Barriers to accessing suicide prevention services for Australia’s multicultural communities

Completed: October 2024 

Better Place Australia’s Hospital Outreach Post-suicidal Engagement program (also known as HOPE Outreach Program) is a community-based program which provides psychosocial support to people following a suicide attempt or serious ideation planning. Supporting individuals recently discharged from an emergency department, HOPE provides a non-clinical approach to suicide aftercare and prevention. This approach compliments clinical interventions. 

The HOPE program provides support during this high-risk period, with the client being assessed and allocated to a Care Coordinator who identifies their individual needs and safety planning. 

In November 2023, we conducted a workshop with Care Coordinators from our HOPE program and a representative from a partnering hospital. Through these discussions, participants identified that people from culturally and linguistically diverse (CALD) communities were the main clientele from the HOPE program. Participants discussed key factors that made it difficult for CALD clients to access and engage with the HOPE program. Below is a summary of the barriers identified by the workshop participants.  

Language barriers 

Language was a significant barrier in the service delivery of the program. Care Coordinators agreed that many clients had limited English language skills. This meant many clients did not understand the aims and objectives of the program, or why they were in the program. The use of acronyms within the program was also problematic (e.g. CAT, CTT, SMRC) and caused further confusion. Additionally, clients receive text messages throughout the program, however, those with limited English did not understand the context or meaning of these messages.  

General illiteracy 

Some HOPE clients struggled with general literacy within their own language making it difficult to communicate with Care Coordinators and third-party responders. Most importantly, sharing knowledge and working together to translate the importance of safety planning was difficult for all involved. 

Limited understanding of mental health and wellbeing 

Participants commented that several cultures represented among the clientele did not have terminology that aligns with mental health, suicidality, social isolation, wellbeing, or sense of belonging. This increased difficulty for Care Coordinators when communicating the aim of HOPE. It was difficult to communicate with clients about the steps that were needed to increase their overall wellbeing through building social connectedness, a key aim of the program. 

Stigma and discrimination 

Asking for help when experiencing mental health issues is stigmatised within some cultures. Participants suggested that some cultures reflect a medico-spiritual model of health where mental health issues are viewed as the result of black magic or spirits. This can compromise the safety planning developed by the client and Care Coordinator.  

Interpreter issues 

Participants suggested that clients are sometimes concerned that interpreters will ‘gossip’ their issues back to their communities. This meant that some clients may refuse interpreters because of how small their community is, and they do not trust the interpreter to keep their information confidential. When interpreters were used, they were often only available over the phone. This can be clunky and create confusion for the Care Coordinator and the client.  

Conclusions 

There are a range of barriers that may prevent people from CALD communities from fully engaging with the HOPE outreach program. It is essential to actively engage with these communities, listen to their unique needs, and work collaboratively to break down the barriers that prevent them from seeking the care they deserve. 

If this post brings up any issues for you, please reach out for support. 
Lifeline offers free and confidential 24/7 crisis support.
Call 13 11 14 
Text 0477 13 11 14 
Chat online at lifeline.org.au