Compulsory community treatment and ethnicity: Findings from a culturally and linguistically diverse area of Queensland

2019 ◽  
Vol 62 ◽  
pp. 154-159 ◽  
Author(s):  
Katherine Moss ◽  
Marianne Wyder ◽  
Vivienne Braddock ◽  
David Arroyo ◽  
Steve Kisely
2020 ◽  
pp. 000486742095428
Author(s):  
Steve Kisely ◽  
Dong Yu ◽  
Saki Maehashi ◽  
Dan Siskind

Objectives: Australia and New Zealand have some of the highest rates of compulsory community treatment order use worldwide. There are also concerns that people from culturally and linguistically diverse backgrounds may have higher rates of community treatment orders. We therefore assessed the health service, clinical and psychosocial outcomes of compulsory community treatment and explored if culturally and linguistically diverse, indigenous status or other factors predicted community treatment orders. Methods: We searched the following databases from inception to January 2020: PubMed/Medline, Embase, CINAHL and PsycINFO. We included any study conducted in Australia or New Zealand that compared people on community treatment orders for severe mental illness with controls receiving voluntary psychiatric treatment. Two reviewers independently extracted data, assessing study quality using Joanna Briggs Institute scales. Results: A total of 31 publications from 12 studies met inclusion criteria, of which 24 publications could be included in a meta-analysis. Only one was from New Zealand. People who were male, single and not engaged in work, study or home duties were significantly more likely to be subject to a community treatment order. In addition, those from a culturally and linguistically diverse or migrant background were nearly 40% more likely to be on an order. Indigenous status was not associated with community treatment order use in Australia and there were no New Zealand data. Community treatment orders did not reduce readmission rates or bed-days at 12-month follow-up. There was evidence of increased benefit in the longer-term but only after a minimum of 2 years of use. Finally, people on community treatment orders had a lower mortality rate, possibly related to increased community contacts. Conclusion: People from culturally and linguistically diverse or migrant backgrounds are more likely to be placed on a community treatment order. However, the evidence for effectiveness remains inconclusive and limited to orders of at least 2 years’ duration. The restrictive nature of community treatment orders may not be outweighed by the inconclusive evidence for beneficial outcomes.


2019 ◽  
Vol 54 (1) ◽  
pp. 76-88 ◽  
Author(s):  
Steve Kisely ◽  
Katherine Moss ◽  
Melinda Boyd ◽  
Dan Siskind

Background: There is conflicting and equivocal evidence for the efficacy of compulsory community treatment within Australia and overseas, but no study from Queensland. In addition, although people from Indigenous or culturally and linguistically diverse backgrounds are over-represented in compulsory admissions to hospital, little is known about whether this also applies to compulsory community treatment. Aims: We initially investigated whether people from Indigenous or culturally and linguistically diverse backgrounds in terms of country of birth, or preferred language, were more likely to be on compulsory community treatment using statewide databases from Queensland. We then assessed the impact of compulsory community treatment on health service use over the following 12 months. Compulsory community treatment included both community treatment orders and forensic orders. Methods: Cases and controls from administrative health data were matched on age, sex, diagnosis and time of hospital discharge (the index date). Multivariate analyses were used to examine potential predictors of compulsory community treatment, as well as impact on bed-days, time to readmission or contacts with public mental health services in the subsequent year. Results: We identified 7432 cases and controls from January 2013 to February 2017 (total n = 14,864). Compulsory community treatment was more likely in Indigenous Queenslanders (adjusted odds ratio = 1.45; 95% confidence interval = [1.28, 1.65]) subjects coming from a culturally and linguistically diverse background (adjusted odds ratio = 1.54; 95% confidence interval = [1.37, 1.72]), or those who had a preferred language other than English (adjusted odds ratio = 1.66; 95% confidence interval = [1.30, 2.11]). While community contacts were significantly greater in patients on compulsory community treatment, there was no difference in bed-days while time to readmission was shorter. Restricting the analyses to just community treatment orders did not alter these results. Conclusion: In common with other coercive treatments, Indigenous Australians and people from culturally and linguistically diverse backgrounds are more likely to be placed on compulsory community treatment. The evidence for effectiveness remains inconclusive.


Author(s):  
Ashley M. Frazier

Abstract School speech-language pathologists (SLPs) are increasingly likely to serve children of gay, lesbian, bisexual, and transgender (GLBT) parents or GLBT students as cultural and societal changes create growth in the population and increased willingness to disclose sexual orientation. The American Speech-Language-Hearing Association (ASHA) has a progressive nondiscrimination statement that includes sexual orientation as a protected status and strongly urges the membership to develop cultural competence as a matter of ethical service delivery. The purpose of this article is to describe cultural competence in relation to GLBT culture, discuss GLBT parent and student cultural issues as they are important in parent-school or student-school relations, and to provide suggestions for increasing sensitivity in these types of interactions. A list of resources is provided.


Author(s):  
Elena Dukhovny ◽  
E. Betsy Kelly

According to the 2010 U.S. Census, over 20% of Americans speak a language other than English in the home, with Spanish, Chinese, and French being the languages most commonly spoken, aside from English. However, few augmentative and alternative communication (AAC) systems offer multilingual support for individuals with limited functional speech. There has been much discussion in the AAC community about best practices in AAC system design and intervention strategies, but limited resources exist to help us provide robust, flexible systems for users who speak languages other than English. We must provide services that take into consideration the unique needs of culturally and linguistically diverse users of AAC and help them reach their full communication potential. This article outlines basic guidelines for best practices in AAC design and selection, and presents practical applications of these best practices to multilingual/multicultural clients.


2017 ◽  
Vol 2 (12) ◽  
pp. 81-88
Author(s):  
Sandy K. Bowen ◽  
Silvia M. Correa-Torres

America's population is more diverse than ever before. The prevalence of students who are culturally and/or linguistically diverse (CLD) has been steadily increasing over the past decade. The changes in America's demographics require teachers who provide services to students with deafblindness to have an increased awareness of different cultures and diversity in today's classrooms, particularly regarding communication choices. Children who are deafblind may use spoken language with appropriate amplification, sign language or modified sign language, and/or some form of augmentative and alternative communication (AAC).


2017 ◽  
Vol 13 (3) ◽  
pp. 263-274 ◽  
Author(s):  
Tonia Crawford ◽  
Peter Roger ◽  
Sally Candlin

Effective communication skills are important in the health care setting in order to develop rapport and trust with patients, provide reassurance, assess patients effectively and provide education in a way that patients easily understand (Candlin and Candlin, 2003). However with many nurses from culturally and linguistically diverse (CALD) backgrounds being recruited to fill the workforce shortfall in Australia, communication across cultures with the potential for miscommunication and ensuing risks to patient safety has gained increasing focus in recent years (Shakya and Horsefall, 2000; Chiang and Crickmore, 2009). This paper reports on the first phase of a study that examines intercultural nurse patient communication from the perspective of four Registered Nurses from CALD backgrounds working in Australia. Five interrelating themes that were derived from thematic analysis of semi-structured interviews are discussed. The central theme of ‘adjustment’ was identified as fundamental to the experiences of the RNs and this theme interrelated with each of the other themes that emerged: professional experiences with communication, ways of showing respect, displaying empathy, and vulnerability.


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