The mental health ‘safety gap’ causing decade-long delays for vulnerable Australians

People who were born overseas are more likely than those born in Australia to delay seeking support for their mental health by a decade or more, according to new research from the nation's peak body for the mental health sector.

The study, released on Monday by Mental Health Australia's Embrace Multicultural Mental Health Project, shows that people who arrived in Australia more recently — along with younger people and women — are more likely to experience poorer mental health than their local peers.

The report also shows that diverse Australians face social hurdles and stigma in accessing mental health support, along with barriers to accessing care.

Adriel Appathurai, an advocate with youth mental health organisation Orygen, told SBS News that different cultural groups faced varied challenges in mental health care, but there were some commonalities.

The Sri Lankan-born man said growing up in Australia as a child of refugees instilled a mindset that made it harder to seek help.

"I think for anyone who's come from overseas, especially those from refugee asylum seeker backgrounds, there is that pressure to succeed, that pressure to do well," he said.

"It can be more direct from your parents, but it can also be just that internalising again of, 'my parents have worked so hard to bring me here, they've sacrificed so much, and it's my responsibility to now provide for them, care for them, do well and be successful'."

'Considerable stigma'

Mental Health Australia CEO Carolyn Nikoloski said the group's research identified several pressures experienced by Australians with multicultural backgrounds and those born overseas.

"We know that the process of moving overseas is in and of itself a really stressful experience, so that can be a risk factor for poor mental health," she told SBS News.

"We also know that when people are separated from their family and friendship and other support networks, that can be a contributor to poor mental health."

Australians with multicultural backgrounds were more likely to experience racism and discrimination, causing further harm to their mental health, the organisation found.

Racism and discrimination could create stigma, she said, which can be compounded by feelings of judgement from within a family or cultural group.

"Particularly for people from multicultural communities, we know that there's still considerable stigma associated with mental health. And that stigma can be tied to feelings of shame and a concern about not wanting to worry family members," Nikoloski said.

Systemic issues

There are also practical barriers to getting support for mental health, like the service system itself being confusing and hard to navigate.

Co-author of the new research, Dr Andre Renzaho, said the delay in multicultural Australians seeking mental health support showed systemic and structural barriers prevented meaningful engagement with the healthcare system.

"Australian-born individuals were more likely to receive 20 or more consultations than migrants, which is really a problem, showing systemic issues," said Renzaho, who is a professor at Western Sydney University with a background in health and development.

Renzaho said challenges for migrants can begin when they first arrive in Australia and try to navigate the nation's "complex" health system.

"Being able to communicate within that system, being able to understand the referral pathways within that system, being able even to understand the difference in services provided by professionals, or a GP, for example, as opposed to a mental health professional, are all hard things to navigate," he said.

Even after finding an appropriate appointment, some may face other challenges, such as language barriers, transport, and finances, he said, adding that this could lead to a "safety gap" that can fuel mistrust and misunderstanding.

"Migrants may have a different understanding that incorporates also a traditional construction, a cultural belief and the cultural construction of mental health, which may dictate how they seek help," he said.

"And those cultural beliefs and the cultural norms may not be understood by mental health service providers."

The report makes several recommendations to address these concerns, including culturally aware mental health education and training a bicultural mental health workforce.

Readers seeking support with mental health can contact Beyond Blue on 1300 22 4636. More information is available at beyondblue.org.au. Embrace Multicultural Mental Health supports people from culturally and linguistically diverse backgrounds.

For the latest from SBS News, download our app and subscribe to our newsletter.