Cultural Concerns in Addressing Barriers to Learning (revised 2015) *The national Center for Mental Health in Schools is co-directed by Howard Adelman and Linda Taylor and operates under the auspice of the School Mental Health Project, Dept. model of service is culturally inappropriate; service not perceived as relevant due to lack of cultural diversity in the workforce and marketing of services; service choice perceived as limited due to lack of cultural diversity in the workforce; and. For example, they may be concerned that they will be seen as being overly dependent on their family or not sufficiently independent, compared to their age-matched Anglo peers. Such differences can either decrease empathy or understanding for the family's concerns and/or increase (pre-)judgement; CALD families may feel service providers and practitioners who are not as aware of their cultural norms and expectations will judge them less. Learning to nurture cultural respect and inclusion is vital to reducing health disparities and to facilitate and improve access to high-quality healthcare that is directly responsive to a patient’s needs (Zamanzadeh et al. However, we anticipate that because most ethnic minority families live in urban areas, being a more conspicuous minority in regional Australia can exacerbate the extent to which racism and discrimination are perceived or experienced. The concept of cultural competence has emerged in response to widespread disparities in care by culture, race, ethnicity, religion, gender and sexual orientation, and refers to care that respects patients’ health beliefs about their illness and its causes, interprets health issues from a biopsychosocial rather than biomedical context, involves communication in language accessible to patients, and … 4. Although treating everyone in the same way is superficially equivalent to providing equal opportunities, it can in fact result in discrimination and "institutional racism" (discussed below). As such, institutional racism has been redefined here to broadly refer to racism that is not due to prejudice or discrimination by individuals, but rather occurs when the policies, practices or procedures of organisations intentionally or unintentionally discriminate against particular sectors of the population. In 2016, nearly half (49%) of Australians had either been born overseas (first generation Australian) or one or both parents had been born overseas (second generation Australian) (ABS 2016). Aboriginal health - barriers to physical activity . Journal of Telemedicine and Telecare 1995; 1(4): 187-195. Statistics from the most recent national census reveal how truly diverse Australia is as a nation. Traditional healing practices as well as Western healthcare. (1984) stated that one of their cultural beliefs is that "the private shame of a family should not be made known to outsiders" (cited in Forehand & Kotchick, 1996, p. 199). Keywords: Australia, barriers, telemedicine, telehealth. To break cultural barriers and open the lines of communication, some healthcare organizations have been working to attract individuals from a more diverse range of ethnicities and economical backgrounds. It is worth keeping in mind that there is a variance in the prevalence of illnesses between cultural groups. To ensure that they are able to provide culturally-considerate nursing, an individual must first consider their own cultural biases and how these may impact their practice. The patient and their family’s religious and spiritual beliefs – particularly in relation to death, dying, the afterlife, and healing. It is important to consider the experiences, challenges and issues of ethnic minority families in conjunction with those of service providers and practitioners, to see how best to improve the fit between service providers and service users. But beyond that, it is the exposure to racism itself that has … These issues not only point to the importance of a culturally diverse staff to increase the sense of choice for CALD families, but also demonstrate the limitations of assuming that a culturally diverse staff is sufficient for meeting the needs of CALD families. In 2009, 23 per cent of Australians living in outer regional and remote areas felt they wai… We acknowledge all traditional custodians, their Elders past, present and emerging, and we pay our respects to their continuing connection to their culture, community, land, sea and rivers. A series of papers for those yearning to propel telehealth to new heights. In doing so, they hope to better understand and serve their patients, by better understanding differing cultures, values, and perspectives. Commitment on an organisational level that recognises and. Barriers to good health care. © 2021 Australian Institute of Family Studies. For example, based on research that investigated parent training issues with Chinese families in the US, Lieh-Mak et al. The ways in which services are marketed can have a significant effect on whether families perceive the service to be relevant to them. Lack of information and partnering with CALD-focused services in the local community can compromise the holistic approach that service delivery can offer. In a study by Katz (1996), Asian families in the UK (who in the main refer to families from India, Bangladesh and Pakistan), for example, viewed children's mental health issues as being behavioural or spiritual difficulties, and sought advice from Imams, who generally recommended increased religious observance and training (or marriage, in the case of young women) as the solution, rather than psychiatry. Of the 6,163,667 overseas-born persons, nearly one in five (18%) arrived since the start of 2012 (ABS 2016). Print; Summary. Ultimately, keeping these frameworks in mind and undertaking cultural assessments will help healthcare professionals provide safe and person-centred care to all people regardless of their race, ethnicity, culture or language. Example: Compatibility of cultural backgrounds of client and service provider A Tamil Sri Lankan who is culturally Dravidian may prefer not to have a Sri Lankan service provider or practitioner who is Buddhist Singhalese, because of the in-fighting between these two cultural sub-groups. of Psychology, UCLA. These include: 1. lack of awareness or confidence to address the needs of CALD families; 2. practice that is not culturally competent; 3. lack of adequate resources; 4. institutional racism; and 5. lack of awareness and partnering with CALD-focuse… As Bhui et al. There is no clear definition of the term "institutional racism", as it is used differently in the medical, health, social work and education literatures. It is the combination of these as well as ideas, skills, arts, and other capabilities of a people or a group as a whole – and it is more than any of these elements and constantly in flux (Engebretson 2016). As Forehand & Kotchick (1996) pointed out: Ethnic minorities walk a fine line between maintaining their cultural values and customs and adopting the cultural strategies of the European American culture that are typically associated with success. How they and their family cope with suffering. Within their culture, find out whether they prefer to make decisions as a group or if it is mostly up to the individual. Kagawa-Singer, M & Backhall, L 2001, ‘Negotiating Cross-Cultural Issues at End-of-Life’. Services are more thinly spread, and people have to travel longer distances to reach them. Because of the long history of abuse of ethnic minorities in this country, many of these families resist any efforts of the "white establishment" to assist them in raising their children. Sensitivity and communication should be the tools you rely on in these situations. The authors also suggested that service providers or practitioners may misinterpret the body language of CALD families, which can interfere with how comfortable the latter feel about expressing their issues or concerns. New migrants arrive in Australia tend to have minimal knowledge about the health-care system in Australia. Forster a therapeutic relationship that portrays genuine respect for the client’s cultural beliefs and values. Because of differences in cultural characteristics between Anglo-Australian and ethnic minority cultures, a number of barriers to equal access and use of services may be perceived or experienced by service providers and practitioners who deliver services to CALD families. Although all Australians have the right to equitable healthcare, patients from culturally and linguistically diverse (CALD) backgrounds (including Aboriginal Peoples) may experience significant barriers to accessing and using healthcare services and suffer adverse events including medication errors, misdiagnosis and healthcare-associated infections (DoH 2019; Brach, Hall & Fitall 2019). Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. Additionally, a national online survey was conducted with 98 service providers working with refugee families. The primary consequences of cultural neglect are poorer outcomes for people of diverse or marginalised backgrounds and, on a more general level, distrust for the healthcare industry (Ferwerda 2016). Most conversations are simply monologues delivered in the presence of a witness. Volume 39, No.1, January/February 2010 Pages 71-73. Notwithstanding, the literature indicates that, broadly, the barriers common to ethnic minority families can be divided into: Ethnic minority families may experience language barriers. As the term "culturally diverse" suggests, the nature and magnitude of these barriers vary both within and across cultures. Patients from diverse cultural backgrounds (including First-Nation Peoples) experience almost twice as many adverse effects as English-speaking patients (Multicultural Health Communication 2013). Such matches can be useful to families who are concerned they will not be understood or that service providers who are not of the same cultural background will judge them. The ongoing and fluid process in which individuals from CALD groups must balance their conflicting needs for cultural preservation and cultural adaptation is known as acculturation (Berry, 1980). It is important for service providers and practitioners to be aware of the cultural, structural and service-related barriers that ethnic minority families may experience or perceive. Culture is influenced by political and economic conditions and varies with factors including age, gender, class, education and personality (Engebretson 2016). When the family relationship service cannot meet the needs of the CALD family, it is especially important that it be able to broker the services to other CALD-focused organisations. For example, service providers and practitioners may assume knowledge of English or define culturally acceptable practices as abuse. With increasing cultural diversity among nurses and patients in Australia, there are growing concerns relating to the potential for miscommunication, as differences in language and culture can cause misunderstandings which can have serious impacts on health outcomes and patient safety (Hamilton & Woodward-Kron, 2010). The potential of error in the absence of culturally-aware nursing is vast. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. Alternatively, some CALD families may prefer to have a service provider or practitioner who is not of the same cultural background as themselves. However, Weerasinghe and Williams (2003) importantly pointed out that even among CALD families who are proficient in English, the use of professional jargon by service providers and practitioners, without accompanying explanations, can be a deterrent to their uptake of services. Nevertheless, a staff profile that reflects the ethnic mix of the local population is preferable. Whitten P, Holtz B. Of the 6,163,667 overseas-born persons, nearly one in five (18%) arrived since the start of 2012 (ABS 2016). (2007) pointed out that, even among service providers and practitioners from ethnic minority groups, standardised professional training practices reduce the number of culturally tailored options for models of service delivery. Where possible, accredited interpreters should be employed to overcome issues that may occur due to varying levels of skill and training. They are usually more satisfied with services when they feel they are being treated equally, feel they are receiving full and accurate information about service provision, and that the services offered are sufficient in addressing their range of needs (Chand & Thoburn, 2005; Lloyd & Rafferty, 2006). One of the major problems we identified in our previous article was access to health services. 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