Four years ago, Amber Zahra hit rock bottom.
- Amber Zahra struggled for culturally appropriate mental health help
- Experts say there is not enough funding for services for CALD people
- They say women and young people are especially vulnerable
She filed for divorce and her father died — but they were not the only things causing her immense grief.
It was also the lack of mental health support when she needed it the most.
Originally from Pakistan, Ms Zahra moved to Perth in 2014 with her then husband and two young sons, aged 7 and 8 months.
While she faced significant challenges in her marriage, she felt divorce was not an acceptable option in her culture.
She reached out to a counselling service but felt something was amiss.
“I wasn’t sure about divorce at the time, and [the counsellor] sort of pushed that idea on to me, and I think that came from her lack of awareness regarding our culture — like how strongly my culture is against divorce,” she said.
“That was the reason why I was actually struggling to go back to therapy during separating.
“I just wanted to sort my thoughts … and I didn’t feel like she was aware of where I was coming from, so I left after a couple of sessions.”
Pressure to fit in
It was only when Ms Zahra started a university course in counselling that she realised she needed better mental health care addressing the cultural barriers she faced.
“Right after [my] divorce, I was having panic attacks … anxiety, I wasn’t even aware of what was going on in my body until I read it in my studies, what were the symptoms,” she said.
With much hesitancy, she decided to seek help again.
“Coming from another culture, I perceive myself as an alien,” she said.
“You don’t want to ask for anything, you just want to fit in, and the only thing you focus on is being able to adjust, and that brings so much depression and pressure over yourself.”
The 38-year-old was eventually referred to Multicultural Futures, an organisation which provides various services for culturally and linguistically diverse (CALD) communities.
“There wasn’t a single time that they made me feel uncomfortable,” Ms Zahra said.
“I could talk about arranged marriages, divorce being taboo, not having support from my brother over a divorce … they understood that.”
Falling through the gaps
The need for more mental health services has been a talking point for years.
But in the lead up to the WA election, there are renewed calls for urgent funding to address gaps in mental health services, particularly for prevention.
Experts say while there is a need to expand services, there should be greater emphasis on funding mental health support specifically for culturally diverse communities due to the complexities of their cases.
Multicultural Futures health and wellbeing manager Marina Korica believed many migrants and refugees were falling through gaps in the system, as they often were not provided with early intervention.
“CALD communities have pre-arrival experiences such as grief, loss, trauma, war, poverty, a sense of displacement, and then coming to a new country they often experience racism and discrimination that are affecting their mental health,” she said.
“Because people are coming from different countries, from different systems, they don’t know much about the health or mental health system here.
“They are not seeking help until they have to be hospitalised or there’s no other way to help them.”
Women staying in abusive marriages
The main factors preventing people from reaching out include a lack of accessibility, language and cultural barriers, as well as the stigma surrounding mental health issues, according to Ms Korica.
Multicultural Futures sees around 300 new clients from 40 to 60 different countries annually, and Ms Korica said it operated with limited funding.
She wants a newly elected WA government to ensure more culturally appropriate counsellors and services are prioritised.
Ms Korica said a worrying recent trend was the number of women seeking help for domestic violence.
“In the last three to four years, 57 per cent of female clients accessing our service have been in domestic violence situations … that’s huge and it is problematic,” she said.
“Because of cultural beliefs — that they are married now and should be obedient — often they stay in abusive relationships for a long time. Their mental and physical health is greatly affected.”
Mental health stigma
Young people are also vulnerable.
Zinab Al Hilaly is part of the Multicultural Youth Advocacy Network of WA and believes the generational gap between young CALD people and their parents adds a layer of complexity to the issue, leaving many isolated.
“Especially when they come from families where their parents or grandparents may have experienced very severe traumas in the past such as war, conflict, poverty and abuse, and often feel like their mental health issues are small and insignificant and therefore might not take that action to get that support that they need,” she said.
Ms Al Hilaly said many young people raised concerns about their healthcare workers, including GPs and counsellors, having limited awareness of CALD mental health and traumas which deterred them from seeking help again.
“A few young people have said that their mental health was impacted by racism but their psychologist or mental health worker kept ignoring [them] … and they weren’t taken seriously,” she said.
The McGowan government has pledged to increase funding for CALD mental health services if re-elected, although their policies did not score highly on the Western Australian Association for Mental Health (WAAMH) 2021 election scorecard.
The WA Liberals have also committed to funding more services, but it is unclear where exactly the money will go for CALD or migrant communities.
Ms Zahra, who has since remarried, credits her ability to move on with her life to the work done by community organisations.
She believes an expansion of services like Multicultural Futures in outer suburbs, where services are limited, is critical.
“Even at Centrelink, I feel like before they talk about anything to do with finances, they should first have this conversation — [asking] ‘how are you doing?'” she said.
“There should be some place where they know help is available.”