Culturally and linguistically diverse populations


Facts and Statistics

Click on links below for quick access to the coinciding information on this page.
Population context
Refugee and asylum seekers
The mental health of migrants
Refugees and mental health
The effect of detention on mental health
Women and children refugees


Media IconPopulation context1

ABS data shows that at 30 June 2011, 27% of the estimated Australian population were born overseas. Those born in the United Kingdom are the largest group of overseas-born residents (5.3%), followed by New Zealand (2.5%), China (1.8%), India (1.5%), Vietnam and Italy (0.9% each).


Media IconRefugee and asylum seekers

  • Since the beginning of its humanitarian resettlement in 1947, Australia has welcomed more than 750,000 people from different countries in response to changing global resettlement and humanitarian needs2.
  • From 2009-2010, a total of 13,770 visas were granted under the Humanitarian Program. This comprised 9,236 visas granted to persons overseas and 4,534 visas granted to people in Australia3.
  • Australia's Humanitarian Program has two components:

Offshore resettlement for people in humanitarian need overseas; and

Onshore protection for those people already in Australia who engage Australia’s protection requirements under the United Nations 1951 Refugee Convention4. 

  • On 18 August, 2012 the Migration Act 1958 was amended to allow for regional processing of Irregular Maritime Arrivals (IMAs) to Australia. In particular, the Migration Act now provides for transfer of people entering Australia via offshore methods to a regional processing country5.

Media IconThe mental health of migrants

Over a quarter of a million first generation adult Australians from culturally and linguistically diverse backgrounds are estimated to experience some form of mental disorder in a 12-month period6.

The prevalence of mental disorders for people born in Australia was higher (19.5% for males and 24.0% for females) than people born overseas (17.7% for males and 19.9% for females). For people born in non-English speaking countries the prevalence of mental disorders was 8.4% for males and 16.2% for females7.

The nature of this relationship (particularly when compared to the general Australian population) is difficult to determine but may be explained in part by the ‘healthy migrant effect’. This relates to the fact that people who successfully migrate to Australia are required to complete rigorous health checks and testing which means they are more likely to be physically healthier than the remainder of the population. This may also be true for mental disorders8.

Prevalence of affective and anxiety disorders do not vary significantly by country of birth. However there is a modest trend for people from non-English speaking countries to have a lower prevalence of affective and anxiety disorders compared to those born in Australia or another English-speaking country9.

People born in non-English speaking countries have lower levels of substance use disorders (1.6%) than people who were born in Australia and other English-speaking countries (6.0% and 4.4% respectively)10.

Research suggests that whilst many migrants arrive in Australia with good mental health, their mental health tends to deteriorate after the first 12 months spent in Australia. This is often linked to the stressful process of acculturation, language and social difficulties and difficulties in finding employment11.

The conceptualisation of mental illness differs from culture to culture. In less industrialised cultures mental illness may be interpreted as being caused by external forces. For example12:

In south-western Greece, residents are more likely to attribute causes of psychotic illnesses to a metaphysical belief of a magico-religious nature (e.g. satanic interference); and

Latin Americans are more likely to conceptualise psychiatric symptoms physically (somatisation). The somatisation of psychological problems in some communities may result in the misdiagnosis of the illness and subsequent inappropriate treatment.

The impact of language around mental illness may be different in other cultures. For example, in Islamic culture, being labelled as 'insane' can carry positive connotations. The individual might be seen to be innovative, original and creative, or attempting to find alternatives to static and stagnant modes of living13.

Older migrants are at an increased risk of depressive disorders and suicide. Factors contributing to this risk include: loss, physical illness or disability, or the onset of disorders such as dementia, which often results in a loss of competency in English. Nostalgia and loss of hope of returning to the homeland and increased inter-generational conflict are particular stressors in the later years of life for migrants in Australia14.

People from diverse backgrounds settling in rural and remote areas may face increased isolation due to language and communication barriers, remoteness from culturally appropriate services, lack of adequate social networks, alienation and discrimination15


Media IconRefugees and mental health16

Refugees and asylum seekers are at high risk of mental health problems as a direct result of the refugee experience and their displacement. In addition, they come from a range of countries and cultures and have a wide range of experiences that may affect their mental health.

  • There is substantial evidence that trauma and loss may have profound and ongoing effects on people who migrate to Australia as refugees.
  • The mental health problems that refugees and asylum seekers may experience are anxiety disorders including post-traumatic stress disorder, depression and chronic grief.
  • The most serious mental health problems for refugees may manifest themselves in severe depressive behaviour, agoraphobia, panic attacks, self-harm, violent or disruptive behaviour, alcohol or drug abuse, sleeping disorders, eating disorders and psychosomatic illness.
  • Refugees who have a mental illness face many obstacles in accessing treatment for psychological trauma and mental illness in both the pre- and post-migration period.
  • Stressors that may accompany the post-migration period for refugees include: uprooting, which may include loss of family, friends and possessions; poverty; and experiencing marginalisation and racism in the host country.
  • Experiences that exert a negative effect on children during war are: the violent death of a parent, witnessing murders or torture of family members, separation from family, migration, terrorist attacks, child soldier activity, bombardments and shelling, physical injuries and famine.

Media IconThe effect of detention on mental health

  • Asylum seekers who are placed in detention whilst their refugee status is determined experience a specific set of stressors, reflecting both the detention environment and the detention process itself. Some of these stressors include; loss of liberty, uncertainty regarding return to country of origin and social isolation17.
  • Research examining the relationship between detention and mental health suggests that time in immigration detention significantly impacts on the mental health of refugees; even when other risk factors (e.g. previous history of trauma, age and gender) are taken into account18.

An inquiry undertaken by the Australian Human Rights Commission found that19:

 

Mental distress in varying degrees is common in detained asylum seekers with 'a large number of detainees experiencing mental health problems'.

Factors regarded as increasing the risk of mental distress included: prior experiences of torture or other forms of persecution in the country of origin; the stresses created by the length and conditions of detention; and the feelings of anxiety and desperation in those whose refugee claims are rejected.

There is 'considerable tension created by the regime of control necessary to implement the policy of mandatory detention' and the indeterminate nature of the detention made it considerably more difficult to endure.

Prolonged detention has harmful effects on the mental health of adults and development of children and adolescents.

Institutionalisation of children has a negative impact on their mental health. Children in immigration detention centres may suffer from anxiety, distress, bed-wetting, suicidal ideation and self-destructive behaviour including attempted and actual self-harm20.

The longer children are in detention the more likely it is for them to suffer serious mental harm21.

 


Media IconWomen and children refugees

Women and children make up 80% of the world's refugees and displaced persons22.

  • For many women refugees, the violent situations that cause them to flee their home countries is the beginning of a path which may itself present many dangers such as physical abuse, rape and abduction23.
  • Many refugee women are widowed or become separated from their husbands during flight and become the sole adult responsible for their dependent children. This responsibility and the potential isolation and stress on the mother increases her risk of mental illness24.
  • A consistent finding from studies is that separation from family members was perceived as more distressing to children than air raids or bombings25.
  • Research has shown that the way trauma is experienced is related to the age and developmental stage of the child. Preschool children, who are particularly dependent on their parents, may react to trauma with anxious attachment behaviour, while school-age children may change radically following a traumatic event. Adolescents may lose impulse control and engage in antisocial acts26.
  • Post-Traumatic Stress Disorder (PTSD) among children and adolescents may become chronic when factors such as a lack of supportive parents or other adult attachment figures, inadequate mental health services and ongoing trauma persist. On the other hand, maintenance of attachment relationships and enabling adults to support traumatised children has been found to protect children from the development of chronic PTSD27.

References

[1] Australian Bureau of Statistics. (2012a). Migration, Australia 2010-2011. ABS Catalogue. No. 3412.0. Canberra, ACT: Australian Government.

[2] South Western Sydney Local Health District. (2012). NSW Refugee Health Service. Sydney, NSW: NSW Government. Accessed November 27, 2012 from http://www.sswahs.nsw.gov.au/services/refugee/faq-settlement.html

[3] Australian Bureau of Statistics. (2012b). Year Book Australia 2012. ABS Catalogue. No. 1301.0. Canberra, ACT: Australian Government.

[4] Ibid. 

[5] Australian Government, Department of Immigration and Citizenship. (2012). Migration Legislation Amendment (Regional Processing and Other Measures) Act 2012. Accessed November 27, 2012 from http://www.immi.gov.au/legislation/amendments/2012/120818/lc18082012-01.htm

[6] Commonwealth Department of Health and Aged Care. (2004). Framework for the Implementation of the National Mental Health Plan 2003-2008 in Multicultural Australia. Canberra, ACT: Commonwealth of Australia. 

[7] Slade, T., Johnston, A., Teesson, M., Whiteford, H., Burgess, P., Pirkis, J. & Saw, S. (2009). The Mental Health of Australians 2. Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra, ACT: Department of Health and Ageing.

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Anikeeva, O., Peng, B., Hiller, P. R., Roder, D., & Han, G. S. (2010). The Health Status of Migrants in Australia: A review. Asia Pacific Journal of Public Health, 22(2), 159-193.

[12] De Leo, D., & Spathonis, K. (2003). Culture, society and suicide. Australian Mosaic, 4, 27-30.

[13] Okasha, A. (1999). Mental health in the Middle East: An Egyptian perspective. Clinical Psychology Review, 19, 917-933.

[14] Commonwealth Department of Health and Aged Care. (2004). Op. Cit.

[15] Ibid.

[16] Robjant, R., Hassan, R., & Katona, C., (2009). Mental Health Implications of detaining asylum seekers: Systematic review. British Journal of Psychiatry, 194, 306-312.

[17] Steel, Z., Silove, D., Brooks, R., Momartin, S., Alzuhairi, B., & Susljik, I. (2006). Impact of immigration detention and temporary protection on the mental health of refugees. British Journal of Psychiatry, 188, 58-64.

[18] Ibid.

[19] Human Rights and Equal Opportunities Commission. (1998). Those Who've Come Across the Seas: The report of the Commission's Inquiry into the detention of unauthorised arrivals. Canberra, ACT: Human Rights and Equal Opportunities Commission.

[20] Human Rights and Equal Opportunities Commission. (2004). A last resort? The national inquiry into children in immigration detention. Canberra, ACT: Human Rights and Equal Opportunities Commission.

[21] Ibid.

[22] NSW Refugee Health Service. Fact Sheet 5: Refugee women. Liverpool, NSW: NSW Health. Accessed November 26, 2012 from http://www.swslhd.nsw.gov.au/refugee/pdf/Resource/FactSheet/FactSheet_05.pdf 

[23] United Nations High Commissioner for Refugees. (1991). Guidelines on the protection of refugee women. Geneva: UNHCR.

[24] Ibid.

[25] Barnes, D. (2003). Asylum seekers and refugees in Australia: Issues of mental health and wellbeing. Sydney, NSW: Transcultural Mental Health Centre.

[26] Australian Centre for Posttraumatic Mental Health. (2012). Fact sheet: Trauma and Children. Melbourne, VIC: University of Melbourne. Accessed November 26, 2012 from http://www.acpmh.unimelb.edu.au/site_resources/factsheets/ACPMH_trauma_and_children.pdf

[27] Ibid.