Research tells of the serious and compounding emotional problems experienced by people with mental health issues emerging from discrimination on account of ethnicity, race, culture or sexual orientation.

This section commences with a discussion of generic principles and practice for keeping diversity in mind in recovery-oriented practice and follows with some specific guidance for working with people and communities who are:

  • Aboriginal and Torres Strait Islander
  • from culturally and linguistically diverse backgrounds, including refugees and asylum seekers
  • of different ages, including children, young people and older people
  • lesbian, gay, bisexual, transgender and intersex
  • living in rural and remote communities
  • experiencing socioeconomic hardship and stress
  • experiencing coexisting conditions and complex needs
  • involved in the criminal justice system (including youth justice).

Some generic principles and practice5

Biological, psychological, physical, environmental, economic, social and political factors all impact on health and wellbeing at a personal, local and global level. Practitioners and services need skills for identifying potentially adverse or isolating impacts on a recovering person, and acting to prevent or mitigate those experiences. Recovery occurs within a web of relations including the individual, family and community, and is contextualised by history, culture, privilege or oppression and the social determinants of health. Recovery also occurs within the context of gender, age and developmental stages.

Recovery approaches are alert to the impacts on health and wellbeing, both positive and adverse, of diversity—whether they are socially, culturally or language based (Ida 2007, p. 49). Culturally and socially responsive practice entails an understanding of:

  • a person's cultural identity as a basis for understanding how they see self, kinship and relations with the broader community
  • a person's explanatory models of illness, distress and wellness
  • experiences of torture, trauma, displacement, loss, racism and discrimination
  • internalisation of stereotypes of mental illness and the burden of hiding personal identity (Deegan, G 2003)
    how spirituality, community, kinship and family can support recovery processes
  • the impact of the practitioner's own language, cultural beliefs and values on the therapeutic relationship
  • barriers to service.Top of page
Practice skills are required that enable service delivery to:
  • be in an appropriate ethnic or social language using the help of interpreters, bilingual counsellors, cultural advisers, peer support workers, community-based organisations and community leaders
  • accommodate both collective and individual experiences of identity and respect specific spiritual, emotional, psychological and religious traditions
  • be alert and responsive to the potential impact of an inherited history and continuation of collective trauma
  • be multidisciplinary, multiagency, cross-sectoral and partnership based.
Culturally and socially sensitive service delivery requires customised procedures to:
  • acknowledge the importance of relationships in an individual's recovery
  • work with families, close relationships, support networks, elders, interpreters and cultural advisers from different cultural traditions
  • provide physical and emotional environments in which people of differing ages and developmental stages and with differing cultural and social backgrounds feel safe and supported.
Integrating primary health, mental health, drug and alcohol and community and family services will support people who are trying to recover by reclaiming culture and reconnecting with community.

Recovery is not the same thing as being cured. Recovery is a process not an end point or a destination. Recovery is an attitude, a way of approaching the day and facing the challenges. Being in recovery means recognising limitations in order to see the limitless possibilities. Recovery means being in control. Recovery is the urge, the wrestle, and the resurrection ...
Pat Deegan (1996)
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The artwork by Pauline Miles titled 'There are Many Points of View'  depicts a figure standing in a room with artist materials on work surfaces and different views of external images on the far wall.

Footnotes

5 The report written by Rickwood for the National Mental Health Promotion and Prevention Working Party, Pathways of recovery: 4As framework for preventing further episodes of mental illness (2006) commenced this discussion.