Exploring Spirituality, Religion and Traditional Healing as Protective Factors in Transcultural Mental Healthcare

Abstract

This study details the results of a qualitative investigation into the role and importance of spirituality, religion and traditional healing, as perceived by mental health practitioners working with culturally and linguistically diverse (CALD) individuals. A qualitative method was used to extract deeper meaning from discussion content. This was considered particularly important in catering to CALD communities, both in terms of how well they understood the meanings of questions, and how well they conveyed their intended meanings in responses. The histories of many practitioner participants in this study were informed by ongoing conflict in their home countries, where they reported distrusting government-run institutions. Many of them entered this study still bearing the emotional effects from their experience of war, and many also struggled with language and other cultural differences. In addition, some had strained relations with medical systems in their countries of origin. The research design therefore allowed for subtle nuances to be expressed during focus group discussions, and was sensitive to the cultural and socio-political issues plaguing these communities, both in Australia and abroad. Close attention was paid to building rapport and creating a safe environment for the full participation of each person. This is why transcultural mental health as a treatment approach was utilised to meaningfully examine the context in which people exist and the local and global implications of being estranged from one’s homeland. Research addressing sensitive topics with people from CALD backgrounds can present challenges that are difficult to address using conventional methods, as many of these communities may feel over-researched in a way that sets them up to feel exploited and more vulnerable to Western influence. Many of these people speak English as a second language, and so may feel that since they have been accepted into this country, they cannot disagree with what medical personnel ask of them. The study was carried out using informal community collaboration, the key factor to the success of this research, which optimised the development of research questions and engendered a trusting research environment. Most research in this field to date has been conducted from the perspective of Western medical practice; however, in contrast, this study gains insight into the perspectives of a range of CALD communities, in terms of how they address mental health issues within their respective communities. The study combined perspectives from a range of mental health practitioner participants, including professional and para-professional mental health workers from both CALD and non-CALD backgrounds. Services provided by these groups are routinely accessed by CALD people at the onset of their wellbeing issues. Participants included government and non-government mental health practitioners from various academic disciplines, and there was a balanced representation of gender and country of origin. As immigration is taking place globally at an unprecedented rate, consumers from many CALD communities are presenting in mental health systems with a range of emotional needs. As a result, mental health services are finding themselves faced with assessment and treatment challenges. The immigrant journey consists of complex resettlement issues often associated with visa status, ongoing grief and loss issues, and trauma from leaving one’s homeland for a host of ecological, socio-political or religious reasons. Immigration is often accompanied by stressful adaptation to a new host environment, which can be challenging even if the migrant is welcomed by their new country and given all the benefits of being able to begin a new life there. This study demonstrated that mental health practitioners working with CALD clients should approach treatment while considering the acculturation process involved in resettlement, as this may be more traumatic for the individual or community when they are not accepted, directly or indirectly, by the host environment. Such a situation, in which the individual or community has been taken away from everything familiar to them, often leads to an existential crisis. Many of these individuals are placed in detention or are left within the wider Brisbane community with no financial benefits or resources. This heightens their reliance on a higher power, as many feel they are stripped bare of all earthly relationships and possessions and left with only their spiritual, religious and traditional dimensions. The data from this study show clear evidence for the importance of spirituality, religion and traditional healing in transcultural mental healthcare, while at the same time pointing to a level of reluctance on the part of practitioners and management to fully integrate these issues into their approach. The CALD participants overwhelmingly agreed that spirituality, religion and traditional healing were essential cultural entities which form the foundation for who they are as people, and to forego these practices in, of all places, mental healthcare, would be counterproductive. The results from this study have implications for current and future mental health practice, for mental health policy, for training of mental health personnel and for future research.