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Voicing experiences: People with disability from culturally and linguistically diverse communities and service provision

Summary and Recommendations

As both the official adviser to the NSW Government on issues affecting people with disability and their families and an adviser to the Commonwealth Government on important issues for people with disability in NSW, the Disability Council is keen to develop a better understanding of service provision issues and experiences of people with disability from culturally and linguistically diverse (CALD) communities.

Voicing Experiences: People with disability from culturally and linguistically diverse communities and service provision is part of a developing strategy to improve our understanding of these issues. This report is based on consultations held by the Council from 2002 to 2005 with three hundred people with disability and their families from six culturally and linguistically diverse communities.

In both developing the project methodology and in its implementation, advice and assistance was sought from key organisations within each of the six communities. In addition, feedback from each community on the draft reports was actively sought and modifications made to reflect their comments.

We worked hard to make the consultations inclusive of people with disability from each community. We note, however, 80% of participants were family members of people with disability. We value the information received from participants at each consultation. However, we acknowledge that people with disability were under-represented. That is a concern we are committed to addressing in future consultations. Nevertheless, the comments of participants provided valuable insight into their experience of service provision and of dealing with a double disadvantage.

There was consistency in the views expressed by all six communities on each of the issue areas covered by the consultations' focus groups. Each expressed a general appreciation for a range of formal support services they were using. This is particularly true of respite and ethno-specific services. At the same time we recognise that many people from CALD communities engage with whole-population disability services and generic service systems. Some of that engagement is valued, some is not. The key point is that we must listen to what people tell us.

There was also general consensus about the aspects of service provision that presented barriers to accessing services, including:

• a lack of information in languages other than English about available services, rights and complaints processes;
• a lack of short-term, emergency and centre-based respite, supported accommodation, general support in times of crisis, early intervention or therapy services for children or enough bilingual workers and interpreters;
• waiting lists for home and community care services such as personal care, speech therapy, occupational therapy and physiotherapy;
• time-limited assistance;
• poor quality of services, for example, workers being late or not turning up; untrained staff; workers' cultural attitudes and knowledge of service; no relief staff; services inability to meet cultural and religious needs;
• limited resources available for services;
• lack of flexibility because of strict guidelines for services; and
• very high costs of activities, transport and equipment often paid for directly by families.

In addition to these barriers, participants spoke about two other important difficulties that stop them from using services. These were feeling unable to ask for assistance, and negative experiences with services in the past.

Participants reported both a lack of knowledge of where to go to get help if they have problems with a service, and a reluctance to make complaints if problems occur.

The difficulties experienced in using and accessing services were exacerbated by both communication difficulties and cultural differences, including a lack of information about services in plain English; difficulties communicating with workers in English; a lack of bilingual workers and interpreters, and a lack of culturally sensitive workers.

Overwhelmingly, people we spoke to said that accessible information and culturally sensitive as well as flexible service provision would help address the problems they identified. They said that this could be made possible by supporting :

• Parent/family groups and multicultural support agencies;
• A better flow of information to, and resources for, CALD workers;
• Culturally sensitive workers for assessment and casework management through Cultural Competency Training;
• Employment of CALD workers at decision-making levels to assist services develop culturally sensitive policies and procedures;
• Free and readily available interpreter services;
• More consultations and information sessions to strengthen networks across services and people with disability and their families from CALD backgrounds;
• Accessible centres for people with disability from CALD backgrounds and their families where they can access relevant information, specialists, support services and/or training as needed, and
• Community Education Campaigns to lessen the disadvantages of disability and increase their awareness of and access to available services.

Though the findings of this report are not new to many people working in the field, they do confirm that people with disability from CALD communities experience a double disadvantage. They not only face disability related barriers when trying to obtain services but cultural and linguistic barriers as well. To this day people from CALD backgrounds remain under-represented in their access to disability services.

It is not surprising that the kinds of services that work best for the people we talked to are those which are sensitive to people's cultural and linguistic needs. Why? Because they link them into mainstream services, assist them in their role as carers, give them an opportunity to socialise and provide a safe place to meet other families who are in similar situations and who share the same culture, language and religious beliefs. Such services make people feel connected, understood and accepted.

The first step then to improving access to services for people with disability from CALD communities and their families must deal with the additional disadvantages people face because of their cultural differences and language difficulties.

This highlights the need for us to look beyond issues of resources to face the real challenge of providing services that are sensitive to the needs of people from culturally and linguistically diverse backgrounds. With this in mind, the recommendations of this report are predominately about taking responsibility in providing people with disability from CALD communities and their families with the support needed to reduce disadvantage. To do this successfully the Disability Council, government and service providers need to work together to support a more proactive approach to providing culturally appropriate service delivery.

For the Disability Council this means:

• Ensuring that its planning and activities adequately address the ineeds of people with disability from CALD communities
• Ensuring CALD community representation on the Council
• Working with CALD communities to raise their issues with the NSW Government
• Developing a strategy to work with government agencies and service providers to ensure that services provide culturally sensitive service delivery
• Working with CALD communities to develop community education and awareness campaigns that lessen the stigma and taboos associated with disability
• Acting as a catalyst between government departments (DADHC) and non-government organizations about the development of a CALD specific disability services forum to consult, inform and strengthen networks across services and people with disability from CALD communities
• Ensuring that any future consultations with people with disability from CALD communities investigate ways of facilitating the participation of people with disability from CALD communities so that their voices are better heard.

For Government this means:

• Listening closely to what people from CALD communities say about their experience of disability and other services;
• Developing and sustaining partnerships with key non-government organizations that are well connected to CALD communities;
• Ensuring government departments have policies that support culturally sensitive service provision;
• DADHC taking a lead role to develop infrastructure within CALD communities to develop supports for people with disability from these communities and their families;
• Ensuring and monitoring the provision of interpreting services in line with the NSW Premier's memorandum No: 98/22, which states:
  "NSW Government Agencies including Government Trading Enterprises are expected to ensure that contracts with private providers and funding agreements with non-government organisations identify a budget for interpreting and translation appropriate to the service provided and the needs of the clients of the service. In relation to state owned Corporations, I consider that this provision provides a sound approach when dealing with people from a non-English speaking background. Funding agencies are also expected to ensure through program monitoring that where such funding is made that language services are provided to clients who need them"
• Ensuring that funded bodies establish a benchmark for a service access rate to match the population of people with disability from CALD communities in service catchment areas as well as ongoing monitoring and evaluation of services to ensure equitable access for people with disability from CALD backgrounds.

For service provider this means:

• Engaging with culturally and linguistically diverse communities to ensure their needs are being adequately met;
• Providing information in plain English and/or in languages other than English on services, rights and complaints mechanisms;
• Facilitating access to bilingual workers, interpreters and CALD support networks whenever possible;
• Ensuring and monitoring their provision of interpreting services in line with the NSW Premier's memorandum No: 98/22;
• Developing and working in partnership with CALD groups to ensure that information is widely distributed to both community workers and CALD communities;
• Ensuring that staff development programs provide a component of skills based training on culturally sensitive service provision or Cultural Competency Training;
• Ensuring equitable access to all services by measuring and monitoring the services access rate of people with disability from CALD backgrounds.