Introduction

Australia is built on cultural diversity, grounded in the presence and traditions of Aboriginal and Torres Strait Islander peoples, whose connection to Country spans more than 65,000 years and whose heritage reflects one of the world’s oldest and most resilient living cultures.

Today, Australia is home to people with 320 ancestries. In 2024, 31% of Australians were born overseas and over half (51.5%) had a parent born overseas.¹ According to the latest census data from 2021, Australians’ speak 429 languages (including 183 First Nations languages) with 22.8% of Australians speaking language other than English at home, up from 21.6% in 2016.² Migration continues to shape our population, with temporary migrants, international students, skilled workers, refugees, people seeking asylum, and permanent residents all making Australia home and enriching our society. This increasingly diverse population presents challenges and opportunities for mental health services, and requires culturally responsive, inclusive and innovative approaches.

We have a shared responsibility to ensure that multicultural communities, who represent a significant proportion of our population, have equitable access to timely, appropriate, high-quality mental health care. The Framework for Mental Health in Multicultural Australia (Framework) supports mental health and suicide prevention services to meet that responsibility by building their capacity to deliver culturally responsive care.

Cultural responsiveness in mental health care refers to the ongoing quality improvement process by which services adapt and improve to effectively meet the needs of multicultural communities, ensuring safe, high quality and equitable care.³

Why cultural responsiveness matters

People and communities from multicultural backgrounds bring unique stories, cultural and religious beliefs, and experiences that all shape how mental health, mental illness and wellbeing are understood and explained. There can also be considerable variation across individuals, families and communities in how distress is expressed, how symptoms are described, and whether people choose to access formal health services or seek help elsewhere.⁴ The concept of mental illness as a health problem requiring medical treatment is grounded in western thinking. For some people from multicultural communities, engaging with services and discussing mental health can seem unfamiliar and even create fear.⁵

Organisations and professionals who seek to work in ways that are culturally responsive, integrated, and utilise strengths-based approaches that have been co-designed with community, can enhance effective engagement with multicultural communities and contribute to enhanced mental health outcomes for multicultural communities.⁴

Cultural responsiveness is not optional, but it is fundamental to safe, high-quality and equitable care.

What the evidence tells us

There are considerable gaps in data and research on the mental health status, service needs and experiences of multicultural communities in Australia.⁴ National and local data collection systems are often poorly equipped to reflect cultural and linguistic diversity within multicultural Australia, with research highlighting that variable and data definitions are needed that are meaningful for multicultural communities.⁴

Despite these gaps, several key themes from recent research indicating that the mental health experiences of some multicultural communities differ significantly from those of other Australians including. These include:

Lower service use and delayed treatment
Overseas-born individuals in Australia are less likely to access mental health care and are more likely to delay treatment, often for 10 years or more, with this likely due to factors such as limited availability of culturally appropriate services and lower mental health literacy.⁴
Increased risk for recent arrivals
Recent settlement in Australia is a risk factor for mental illness with people who have arrived recently (2012-2022) having a higher likelihood of experiencing anxiety and affective disorders like depression.⁴
Refugees and People seeking asylum at heightened risk
There is heightened vulnerability among specific groups of people from multicultural backgrounds in Australia, specifically people from refugee backgrounds and people seeking asylum. Studies show refugees and people seeking asylum are at greater risk of mental illness and coupled with the fact that mistrust of health systems may be even more heightened due to trauma experiences related to past experiences with authorities. Prolonged detention is particularly associated with poorer mental health outcomes, especially for children. Refugees may have experienced torture, trauma, detention, deprivation and loss of family and community prior to arriving in Australia and mental health services must be equipped to respond to this complexity.

The research is also clear on current and emerging good practices for supporting multicultural mental health. This includes that:

A range of interventions are required to meet evolving multicultural mental health needs, however all multicultural mental health care must be based on culturally safe, trauma informed and strengths-based principles.⁴
Culturally tailored mental health literacy and anti-stigma campaigns can improve mental health and promote help-seeking behaviours.⁴
Working directly with people and communities from multicultural communities to co-design services, integrate support within existing community infrastructures, improve the bicultural workforce and strengthening language services are all enablers of improved mental health outcomes.⁴
Specialist support is needed to support particularly multicultural groups, such as the for The Program of Assistance for Survivors of Torture and Trauma (PASTT) which provides specialist support for people with experiences torture and trauma in the refugee journey.⁴

How the Framework responds

Australia’s mental health policies and plans include principles promoting cultural responsiveness, but evaluation of how well these have been implemented for multicultural communities remains limited.⁴ While current policies articulate what needs to be done, they do not always provide the strategies or indicators needed to achieve and track improved cultural responsiveness over time. The Framework is designed to address this gap.

The Framework is mapped to existing national quality and safety standards, including the:

This alignment means organisations can align Framework activities to existing quality and accreditation processes.

The Framework aims to complement and work effectively with a broader ecosystem of mental health and suicide prevention services, including mainstream public, private and community services, state-funded Transcultural Mental Health Centres (NSW, VIC and QLD), the Forum of Australian Services for Survivors of Torture and Trauma (FASSTT), and established refugee health services. Settlement services, language support, employment programs and community organisations also play a vital role in the mental health and wellbeing of newly arrived migrants and refugees, and the Framework connects to these resources to support a nationally coordinated approach.

1. Australian Bureau of Statistics. (2024) Australia's population by country of birth 2024 [Available from: https://www.abs.gov.au/statistics/people/population/australias population-country-birth/latest-release.

2. Australian Bureau of Statistics. (2024) Australia's population by country of birth 2024 [Available from: https://www.abs.gov.au/statistics/people/population/australias population-country-birth/latest-release.

3. Mental Health in Multicultural Australia (MHiMA) (2024). Key concept 1: Cultural responsiveness 2014 [Available from: https://embracementalhealth.org.au/images/knowledge-hub/Key%20Concept%201%20-%20Cultural%20Responsiveness.pdf]

4. Slewa-Younan S, Blignault I, Chimoriya R, Agho K, Li B, Jorm AF, Salvador-Carulla L, Bagheri N, Renzaho AM. (2025) The State of Multicultural Mental Health in Australia Research Report. Western Sydney University, Sydney.

5. Radhamony, R., Cross, W. M., Townsin, L., & Banik, B. (2023). Perspectives of culturally and linguistically diverse (CALD) community members regarding mental health services: A qualitative analysis. Journal of Psychiatric and Mental Health Nursing, 30, 850–864