Victorian Transcultural Psychiatry Unit
The Cultural Diversity Plan, Cultural Portfolio Holders and
Recommendations to Services on Working Effectively with
Clients and Carers from CALD backgrounds
Y. Stolk, S. Klimidis, M. Stankovska
Introduction
The Cultural Diversity Plan for Victoria’s specialist mental health services 2006-2010
(Department of Human Services [DHS], 2006) provides a framework for specialist mental
health services1 to better meet the needs of their culturally diverse communities in
accordance with current state government policy. It clearly defines the responsibilities of the
Mental Health Branch, specialist mental health services and the organisations funded to
assist mental health services with this work: the Victorian Transcultural Psychiatry Unit
(VTPU), Victorian Foundation for Survivors of Torture (VFST) and Action on Disability in
Ethnic Communities (ADEC).
This document aims to assist specialist mental health services (abbreviated to MHSs) to plan
for cultural diversity by providing a brief overview of the broad principles in the Cultural
Diversity Plan, clarification of the role of MHSs in implementing the plan, and
recommendations regarding an appropriate role for Cultural Portfolio Holders – the servicebased resource suggested in the Plan as the primary means for MHSs to generate service
improvement activities for culturally and linguistically diverse (CALD) consumers and carers.
The document also describes the type of assistance that can be provided by the VTPU.
Mental Health Service Responsibility
Service reform agenda
It is the responsibility of the MHS to enact the Cultural Diversity Plan and to develop
processes for its strategic implementation. The Cultural Diversity Plan specifies six areas for
action that will enhance the capacity for services to meet the needs of CALD consumers and
carers. These requirements provide an agenda for service reform that can assist service
planning.
The Cultural Diversity Plan stipulates that the following broad outcomes are prioritised:
1. Each MHS has language services that are available and accessible; mental health
staff are aware of interpreter booking processes; and language services are
appropriately used at critical points of service delivery (DHS, 2006, p 32)
2. The majority of staff are trained in working effectively with interpreters (DHS, 2006,
p32)
3. All staff have access to a minimum level of training in cross-cultural competence
(DHS, 2006, p18)
4. All MHSs have established links with local ethno-specific community organisations,
other relevant organisations and bilingual service providers to facilitate CALD
community access and discharge planning (DHS, 2006, p27)
5. All MHSs will review policies, service plans and work practices to ensure cultural
appropriateness and relevance (DHS, 2006, p27)
6. All MHSs have established procedures for recording and reporting on the crosscultural activities (described in points 1-5 above), consistent with quality monitoring
and improvement processes in the Victorian Strategy for Safety and Quality in Public
Mental Health Services 2004-2008 (DHS, 2004) (DHS, 2006, p40–41).
1
Specialist mental health services include both clinical services and psychiatric disability rehabilitation
and support services (DHS, 2006, p. 11).
D:\106744393.doc. MS edit 8/04/08:17.30
2
Cultural Portfolio Holders
The Cultural Diversity Plan also stipulates that every MHS should appoint a Cultural Portfolio
Holder (CPH) to support implementation of the Cultural Diversity Plan (DHS, 2006, p. 25).
Appointment of a CPH by each MHS will facilitate implementation of the goals of the Service
Reform Agenda mentioned above. The appointment of CPHs by services also provides a
means of connecting with the VTPU for assistance and support.
The VTPU investigated issues in implementing and maintaining the Cultural Portfolio holder
role in MHSs by interviewing existing Cultural Portfolio holders (see Appendix 1). The
findings from this investigation informed development of the following recommendations
regarding the appointment, implementation, ongoing support, and effective use of the role of
Cultural Portfolio Holder.
Organisational location of Cultural Portfolio Holders in MHS
The broad responsibility of the CPH is to support the MHS as it enacts the Cultural Diversity
Plan and develops processes for its strategic implementation. To enable the CPH to function
effectively it is recommended that the CPH role:
1. Be undertaken by someone with leadership qualities and at a level of appointment
with access to managerial decision-making
2. Has sufficient authority to develop and implement policy, including the development
of service structures and processes, projects and collaborations
3. Aims to integrate CALD service improvement planning with overall service quality
improvement planning
4. Be recognised by the service with an allocation of EFT dedicated to the portfolio,
depending on the CALD population density of the catchment area
5. Has responsibility for no more than one mental health service (as designated by the
DHS2). If there is responsibility for more than one service, this should be recognised
through a pro-rata increase of EFT
6. Has a working space/office where pressures to respond to clinical issues can be
avoided
7. Addresses CALD issues across all teams and pathways of care.
Broad proposed areas of responsibility of Cultural Portfolio Holders
The responsibility of the CPH is to assist the MHS to promote culturally sensitive service
provision in the MHS and to facilitate service access by members of ethnic communities. To
achieve these objectives the following activities (which are neither prescriptive nor
exhaustive) may be undertaken, in consultation with MHS management and consistent with
the MHS Quality Improvement Plan:
1. Establish support structures (e.g., Cultural Working Group) to promote the
implementation of the Cultural Diversity Plan for Victoria’s Specialist Mental Health
Services 2006-2010 (DHS, 2006)
2. Act as a contact point for communication within the MHS as well as between the MHS
and VTPU
3. In collaboration with appropriate support structures (see point 1) identify and respond to
service priorities consistent with the Service Reform Agenda and overall service planning
4. Disseminate resources, foster cross-cultural education and community liaison
5. Disseminate relevant information and/or statistical data in order to support the
development of strategies and procedures for service improvements
2
See DHS website for delineation of mental health services
http://www.health.vic.gov.au/mentalhealth/services/index.htm
3
6. Liaises regularly with other CPHs and VTPU for mutual learning, information sharing, and
planning of cross-catchment collaborative projects
7. Obtains support from the VTPU by participating in regular VTPU CPH support meetings.
Support for mental health services by the VTPU
The VTPU is available to support and assist MHSs to meet the requirement of the Cultural
Diversity Plan in providing high quality mental health services to clients and carers from
immigrant backgrounds. As such, the provision of support and assistance to Cultural Portfolio
Holders is a priority. A range of services are offered, including consultancy in service planning
and development, education and professional development, and the provision of direct
information and advice.
The consultancy support in service planning and development comprises activities that aim to
assist services to improve the design and delivery of services to people from CALD
backgrounds. This includes assistance with:
 Policy development
 Needs identification and prioritisation
 Integrating CALD responsiveness into existing service protocols and structures
 Assisting CPHs to build capacity within the service
 Developing resources to support staff
 Linkage with ethnic communities, and
 Information on evidence-based service provision models, cross-cultural research or
resources that may be useful.
The VTPU Education and Professional Development program includes:

Discrete in-service sessions across a wide range of themes designed to enhance the
knowledge and skills of mental health staff in assessing and managing the mental
health and well-being of people from CALD backgrounds. Sessions have a duration
ranging from two hours to a full day and are held on-site at mental health services
 Monthly seminars in the field of transcultural mental health practice held at the VTPU
 Monthly clinical case discussions held at the VTPU, and
 Interactive workshops designed to explore important aspects of culture,
communication and difference in transcultural mental health, also held at the VTPU
or in rural or service locations by arrangement.
Further, the VTPU provides a telephone and email information and advice support service to
assist clinicians and other mental health services staff in their work with clients and carers
from immigrant backgrounds.
Detailed information about VTPU programs and resources may be found at:
http://www.vtpu.org.au
References
Department of Human Services (2004). Victorian Strategy for Safety and Quality in Public
Mental Health Services 2004-2008. Melbourne: DHS.
Department of Human Services (2006). Cultural Diversity Plan for Victoria’s Specialist Mental
Health Services 2006-2010. www.health.vic.gov.au/mentalhealth/publications/caldstrategy.pdf
4
Appendix 1
Roles of Current Portfolio Holders
Interviews were held with four existing CPHs in June, 2007 to clarify the development of the
role, position description, nature of activities engaged in, and factors that limited or enhanced
performance of the role. CPHs ranged in experience from one having recently been
appointed, to three having a substantial working history in the CPH role. Conclusions
reached from the investigation were as follows:
1. CPHs ability to enact reform and relevant quality improvements appeared to be related to
their level of appointment. While personal interest in the role was beneficial in a
favourable service environment, reliance on personal commitment makes the role fragile
as departure of the individual is likely to lead to discontinuation of relevant activities. Thus
a sustainable solution needs to be considered.
2. CPHs lacking access to the service’s executive experienced a sense of isolation,
uncertainty and a lack of guidance in developing and implementing projects relevant to
improving access and equity for CALD communities.
3. Models of the CPH role varied according to whether the CPH worked alone, the level of
access to executive/management committees within the service, availability of a cultural
working group, support from the VTPU, level of collaboration with the VTPU, level of
integration of the CPH role in their usual role in the service and, where access to
executive decision processes was low, access to local management to support the CPH
role.
4. CPHs with responsibility for services with multiple sites and programs experienced
problems of geographical and functional inaccessibility, that is, limited reach of activities
inside the various components of the service to implement quality improvements.
5. It was felt that it would be beneficial if the CPH role was functionally tied with quality
improvement processes in collaboration with the quality manager.
6. It was not clear whether current CPH activities were as yet guided by the Victorian
Cultural Diversity Plan, though they were consistent with its general direction. Local
assessments of issues of priority were an important driver of activity.