participants’ homes. The other two were
conducted at community centres.
Common problems and needs identified by the community were: embarrassment and fear of
exposing their problems to other members of the community; intergenerational difficulties due to
the clash of cultures; isolation; no extended family support; homesickness; insufficient English-
language skills; difficulties integrating into the wider society; loss of status after migration;
discrimination (which has increased after the September 11 events); and drug abuse (especially
among young people). Youths expressed the need to receive more support at school to achieve a
higher ‘OP’ because of the language barrier (this also applies at the university level). When facing
personal, family or emotional problems, members of the Farsi-speaking community recur to
prayer, meditation, spiritual leaders or medical practitioners from their own community.
Participants suggested some strategies to address their needs: having someone they trust from
the community or mental health services who can visit them in their homes ‘just to talk’, ‘feeling
that somebody cares’; mental health workers able to visit people with drug and alcohol problems
and psychiatric disabilities. Some youths mentioned the importance of improving communication
with parents to tackle intergenerational difficulties and more tutorial assistance to cope with
school and university.
SUMMARY: Filipino community
communities.
In stage one of the project, six sessions involving 40 members of the Filipino community were
conducted. Fourteen were men and 26 were women. Nine participants were 21 years old or
younger. In one of the sessions, most participants were women who came to marry Australian
men. Different Christian religious groups were represented. Three sessions took place at
participants’ homes, one at a community centre (church), one at the BCDW’s workplace and the
other one at a park.
Some common problems and needs identified by participants were: denial of mental health
problems because of the stigma attached; lack of knowledge about mental health issues and
services; lack of more effective strategies to deal with mental health problems; family conflicts
and intergenerational difficulties; and lack of integration with the wider community. In the case of
women who are married to Australian men, ‘they avoid talking about their problems (e.g.
domestic violence) or going to mental health services for fear that they will be labeled as mentally
ill or crazy, and this will jeopardize their permanent residence status or Australian citizenship’.
This causes a feeling of ‘hopelessness and resignation’.
In order to address the needs identified, several suggestions were given: increasing information
about what mental health services provide; employing Filipino community workers in the mental
health system; making changes in lifestyle; counselling services for youth; family workshops to
address family issues; extending services to rural areas where the incidence of suicide is higher;
more research on mental health; more government funding; alternative approaches, not only
drugs, to address mental illness. Participants considered that the Filipino community initially
seeks help within the community, they rely on priests or other religious leaders and therefore,
these leaders should have proper training to deal with mental health issues.
to the communities which provided their thoughts and expertise in relation to mental health
SUMMARY: Samoan community
communities.
During stage one of the project, 44 participants (31 of them women) from the Samoan community
attended six community sessions. Different religious denominations were represented. Two
sessions took place at the BCDW’s house and the others at community venues.
Participants identified some issues: the holistic view of health in the Samoan culture makes it
difficult for most Samoans to understand the way mental health problems and illnesses are
treated in the western culture (people prefer to use traditional healing practices rather that attend
mental health services; services do not involve families of people with mental illness); stigma
attached to mental illness; family’s denial in recognizing the problem and the fear of talking about
it openly. Some participants expressed the need to conceive mental illness like any other illness
and not like a punishment or a possession by spirits. The stressors involved in the migration
experience (e.g. the feeling of isolation and the lack of support of the extended family and/or
friends, the new culture, economic stressors, racism and discrimination, etc).
Several suggestions were given to address the needs and problems identified: promotion of
mental health within the community (community leaders, churches, community organisations);
increasing community participation in educational activities related to mental health and
acknowledging the community’s beliefs and practices; training of mental health workers from the
Samoan community to work in mental health services; encouraging family and community
involvement in the planning, implementation and review of the care program; cultural advocacy
through community networks, church groups and probably the establishment of a National
Advisory Council in Mental Health for Pacific Islanders aiming to increase the understanding of
the Samoan culture within the Australian community, reduce discrimination and improve mental
health services.
SUMMARY: Spanish-speaking community
communities.
In stage one of the project, six sessions involving 79 participants from the Spanish-speaking
community took place. The majority (60 participants) were women. One session was conducted
with teenagers, the other with mental health consumers and another with human services
workers from the Latin-American community. All sessions took place at community venues.
The following were the main problems and needs identified during the sessions: lack of
information and/or culturally appropriate services concerning mental health issues; discrimination
and lack of respect for immigrants and their culture; lack of adequate employment in accordance
with previous skills, and the recognition that barriers to employment and education affect
emotional wellbeing; the need for more community participation and development programs.
Mental health consumers specifically mentioned the need for support from family, friends and
workmates, more culturally adequate support groups and centres with staff from their own culture
and language and the need to be actively involved with community activities.
Several ideas were suggested by participants to address these needs: programs supporting the
family and providing information about family issues; more holistic and culturally appropriate
mental health treatments, services and support groups (own language); counsellors and other
health professionals from own culture (changes in process of skills recognitions for migrants);
promoting mental health awareness; promoting respect for immigrants and people from other
races and cultures, promoting cultural identity and pride, researching and implementing other
alternatives to treat mental health problems and mental illness (e.g. yoga, meditation, exercise,
dancing - not only medication), promotion of community models rather than institutional models to
treat mentally ill people.
SUMMARY: Vietnamese community
Mental Health Centre, the Multicultural Centre for Mental Health and Wellbeing, and several CALD
communities.
During stage one of the project, six sessions involving 17 adult participants from the Vietnamese
community were conducted; 12 of the participants were men. The vast majority arrived in Australia
more than 10 years ago. Three of the sessions took place at Vietnamese restaurants. The other
three were conducted at participants’ homes.
Members of the Vietnamese community identified a variety of problems and needs: distress caused
by ‘worrying too much about money and material things’; family conflicts (between husband and wife,
and between parents and children) which are exacerbated by the cultural clash; domestic violence,
gambling, and drug abuse (especially among youth); feelings of isolation and low self-esteem, which
were exacerbated by insufficient English-language skills (especially amongst older people).
According to the participants, racism and discrimination are common in society, ‘but people prefer not
to talk about it’, ‘it’s part of life and we have to face it’. Lack of information about mental health issues
and lack of appropriate peer support to cope with difficulties of life were also mentioned.
In order to address the community needs, several strategies were formulated: increasing the number
of community groups where people can have the opportunity to meet and talk to others, travel, learn
new things, attend religious activities, etc.; having people from the community trained to help them to
improve their wellbeing and ‘live in harmony’ (participants mentioned difficulties using interpreters
when consulting health services); involving community and religious leaders in the promotion of
mental health; using other alternatives for stress control, such as tai-chi, meditation, prayer and
herbs; studying and researching to help solve social problems and people’s needs; programs to
improve parent-children relationships; promoting mental health through newspapers, radio, shops,
posters, seminars, etc.
This document, which has included both processes and findings of stage one, primarily belongs to
the communities, which provided their thoughts and expertise in relation to mental health issues. Any
decision-making process based on this report will include the communities and the personnel
involved in the project. The information contained here aims to stimulate reflection, generate ideas
and strengthen the development and participation of culturally and linguistically diverse communities.
TRANSLATED PROJECT SUMMARIES
Bosnian
REZIME IZVJESTAJA: Bosanska zajednica
Projekat Multikulturalni razvoj zajednice I mentalnog zdravlja sastoji se od tri

stadija. Cilj ovog projekta je da razvije najbolji prakticni nacin kojim bi
omogucili kulturoloski I jezicki razlicitim etnickim zajednicama da ucestvuju u
planiranju, izvrsenju I procjenjivanju aktivnosti servisa za mentalno zdravlje I
svih drugih aktivnosti koje su vezane za te servise. Ovaj projekat je nastao
kao zajednicki napor Queensland Transkulturalnog centra za mentalno
zdravlje I Multikulturalnog centra za dobrobit I nekoliko etnickih zajednica
razlicitog kulturoloskog I jezickog porijekla.
U prvom stadiju ovog projekta odrzano je sest sastanaka sa 36 gradjana koji

su rodjeni u Bosni I Hercegovini (od toga 18 zena I 18 muskaraca). Na
diskusijama su prisustvovali gradjani I muslimanske I krscanske religijske
pripadnosti ili tradicije. Ucesnici ovih diskusija posjeduju razlicito znanje
engleskog jezika, od slabijeg do dosta dobrog poznavanja jezika. Svih sest
sastanaka je odrzano u kucama ucesnika.
Na ovim sastancima, ucesnici iz Bosne I Hercegovine su identificirali svoje

osnovne probleme sa kojima se susrecu ovdje, kao I svoje osnovne potrebe
da bi se osjecali bolje I zadovoljnije. Potrebe I problemi su:
• nedovoljno znanje engleskog jezika, izolacija I usamljenost,
• nedostatak prilika I pogodnih mjesta gdje bi se mogli druziti I provoditi
vrijeme sa ljudima koji su takodje Bosanci I Hercegovci,
• nemogucnost da se prilagodi australijskoj kulturi I nacinu zivota,
• opste neprihvacanje od australijskog drustva jer poticemo iz kulture I
drustva koje je drugacije nego ovo.
Ucesnici rasprava su se zalili I na nedovoljan broj, kao I nezadovoljavajucu

uslugu zdravstvenih servisa uopste, ukljucujuci I servis za mentalno zdravlje.
Problem upotrebe stranog jezika, ili nedovoljnog znanja engleskog, kao I
prisustvo prevodioca su vrlo zabrinjavajuci u ovakvim osjetljivim situacijama.
Sljedeci problem je bio I to sto ovakvi servisi imaju zajednicku praksu da
prepisuju jedno lijekove u slucajevima ako neko ima probleme sa mentalnim
zdravljem, a da ne koriste nikakvu vrstu razgovora, savjetovanja ili
psihoterapije kao lijek.
Ucesnici diskusija dali su I svoje prijedloge kako da se rijese I ostvare njihove

potrebe. Prijedlozi su:
• organiziranje druzenja ljudi iz razlicitih kultura,
• uspostavljanje jednog jedinstvenog Bosanskog centra ili kluba koji bi
gradjanima koji su porijeklom iz Bosne I Hercegovine omogucio da se
druze I relaksiraju, ponudio razlicite aktivnosti za rekreaciju, ali I pruzio
potrebne informacije za rjesavanje vaznih problema u Australiji, kao I
dodatno obrazovanje iz tema koje ih interesuju, kao I da im omoguci da
dobiju razlicite oblike psiholoskog savjetovanja I podrske.
Sljedeci nacin koji bi pomogao u razrjesivanju nekih problema I potreba je da
se profesionalci koji su porijeklom sa prostora bivse Jugoslavije a koji su
specijalizirani u zdravstvu uopste (doktori, medicinski radnici, medicinske
sestre itd), u oblasti ocuvanja mentalne stabilnosti I duhovnog zadovoljstva
(psiholozi, socijalni radnici itd) zaposljavaju u skole, servise za savjetovanje I
podrsku I na sva ostala mjesta odakle ljudi koji su porijeklom iz Bosne I
Hercegovine mogu trebati podrsku I pomoc.
Dalji prijedlozi koji bi zadovoljili potrebe pripadnika BH zajednice su:

• organiziranje razlicitih interesantnih aktivnosti vani, u prirodi,
• pomoganje u prilagodjavanju I razumijevanju australijske kulture I
nacina zivota,
• vodjenje kampanja I javnih zahtjeva da australijsko drustvo postane
otvorenije I gostoljubivije za ljude koji poticu iz razlicitih zemalja I
kultura I da se ne smatraju strancima nego da budu cijenjeni I
postovani zbog toga sto donose vrijedne razlicitosti u ovo drustvo.
Ovaj dokument sadrzi informacije prikupljene u prvoj fazi ovog projekta I

pripada zapravo zajednicama koje su ponudile svoja dragocjena razmisljanja,
ideje I strucnost vezane za pojmove mentalnog zdravlja i stabilnosti. Sve
buduce odluke vezane za ovaj izvjestaj prethodno ce traziti da zajednice I
angazovani na ovom projektu ucestvuju u donosenju odluka. Sve informacije
koje su ovdje sadrzane imaju za cilj da stimuliraju dalja razmisljanja,
prijedloge I ideje, kao I da jacaju I razvijaju dalje aktivno ucestvovanje
zajednica koje imaju razlicita kulturna I jezicka porijekla.
By Lejla Cisic
Filipino
PINAIKLING SAYSAY: KUMUNIDAD NG PILIPINO
Ang Kaayusan ng kumunidad ng nasasakop ang maraming kultura ng

proyekto ng kalusugan ng kaisipan ay kumakatawan ng tatlong bahagi.
Ang pakay nito ay upang isaayos ang pinaka magaling na pamamaraan
modelo para sa partisipasyon ng kumunidad ng marami at iba ibang kultura at
linguahe sa pagplano, pagsagawa at pagaralan ang serbisyo sa kalusugan ng
kaisipan at iba pang katumbas na gawain. Ang proyektong ito ay kapwang
pinagtutulungan ng Queensland Transcultural Mental Health Centre at ng
Multicultural Centre for Mental Health and Well-being at marami pang
kumunidad ng marami at ibaibang kultura at linguahe.
Sa unang bahagi ng proyekto, anim na pulong pulong ang naganap na

mayroon apat na pung sumali sa kumunidad ng pilipino. Labing apat ay lalaki,
dalampu’t anim ang babae. Walo ay nasa dalawang put isa ang gulang or
mas bata pa. Sa isang pagpupu long karamihan ay kababaihan na
nakapangasawa ng australianong lalaki. Maraming kristiyanong samahan ang
nakasali.
Tatlong pulong pulong ay naganap sa bahay ng nakasali sa pulong pulong,

isa ay sa sentrong kumunidad nang simbahan, isa ay sa opisina ng filipino
sumasagawa ng pulong na ito, ang iba ay sa palaruan.
Ang mga karaniwan problema at pangangailangan ng sumali ay:

• Ang pagtangi o di pag amin na sila ay mayroon problema sa kalusugan
ng kaisipan. Dahil ayaw nilang masabi ng ibang tao na sila ay nasiraan
ng bait;
• Kulang sa maraming mabisang pamamaraan upang isa ayos ang
problema sa kaisipan kalusugan;
• Suliranin sa pamilya at iba ibang munkahi ng iba ibang kabataan at
mga nakakatanda;
• Pagkukulang sa kaalaman ng buong samahan ng kalawakan pang
kumunidad.
Sa kaso ng mga babaing nakapangasawa ng australianong lalaki, iniiwasan

nila na pagusapan ang kanilang suliranin (gaya ng pagbubugbog) dahil dito
takot silang pumunta at humingi ng tulong sa serbisyo ng kalusugan ng
kaisipan at masabi na sila ay nasisiraan ng bait, ng dahil din dito takot sila na
baka maging sagabal sa kanilang nilalakad na papeles para maging
permanenteng naninirahan sa Australia, kailangan nila ito para maging
mamamayan ng Australia. Dahil dito nakakaramdam sila ng kawalan ng
pagasa at katuturan.
Para masagot ang mga pangangailangan na naipahiwatig, maraming bagay

ang naimunkahi: dagdagan yun kaalaman tungkol sa serbisyo naibibigay ng
kaisipang kalusugan gaya ng; pagpili ng isang pilipino na magtratrabaho sa
serbisyong ito, palitan ang pamaraan ng pamumuhay; magbigay ng
serbisyong pang kaisipan kalusugan sa mga kabataan, magkaroon ng pam
pamilyang pulong pulong para mapagusapan ang problema sa pamilya;
palawakin at ipalago ang serbiyo na ito sa malayong lugar na mayroon
maraming nagpapakamatay; mas marami pang pagsusuri at pagaaral sa
kaisipang panlusugan; mas marami pang tulong galing sa gobierno; at
maraming iba’t ibang pang pamamaraan, hindi lang ang paggamit ng droga
upang magamot ang sakit sa kaisipan.
Ang kumunidad ng pilipino ay kumihingi ng tulong sa kanilang kumunidad,

umaasa sila sa pari at iba pang pinuno ng ibang paniniwala kung kaya’t ang
mga pinunong ito ay dapat mabigyan ng tamang kaalaman sa pagtulong sa
mga problemang kaisipan.
Ang dukumentong ito na mayroon kasamang pagsagawa at kaalaman ng

unang bahagi, ay nang gagaling sa mga kumunidad na nagbigay ng kanilang
pagkaisipan at kaalaman ukol sa mga kalusugan sa kasipan. Kasali ang lahat
ng taong nagbigay ng kanilang munkahi sa anuman ang napagkayarian base
sa kasulatan ito. Ang inpormasyon nilalaman ay isinulat upang ma enganyong
mag isip ng paraan, mag karoon ng matatag na pagsayos at partisipasyon
ang mga maraning kultura at linguahing samahan sa kumunidad.
By Beth Guanzon
Samoan
OTOOTOGA O LE FA’ATALANOAINA MAI LE ATUNUU O SAMOA
O le Polokalame mo le fa’aleleia oSoifua Maloloina mo tagata o Atunuu ma

Gagana Eseese faapea tagata lautele, ua vaevaeina i ni vaega se tolu. O le
fa’amoemoe ina ia i ai se fa’ataotoga lelei ma se taiala mo i latou o le a
au ai i le nei Polokalame mo tagata e ese a latou Aganuu ma Gagana
Eseese, fa’apea foi se fuafuaga ma lona fa’atinoina fa’atasi ai ma lona
iloiloina o le tautuaga mo le Soifua Maloloina o le Mafaufau, ma isi
gaoioina e fa’atatau i lenei auaunaga. O lenei Polokalame, ua fa’afoeina i
lalo ose faiga fa’apaga a le faalapotopotoga a le Queensland Transcultural
Mental Health Centre ma le Multicultural Centre for Mental Health and Well-
being fa’atasi ai ma le Culturally and Linguistically Diverse (CALD).
I lona fa’atinoina o lenei polakalame o lona vaega muamua, e 44 le aofai o i

latou sa auai mai le Atunu’u o Samoa. O le 31 o i latou nei o Fafine. E 6
fa’atalanoaga sa faia. O i latou nei e afifio mai I Ekalesia esese a Samoa. E
lua fa’atalanoaga sa faia i le laoa ole Bilingual Community Development
Worker (BCDW), ma faatalanoaga sa fai lava i Laoa ma Maota o le Atunu’u.
Sa fuli ifo lalo i luga, fuli foi luga i lalo e le mamalu o le atunuu na auai, ma
iloga ai le faigata o nisi o mataupu na talanoaina. O le mamao o le silasila i
lona aofiaga atoa p’o se ata atoa i le silasila totoa a Samoa i le
Soifuamaloloina o le Mafaufau. O le silasila mamao a Samoa e aofia ai si ana
aganuu e pele i a teia. Sa maitauina ai le faigata ona malamalama i togafitiga
fa’apapalagi mo le togafitiga o Gasegase o le Mafaufau. Faimai le toatele, e
sili atu ona faamalieina I latou pe a faaaogaina faamalologa faasamoa i lo le
alu i le Falemai o le Mafaufau, talu ai ona o lea auaunaga e le o iai le tu ma le
agaifanua a Samoa ma le lagolago a le aiga a le o loo aafia i lea gasegase. E
i ai le talitonuga o Samoa i le mafuaaga ua maua ai i le mai o le mafaufau, e
faigata foi ona fa’ailoa i isi le faafitauli, e lagona foi le matamuli i fa’atalanoa
fa’alauaitele pe talanoa foi I ai. O se tasi o mau na tuuina mai e i latou sa auai
faimai e tatau ona silasila i le mai o le mafaufau e pei lava o isi fa’ amai ae le
o le tagai i ai e pei ose fa’asalaga poo se ua ulufia e le temonio. E talitonu nisi
fai mai, e mafua foi le mai ole mafaufau ina ua malaga ese mai le atunuu, ina
ua tuua aiga, uo ma le faalogolagomaga sa i le aiga lautele ma nuu. O le
feagai ai ma le aganuu e fou, o le falo e mea faatino i tupe, fa’atasi ai ma le
fa’ailoga lanu o tagata, ma isi lava mau mea.
O nai fautuaga nei sa tuuina mai ina ua maea ona faatalanoa ma

faamafolafola nisi o faafitauli. O nei fautuaga ina ia tuuina atu mo le lelei ma le
alualu i luma ma le talafeagai lelei ai ma tu ma aga i fanua a Samoa aua le
togafitia o le Soifuamaloloina o le Mafaufau. (E tatau ona aofia ai taitai, o
tagata me Aiga, o Ekalesia, ma Faalapotopotoga).
Ia faateleina le au ai o tagata Samoa i aoaoga ma sauniuniga e faaaoga mo
le Soifuamaloloina o le Mafaufau.
Ia faatagaina ma amanaiaina ia fofo ma le talitonuga faapea le faatuatuaga o
tagata Samoa.
Ia aoaoina ni tagata faigaluega I le agavaa e mafia ai ona galulue mo le
Soifuamaloloina o le Mafaufau.
Ia faatoatoa ma tauanau i na ia faateleina le agaga e galulue ai Samoa ma le
Soifuamaloloina o le Mafaufau.
Ia faatoata ma tauanau ina ia auai Aiga Samoa ina ia auai I le faataatiaga o
fuafuaga a le Soifua Maloloina o le Mafaufau.
Ia faatoatoa ma faalototeleina Samoa mo le faatinoina ma toe suesueina o
Polokalame mo le puipuiga o le Soifuamaloloina o le Mafaufau.
Ia taulamua Samoa I le unaina o polokalame fou ina ia aofia ai lana tu ma
lana aganuu mo se malamalamaaga o le Soifuamaloloina o le Mafaufau.
Ia silasila i Ekalesia uma a Samoa poo le tagai foi ile fausia Fonoaoao
Faufautua a tagata o Atumotu o le Pasefika mo le Soifuamaloloina ole
Mafaufau mo le faamoemoe ina ia faatuputeleina ai le malamalamaaga i tu
ma aganuu a Samoa i totonu o Ausitalia, ma ia tuu ititia ai le faailoga lanu, ma
faalelei atili ai le auaugana mo le Soifuamaloloina o le Mafaufau.
O lenei pepa o loo faailoa atu ai mataupu na maua mai le faatalanoaga

muamua ole vaega muamua, e patino lava i a Samoa. O Samoa lava e
againa lenei pepa na faaalia ai o latou tomai faapitoa i mafaufauga o aganuu
ma togafitiga o mai o le mafaufau. A fai e i ai se suiga poo se filifiliga e afua
mai i lenei pepa e tatau ona au ai Samoa ae maise i latou sa auai i faatinoina
o lenei polokalame. O faatalanoaga i mafaufau ma tomai atoatoa o Samoa o
loo taua i lenei pepa, na faia i le agagafaamaoni ma le faaitete, ma le
faamoemoe o le a avea ma faaosofia i agaga o tagata ma faatupu ai manatu,
ma le agaga autu ina ia faaolatotoga ma faamalosi au i uso uma mai i Atunuu
ma Gagana Eseese.
By Tusi Luafutu
Spanish-speaking
RESUMEN: Comunidad de habla Hispana
El Proyecto Multicultural para el Desarrollo de la Salud Mental es un proyecto

de tres etapas dirigido a desarrollar un modelo mas práctico para la
participación de las comunidades cultural y lingüísticamente diversas,
en la planificación, implementación y evaluación de los servicios de salud
mental y actividades relacionadas con los mismos. El proyecto es un
esfuerzo conjunto del Centro Transcultural para la Salud Mental y El Centro
Multicultural par la Salud Mental y el Bienestar, y varias comunidades cultural
y lingüísticamente diversas.
En la primera etapa del proyecto, seis sesiones que envolvieron 79

participantes de la comunidad de habla Hispana, se llevaron a cabo. La
mayoría (60 participantes) fueron mujeres. Una de las sesiones fue
conducida con jóvenes, otra con personas que utilizan los servicios de salud
mental, otra con trabajadores de servicios humanos en la comunidad de
habla Hispana, y el resto con otros grupos ya establecidos y la comunidad en
general. Todas las reuniones se llevaron a cabo en lugares comunitarios.
Los siguientes fueron los principales problemas y necesidades identificadas

durante las reuniones: falta de información y/o servicios culturalmente
apropiados con relación a asuntos de salud mental; discriminación y falta de
respeto para los inmigrantes y sus culturas; falta de empleo adecuado de
acuerdo a previas habilidades; falta de reconocimiento de como las barreras
para encontrar empleo y la educación afectan el bienestar emocional; la
necesidad de mas participación comunitaria y mas programas de desarrollo.
Las personas que utilizan los servicios de salud mental mencionaron
específicamente la necesidad de apoyo e información para la familia, amigos,
y compañeros de trabajo; más grupos de apoyo culturalmente adecuados y
centros de salud mental con personal de la misma cultura y lenguaje; y la
necesidad de estar envueltos en actividades comunitarias.
Muchas ideas para llenar esas necesidades fueron sugeridas por los
participantes: programas para apoyar a la familia y proveer información
acerca de asuntos familiares; mas tratamientos complementarios y
culturalmente apropiados para la salud mental; servicios y grupos de apoyo
en la propia lengua; consejeros y otros profesionales de salud de la propia
cultura; cambio en el proceso de reconocimiento de habilidades/estudios para
inmigrantes; promover el conocimiento de la salud mental; promover el
respeto para los inmigrantes, las personas de otras razas y culturas,;
promover la identidad y el orgullo cultural; investigar e implementar otras
alternativas para el tratamiento de los problemas de salud mental y las
enfermedades mentales ( ejemplos: yoga, meditación, ejercicio, bailes; no
solo medicamentos); promover mas modelos comunitarios que sean
alternativa para la institucionalización de las personas con enfermedades
mentales.
Este documento, el cual ha incluido tanto el proceso como los resultados de
la etapa uno del proyecto, primeramente pertenece a las comunidades las
cuales proporcionaron sus pensamientos, ideas y experiencias con relación a
asuntos de salud mental. Cualquier decisión que se tome basada en este
reporte incluirá a las comunidades y el personal envuelto en el proyecto. La
información contenida en este documento esta dirigida a estimular la
reflexión, generar ideas y reforzar el desarrollo y participación de las
comunidades cultural y lingüísticamente diversas.
By Ofelia Rivera

CDW Final Report s1

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MULTICULTURAL COMMUNITY

DEVELOPMENT IN MENTAL HEALTH PROJECT

STAGE ONE REPORT

Queensland Transcultural Mental Health Centre

Multicultural Centre for

The Multicultural Community Development in Mental Health Project involves

Queensland Transcultural Mental Health Centre

Multicultural Centre for Mental Health and Wellbeing Inc.

Multicultural Community Development in Mental Health Project 2

This report is the result of significant contributions from:

Multicultural Community Development in Mental Health Project 3

PROJECT PROCESSES AND FINDINGS 20

RECRUITMENT AND SELECTION PROCESS 20

Multicultural Community Development in Mental Health Project 4

o Participant’s assessment form

o Community Session Feedback Form

o A graphic on Samoan view of health

o Summary: Arabic-speaking community

o Summary: Bosnian community

o Summary: Farsi-speaking community

o Summary: Filipino community

o Summary: Samoan community

o Summary: Spanish-speaking community

o Summary: Vietnamese community

o Translated project summaries

Multicultural Community Development in Mental Health Project 5

Table 1. Project Structure

Multicultural Community Development in Mental Health Project 6

Multicultural Community Development in Mental Health Project 7

Multicultural Community Development in Mental Health Project 8

- Living a normal life

Mental health problems

Multicultural Community Development in Mental Health Project 9

Multicultural Community Development in Mental Health Project 10

Multicultural Community Development in Mental Health Project 11

• Community and consumer participation

Multicultural Community Development in Mental Health Project 12

• Reciprocity in Education approach

Multicultural Community Development in Mental Health Project 13

Table 1: Project structure

1) To increase the capacity of the 9 Bilingual community development 9 June 2002

2) To consult with community 9 Establish a project reference group 9 September

4) To identify the perceptions of 9 Plan and conduct six community 9 November

Multicultural Community Development in Mental Health Project 14

Multicultural Community Development in Mental Health Project 15

Table 2: Project human resources: roles and responsibilities

Project role Name/s Responsibilities

Project Ignacio Correa-Velez • Coordinate the activities of the

Multicultural Community Development in Mental Health Project 16

Project QTMHC: • Prepare and continually review the

(Following stages of the project will

Multicultural Community Development in Mental Health Project 17

Project Name/s Responsibilities

o Queensland Program of Assistance to Survivors of Torture and Trauma

Multicultural Community Development in Mental Health Project 18

Multicultural Community Development in Mental Health Project 19

RECRUITMENT AND SELECTION PROCESS

• Bilingual Community Development Worker

Multicultural Community Development in Mental Health Project 20

• Overview of the project

• Project rationale and conceptual framework

• The Queensland mental health system