Multicultural health in Western Sydney

Narrator
Since the late 70s have impacted people's emotional well-being, especially as people are trying to settle into life in Australia.
People are very concerned about family they left in Afghanistan or trying to find employment, housing, and learn a new language. Afghan refugees are doing multiple difficult things as well as dealing with their trauma.

This video attempts to explain what mental health treatment is and answer common questions raised by the Afghan community. The focus of this video is mental health and mental health services, but there are other community organizations that support people, including connecting them to mental health services.
In this video we showcase two of these organizations and provide a list of other organizations that can support community members.

Staff and volunteers from these organizations will speak in your language and understand your background. They know your settlement-related stresses and some other activities helpful to live in Australia, like swimming and driving lessons.

Also, they can help you with referrals to other services including the mental health services outlined by Nuria and Zaki. These services, along with more clinical services, help people's mental health by increasing their social network and feelings of belonging in a new country.

Nuria (Health Professional)
Mental health is our emotional, psychological, and social well-being. But from time to time during our life, our mental health can get distracted and we might have mental health problems. It will affect our thoughts, feelings, and behaviors.

Many factors contribute to our mental health problems. Some of them are biological factors like the chemistry of our brain, genetics. Some of them can be related to trauma, war, abuse, neglect. Others can be a family history of mental health problems.

When people come from refugee-like backgrounds, like Afghans in a new country, we need to adjust to the new environment while coping with our terrible memories of our past experiences. Sometimes it can be overwhelming, can confuse us inside, make us sad and confused.

And also, sometimes even it will affect our thoughts, our feelings, and our behavior—the way that we relate to others or make decisions.
In those circumstances we might have symptoms like, for instance, we might not be able to concentrate and that will affect us to learn English. We might have bad dreams and we might not be able to sleep. Sometimes we feel lonely and isolated. Sometimes we have really bad memories of the past that won’t go away.

Sometimes we might have body aches, headaches, and muscle aching. We have a lot of tension over our bodies. Sometimes we feel that we’re losing control of our lives. Sometimes we can’t make relationships with others or we’re constantly worried about loved ones that we left behind.

All of these reactions are our normal reaction to abnormal circumstances. It doesn’t mean that we’re going mad or crazy, but we are reacting to extreme traumatic experiences.
In these circumstances, we might feel overwhelmed. And I know as an Afghan we are tough and we are incredibly resilient, but if we’re feeling overwhelmed it’s okay to seek help.

We can get help from different sources. For instance, we can talk to a professional counselor or psychologist. I know counseling is a new concept for many of us. Back home, if somebody had severe mental health problems, that was treated by psychiatrists. For the rest of us, if we were not feeling well, we used to talk with our friends, family, or Imam or Sheikh.

Here, we may not have that support system, but in Australia there are professional counselors and psychologists that we can talk to. They will listen to us with a non-judgmental attitude and they will try to help us adjust in the new environment and manage better our reaction to the new environment—to work through our thoughts, feelings, and traumatic memories, and to have control of our life, to make decisions, to have better relationships with our loved ones.

Also, sometimes we may need medication. Our GP can prescribe us with medication or our GP may decide to send us to psychiatrists and the psychiatrist will prescribe medication. Sometimes we need a combination of both medication and counseling.

There are three low-cost mental health services available to the community and these are:

• General practitioner or GP — it’s recommended that everybody does have a GP that will help people with referrals.
• One of the first things that the GP will do with people is to write a Mental Health Care Plan about treating mental health conditions. The plan identifies what type of healthcare you will require and the details of what you and your GP have agreed that you want to achieve.
• The GP may provide medication or make referrals.

It’s also important to note that physical health is also affected by trauma, and this is why it’s important to have a GP.

Zaki (Health Worker)
This Mental Health Line operates 24 hours a day, seven days a week. It is the central point for access into NSW Health Mental Health Services, to a community mental health service or hospital if you need it.

Call with an interpreter. You need to use the Translating and Interpreting Services (TIS). Call this number and tell the operator you speak Dari, the name and phone number of the Mental Health Line, and the TIS operator will connect you. It may take a while but don’t hang up.

The NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) provides counseling, group work, and community support to help people heal from trauma. There are specific services for children and young people from refugee backgrounds.

The number for STARTTS is this — call with an interpreter using the same procedure mentioned before.

It’s important to note that these are not emergency services. In a life-threatening situation, such as someone attempting to harm themselves, please call triple zero (000).

Sarah Muhammad (Youth Worker, ADSi)
Hello everyone, my name is Sarah Muhammad and I’m from Afghanistan but raised in Pakistan. I’m currently working as a youth worker with Accessible Diversity Services Initiative Limited (ADSi).

ADSi is a community-based non-profit organization established to promote the principles of multiculturalism, access, equity, and social justice.

There are many services in ADSi such as aged and disability, NDIS, settlement, youth, family, community, emergency relief, legal assistance, financial counseling, housing, and Clothing for Dignity. Our programs are delivered in Auburn, Blacktown, and Parramatta.

Onto mental health — we may have positive mental health when we feel contented and fulfilled. Our aim should be to have positive mental health where we can reach our full potential and live a satisfying life. Therefore, ADSi also works directly within mental health services to reach this aim.

To conclude, register for ADSi services. Please contact our office on 02 8737 5500 and you will be referred to one of the services mentioned above, depending on needs and eligibility.

Thank you so much.

[Applause] [Music] [Applause]

 Participant (Hazara Community Member)
And I’m from an Afghan background. My ethnicity is Hazara. I arrived in Australia in 2016 after my father, who was here since 2010, sponsored my family.

I finished high school in 2018 and joined Western Sydney University to pursue higher education. I like when I meet and interact with people.

During the COVID-19 pandemic, I struggled mentally. Getting into the habit of online education was hard, especially with the stay-at-home orders in place. During that time, I couldn’t go out to meet my friends and attend the gym for workout and exercise, which I used to do before.

I found myself consuming social media a lot and procrastinating. This affected my grades in my first online semester and saw my performance at university decline. The constant reminders of daily rising new cases were deteriorating my mental health.

To overcome this, I tried several things to keep myself engaged. I always communicated with my family at home and friends through the internet so that I did not isolate myself mentally and fall into a negative headspace.

I took upon myself to make good of this time to learn and try new things, and so I tried taking on small challenges like exercising at home and giving myself a target.

With time, I adjusted and learned a lot of new things from the challenges that I faced during that time, and so I am grateful that I learned new things about myself by overcoming those challenges to help with my own mental well-being.

Thank you.

[Applause]

[Music]

[Screen shows a Nepalese woman wearing a black top and spectacles sitting and facing forward. Colourful Nepali prayer flags are strung behind her]
[Text showing her name and position appears on the screen: Anju Devkota, Health Promotion Officer, HIV and related programs, Western Sydney LHD]

Anju: Hello, syphilis is spreading in New South Wales, so it is important to learn about it. Syphilis is called 'Viringi' in Nepali. Before talking about syphilis, it is important to understand a few things about sexual health.

[Music]
[Screen shows text in Nepali in black text at the top of the screen with an English translation highlighted in white below: What is sexual health?]

Anju: Good sexual health is important to our physical and emotional wellbeing. Sexual health includes healthy and safe relationships. Safe expression of sexuality. Access to sexual health care. Knowledge about sexually transmitted infections (STIs) and how to prevent them. Today's discussion is focused on Syphilis, which is one of the most common STIs.

[Music]
[Screen shows text in Nepali and English highlighted in white: What is syphilis and how can it be prevented?]

Anju: Syphilis is a common sexually transmitted infection (STI). It spreads through skin-to-skin contact during sexual activity with someone who has syphilis. It can also be transmitted from a pregnant mother to her baby during pregnancy or childbirth. Most of the time, there are no visible symptoms. However, using condoms can help prevent the transmission of syphilis.

[Music]
[Screen shows text in Nepali and English highlighted in white: Where can I get a sexual health check-up in NSW, and what are the options if I don't have Medicare?]

Anju: If you have Medicare or private health insurance, you can get tested for free by a GP (general practitioner). But it's important to ask in advance whether any additional fees apply. Some GP services may charge a gap fee if not fully covered by Medicare or insurance, while others may offer bulk billing, meaning no out-of-pocket fees.

University students can use their Overseas Student Health Cover (OSHC) at university health clinics for testing. If you do not have Medicare, you can contact Sexual Health Infolink at 1800 451 624 (free call) to find a free public sexual health clinic near you.

[Screen shows a telephone number on screen: 1800 451 624]

Anju: These clinics also offer free interpreter services.

[Music]

[Screen shows text in Nepali and English highlighted in white: Who should get a sexual health check and what does it include?]
[Screen shows a Nepalese man wearing a blue checked shirt sitting and facing forward. Colourful Nepali prayer flags are strung behind him]
[Text showing his name and position appears on the screen: Saurav Kiran Shreshta, Representative, Nepalese community]

Saurav: You should get a sexual health check if you have a new sexual partner, you notice any unusual symptoms, you have had sexual contact with someone who has an STI. Note: Most STIs do not show symptoms. The only way to know for sure is to get tested. Tests may include: a blood test, a urine sample, swabs which can often be self-collected. Getting tested for sexual health is common in Australia. Regular testing helps stop the spread of infections and keeps the community safe.

[Music]
[Screen shows text in Nepali and English highlighted in white: Is syphilis testing confidential?]

Saurav: Yes, syphilis testing is confidential. Your information will not be shared with anyone, including service providers, without your permission.

[Music]
[Screen shows text in Nepali and English highlighted in white: Who should I tell if I test positive for syphilis?]

Saurav: If you test result is positive, it's important to inform your sexual partner(s), so they can also get tested and treated. If you need help in telling your partners, you can talk to a health worker who can guide you on how to have that conversation. Notifying your sexual partner(s) helps stop the ongoing spread of syphilis.

[Music]
[Screen shows text in Nepali and English highlighted in white: If my test result is positive, can I get treatment?]
[Screen shows a Nepalese woman wearing a tan shirt and black glasses sitting and facing forward. Colourful Nepali prayer flags are strung behind her]
[Text showing her name and position appears on the screen: Anita Shreshta, Multicultural Health Program Officer, Multicultural Health, Western Sydney LHD]

Anita: Yes, syphilis is treatable, especially if caught early. Treatment usually involves antibiotics. If left untreated, syphilis can cause serious damage to various parts of the body and lead to serious health problems.

[Music]
[Screen shows text in Nepali and English highlighted in white: What if a pregnant woman has syphilis?]

Anita: Since syphilis can be transmitted to the baby, all pregnant women in Australia are tested for syphilis as part of routine antenatal care. Early treatment reduces the risk of harm to the baby. Untreated syphilis can cause miscarriage, stillbirth, or premature birth. Babies infected with syphilis may have complications at birth or show symptoms as they grow. Babies with syphilis also require treatment.

[Music]
[Screen shows text in Nepali and English highlighted in white: Where can I get more information or help about sexual health and syphilis?]

Anita: For more information on sexual health and syphilis, call Sexual Health Infolink at 1800 451 624 or visit www.shil.nsw.gov.au

[Screen shows a telephone number and website URL on screen: 1800 451 624 and www.shil.nsw.gov.au]
[Screen shows a scrolling webpage]

Anita (voiceover): If you need an interpreter, call the Translation and Interpreting Service (TIS) at 131 450.

[Screen shows a telephone number: TIS 131 450]

Anita (voiceover): Provide the TIS operator with the name and phone number of the service you want to contact, the language you need (e.g. Nepali).

[Screen shows the TIS website homepage with the language selection option]

Anita (voiceover): TIS will then connect you with the interpreter and the service.

[Screen shows the TIS website in Nepali]

Anita (voiceover): Please be patient. It may take a little time, so don't hang up.

[Music]
[Screen shows text highlighted in white: To find the clinic nearest to you contact SHIL]
[Screen shows text highlighted in white: Acknowledgements: Western Sydney Local Health District Syphilis Awareness Action Working Group. Public Health Unit, HIV and Related Programs, Multicultural Health, Western Sydney Sexual Health Centre, Aboriginal Health. Produced by Corporate Communications, WSLHD]
[Screen shows NSW Government logo and text: Western Sydney Local Health District]