Health is a human right, for everyone. Multicultural lived experience is the missing voice in the Australian healthcare system. Evidence shows that health services co-designed with the people who use them, are more effective.
Australia is one of the most culturally and linguistically diverse nations in the world.
Multicultural lived experience is a large missing voice.
The Multicultural Lived Experience is shaped by migration, settlement and acculturation. These in turn are shaped by social, cultural, economic and political drivers and may or may not also involve marginalisation, oppression and discrimination as commonly experienced by migrants, refugees and people seeking asylum.
Including the Multicultural Lived Experience in the health system, service planning, service delivery and consultation room, leads to better health outcomes, health equity and health justice.
The Multicultural Lived Experience is an important component of the lived experience consumer movement.
WWG has started a process to intentionally bring lived experience to the forefront in our practice to ensure appropriate service provision via improved collaboration and integration between our health care staff and Multicultural Peer Support Workers.
The Multicultural Lived Experience Framework was developed by a team of Multicultural Peer Support Workers (MPSWs). Two MPSWs acted as facilitators and were briefed on the scope, context and content boundaries of the framework development work. We in turn embarked on a process of regular meetings, discussions, workshops and exploration with an additional four MPSWs who all had distinct migratory and cultural backgrounds. Together we explored the deep meanings and experiences of multicultural lived experience and the role of the MPSW.
The team collectively dissected ‘lived experience’ – our individual understanding, definitions and interpretations, the cultural meanings, the generally accepted meanings. We intentionally used our personal and collective lived experience to reach shared understanding and themes that formed the basis of the framework. We quickly agreed that multicultural lived experience is much more than providing cultural and linguistic peer support.
The Multicultural Lived Experience Framework was developed with the support of the Brisbane North PHN.
01 – CALD Person
Being understood, valued, respected and encouraged is fundamental to recovery.
The multicultural lived experience of Multicultural Peer Support Workers can encourage and support the recovery of CALD people experiencing mental health issues by supporting people and carers to: develop a recovery-oriented perspective, develop important life skills, empower through identifying and pursuing visions and goals in a strength-based approach and also through the redevelopment of valued roles.
Shared understanding of both the culture of origin and the new culture helps to better navigate the mainstream community’s norms, systems and ways of life. The CALD person, peer worker and health worker develop shared understanding, empathy and connection that is grounded in familiarity with socio-economic, cultural, political and historic factors of the country of origin and the new home country.
02 – Health Workforce
Culturally responsive service delivery and practice requires contextual understanding of socio-political and historic drivers that impact on CALD communities and individuals, as well as the influence of culture, acculturation, settlement, system and societal marginalisation, socioeconomic status, health literacy and explanatory models.
There is high risk for misdiagnosis and harmful treatment without contextual understanding. Consumers can be incorrectly and unfairly labelled as non-engaging or non-compliant.
When health workers engage Multicultural Peer Workers into the therapeutic relationship or treatment team, they increase their cultural capability, demonstrate value for multicultural lived experience and support equal partnerships.
03 – Service Planning
Most health services take a ‘one size fits all’ approach and call it ‘universal healthcare’. This approach advantages the mainstream population and further disadvantages diverse communities who are not reflected in health services. There is increasing evidence that services designed by the users, are more effective and produce better health outcomes. Including the multicultural lived experience of CALD service users can lead to improve service access, culturally inclusive services, reach and engagement with ‘hard to reach’ communities and leads to needs-informed service planning.
Understanding and catering for the needs of the local community is fundamental to good service planning. This means, the whole local community.
04 – Health System
The Australian health system does not reflect, nor cater for the diversity within the Australian population. Health systems, services, policy and investment largely ignore the needs of multicultural populations. Tackling the health inequity created by the health system requires long-term commitment and a strategic response.
Multicultural lived experience is the missing voice in the Australian consumer movement. It is absent from research, consultation, policy advice and system design processes.It needs to be understood,incorporated, valued and amplified.