by Drug and Alcohol Multicultural Education Centre (DAMEC)
Download this fact sheet: Making treatment accessible for CLD clients [PDF: 275KB]
Number 5.5 June 2007
Introduction
Alcohol and other drug (AOD) treatment services data for Australia between 2004 and 2005 show that 86 per cent of clients were born in Australia and that English is the preferred language of 95 per cent of clients (Australian Institute of Health and Welfare 2006). It has been argued that the use of AOD treatment services by culturally and linguistically diverse (CLD) clients is low because CLD clients believe available services are unsuitable-not because there is a lower prevalence of AOD issues in CLD communities (Reid, Crofts & Beyer 2001). There are very few services that focus on the treatment of AOD issues for clients from CLD backgrounds. Since resources in the AOD sector are scarce, it is unrealistic to consider that sufficient ethnospecific AOD treatment services can be established to meet the needs of CLD communities.
This fact sheet examines some of the barriers CLD clients and their families experience in accessing AOD treatment services. Some suggestions for improving access are provided for workers with CLD communities.
Barriers to accessing treatment
- CLD clients and their families may have different expectations of treatment due to language barriers, a lack of familiarity with drug treatment services in Australia and general confusion about the nature of AOD dependence.
- Admission into programs offered by AOD treatment services usually requires a high level of proficiency in English. Potential clients may be turned away from services if their English proficiency is considered inadequate.
- If an AOD-specific service is deemed inappropriate for a client with low English proficiency, the client may be referred to an ethnospecific or bilingual service such as a migrant resource centre, which often does not have a worker with a strong understanding of AOD issues.
The experience of CLD clients and their families attempting to access treatment for AOD issues at ethnospecific services with no AOD expertise, or at AOD services with no CLD expertise, can leave a negative impression of treatment options.
Improving accessibility
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Manage expectations: Avoid unrealistic expectations of the service by explaining the process of intake, assessment, detoxification and available options for aftercare, and informing the client of their right to request an interpreter.
- Initial assessment: Experienced workers in an AOD treatment service are best placed to conduct the initial assessment (possibly with the aid of a qualified interpreter) regardless of the client's English proficiency. Referral of a CLD client to an ethnospecific or bilingual service without a full assessment should not be considered as the first or only option. The expertise of AOD workers is essential for the formulation of an appropriate treatment plan.
- Referral: If a client is referred to an ethnospecific or bilingual service that does not focus on AOD issues, then support should be provided to the case worker of this client from the AOD service. Conversely, if a client from a CLD background is referred to an AOD service by an ethnospecific welfare worker, then support for linguistic and cultural issues should be given by that worker to the AOD worker.
- Staff and organisational structure: If there is a high demand for treatment from a particular CLD group, it may be worth considering employing a bilingual worker who is either trained or keen to be trained in AOD issues. This can help to alleviate communication difficulties and provide support to families of clients and to ethnospecific services in the area. However, if a bilingual worker is employed, this does not mean that the rest of the staff should not work with clients from that particular cultural background. Due to sometimes high staff turnover rates, organisational structures should be put in place within an agency to ensure cultural knowledge is disseminated.
The best treatment outcome for a CLD client is likely to come from collaboration between AOD treatment agencies and ethnospecific services.
Conclusion
In order to improve AOD treatment access for clients from CLD backgrounds, it is necessary for services to have the organisational structures in place (and flexibility within those structures) to better equip them for working with CLD clients. These include:
- Protocols for assessment and referral of clients with low English proficiency; keeping in mind that AOD expertise is needed to complete a high quality assessment.
- Protocols for recording information about working cross-culturally in a format that allows the knowledge to be passed on to other staff.
- Policies that promote the networking of staff with workers from ethnospecific agencies and migrant resources centres and the formalisation of these collaborative relationships if necessary.
Institutionalise cultural knowledge
The knowledge gained through working with specific community groups and any particular issues that arise should be recorded. This knowledge can then be shared among current and future workers. It also helps to ensure that the organisation is not dependent on one particular worker who has experience working with a specific CLD group.
References
Australian Institute of Health and Welfare (AIHW) 2006 Alcohol and other drug treatment services in Australia 2004-2005: Report on the National Minimum Data Set, Drug Treatment Series no. 5, AIHW cat. no. HSE 43, Canberra: AIHW
Reid G, Crofts N & Beyer L 2001 "Drug treatment services for ethnic communities in Victoria, Australia: An examination of cultural and institutional barriers", Ethnicity and Health, 6:1, 13-26
Further information
The Drug and Alcohol Multicultural Education Centre (DAMEC) is a state wide organisation funded through NSW Health. The focus of DAMEC is to reduce the harms associated with the use of alcohol and other drugs within CLD communities in NSW. Part of DAMEC's work involves supporting and equipping AOD treatment services in working more effectively with clients from CLD backgrounds. If you work in NSW and are unsure how best to proceed when working with a client from a CLD background, DAMEC may be able to provide assistance. Additionally, if you have had any experiences working with CLD clients that you would like to share, DAMEC would also find this information valuable. Please call (02) 9699 3552 or visit http://www.damec.org.au/.
To access the directory of services in Victoria that offer AOD services, resources or information to CLD communities, visit www.druginfo.adf.org.au/multicultural.