Access to a community aged psychiatry service by elderly from non-English-speaking backgrounds

Objective With the ageing of Australia's ethnic communities, aged mental health services need to examine issues pertaining to accessibility and appropriateness in the context of this sociodemographic change. The aim of this review of referrals to a community aged-psychiatry service was to compare for differences between patients from non-English-speaking backgrounds (NESB) and English-speaking backgrounds (ESB). Method Sociodemographic and clinical variables were retrospectively collated for a 12-month period and analysed according to NESB and ESB status. The 1996 Australian Census data were used for comparison of catchment area representation of different ethnic groups. Results 40.8% of patients referred to the service were from NESB, and 78.8% of these were assessed with an interpreter. Taken as broad ethnic groups, the referral of elderly European migrants was similar to their representation in the local population, while elderly migrants from Asia and other non-European backgrounds were under-represented. Sociodemographic differences were found in that the elderly from NESB were more likely to be poorly educated, have a low proficiency in English, and to have been employed in unskilled occupations. On the other hand, patterns of referral, diagnosis, past psychiatric history and outcome did not differ significantly between the two groups. Clinical variables relating to referral source, past psychiatric history, and outcome did not differ significantly across the two groups. Conclusions This 12-month review of referrals to an aged psychiatry community service found that nearly half were of elderly patients from NESB. The lower utilisation of the service by certain ethnic groups may reflect obstacles in their pathway to care. Alternatively, strong family networks, or a lower prevalence of mental illness in these elderly, may explain the findings in this report. Copyright (C) 2002 John Wiley Sons, Ltd.