Mental Health Support for Migrant and CALD Women in Australia

A resource from Safe Refuge Counselling, a women-specific online and in-person counselling practice founded by Aana Carpenter, a Singaporean-Australian registered counsellor (ACA Level 1). It is not a domestic violence service, despite what the name can suggest at first reading. This guide is written for migrant and culturally and linguistically diverse (CALD) women thinking about whether, when, and how to seek mental health support in Australia.

Content note. This guide discusses mental distress, perinatal mental health, grief, racism, and intergenerational trauma in general, non-graphic terms. It includes help-seeking information throughout. If you are in immediate distress, skip to the help-seeking section at the end.

Acknowledgement. Safe Refuge Counselling acknowledges the Traditional Custodians of the lands on which we live, work, and meet clients. Mount Barker, where the practice is based, sits on the lands of the Peramangk and Kaurna peoples. We pay our respects to Elders past and present, and recognise Aboriginal and Torres Strait Islander peoples as the First Peoples of this continent. If you are Aboriginal or Torres Strait Islander, culturally safe support is available through 13YARN (13 92 76) and Gayaa Dhuwi (Proud Spirit) Australia. This guide centres the experiences of migrant and CALD women, which is a different story, and we name that distinction with care.

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1. Who this guide is for

If you moved to Australia as a child, a teenager, a young adult, or later in life. If your parents moved here and you grew up between languages and cultures. If you arrived recently on a student visa, a partner visa, a skilled visa, or as a refugee. If English is your second, third, or fourth language. If the way your family talks about "being unwell" does not map neatly onto the way your Australian GP talks about "mental health." This guide is written with you in mind.

At the 2021 Census, 27.7% of people counted in Australia were born overseas. A further 22.3% spoke a language other than English at home. That is close to half the country carrying some experience of migration, bilingualism, or cultural movement. Despite those numbers, research and services have not kept pace. A review of three major Australian health journals found that only around 2.2% of published articles were primarily focused on multicultural health issues, and more recent counts suggest that figure has fallen rather than risen. What this means in plain terms: the mental health system you are being asked to trust has not studied you very closely. It is reasonable to feel that the system was not built with you in mind, because in many ways it was not.

This guide is not a substitute for seeing a counsellor, psychologist, GP, or psychiatrist. It is a map. It covers the specific barriers migrant and CALD women face, how the Australian mental health system actually works, what culturally appropriate support looks like, how to think about common presentations such as anxiety, depression, and perinatal distress through a multicultural lens, how to talk to family about help-seeking, and where to find community-specific resources.

A note on language. The term "CALD" (culturally and linguistically diverse) is a government category. It is useful for policy and funding conversations, and limiting everywhere else. An East Asian woman whose family has been in Australia for three generations, a South Asian international student in her first semester, a Middle Eastern woman who arrived as a refugee a decade ago, a Pacific woman raising children across two homelands, and a Latin American woman navigating a partner visa are all "CALD." They are not living the same life. Wherever possible this guide uses specific examples rather than a single averaged experience. Where the guide does use "migrant women" or "CALD women" as shorthand, please read it as a starting point for a conversation, not a summary of who you are.

2. The specific barriers

Migrant and CALD women face barriers that are not simply the general barriers to mental health care with a language issue attached. They are structural, cultural, relational, and sometimes legal, and they interact with each other.

Stigma in home culture. In many cultures, mental distress is framed as a private family matter, a spiritual issue, a weakness of character, a sign of insufficient gratitude, or a problem that will pass if you work harder, pray more, or think less. A woman who has grown up hearing that "we do not talk about these things" is not being stubborn when she hesitates to see a counsellor. She is carrying a cultural inheritance that told her hesitation was wisdom.

Language barriers in therapy. Therapy is a language-dense profession. Even for fluent bilingual speakers, the vocabulary of emotional life often lives more richly in the first language than the second. Words like "grief," "resentment," "shame," "overwhelm," and "longing" carry different weight in different languages, and some experiences genuinely do not translate. A Tagalog-speaking woman may have a word for the specific exhaustion of being the family emotional anchor that has no clean English equivalent. An Arabic-speaking woman may find that the English word "anxiety" flattens a cluster of bodily and spiritual experiences her first language holds more precisely.

The discomfort of describing inner life in a second language. Even when English is strong, describing an inner life in a second language can feel oddly performative, as though you are reporting on someone else. This is a real phenomenon, not a character flaw. Some women find it easier to start counselling in English because the emotional weight is lower. Others find it harder for the same reason. Both are legitimate.

Differing cultural concepts of mental health and distress. Western clinical frameworks categorise distress as disorders with symptom lists. Many cultures locate the same experiences in the body (headaches, heaviness in the chest, exhaustion), in relationships (dishonour, estrangement), or in the spirit (soul-weariness, disconnection from the sacred). Neither framework is the full truth. A good counsellor works with the framework that fits the person in front of her, not the framework on the textbook page.

Navigating the Australian healthcare system. Medicare, bulk-billing, GPs as referral gatekeepers, Mental Health Treatment Plans, private health insurance, the public-private split, the difference between a psychiatrist, psychologist, counsellor, and social worker. None of this is obvious to someone who grew up with a different system. It is not obvious to many Australian-born people either.

Immigration-related fear of disclosure. Women on temporary visas, partner visas, or pathways to permanency can reasonably worry about whether mental health records affect their immigration outcomes. In most cases they do not, but the fear is rational given the stakes, and it keeps women from seeking help they are entitled to access. Any good practitioner will be willing to talk plainly about confidentiality and record-keeping.

Isolation from extended family support. In many home cultures, a new mother, a bereaved daughter, or a woman in a marriage crisis is surrounded by aunts, cousins, grandmothers, and neighbours who carry part of the load. Migration often leaves a woman with a nuclear family, a spouse who may also be struggling, and a few friends. The scaffolding that used to hold distress is simply not there. This is not a personal failure. It is a structural gap.

Racism as a mental health stressor. Everyday racism, microaggressions at work, the fatigue of being the only person of your background in a room, and the cumulative cost of explaining yourself all affect mental health. Research consistently links experiences of racism and discrimination to higher rates of anxiety, depression, and sleep disturbance. When a woman says "I am just tired," racism may be part of what she is tired of.

3. Understanding the Australian mental health system as a newcomer

The Australian mental health system is not a single system. It is a patchwork of public services, private practitioners, Medicare, private health insurance, community-controlled organisations, and free or low-cost services funded through federal or state programs. Here is a plain-language map.

The GP as gatekeeper. A general practitioner (family doctor) is usually the first point of contact for mental health support inside the Medicare-funded system. A GP can talk with you about what you are experiencing, rule out physical causes, prescribe medication if appropriate, and write a Mental Health Treatment Plan (MHTP) that gives you access to subsidised psychology sessions. You do not have to accept medication to see a GP, and you do not have to see a GP to access counselling.

Mental Health Treatment Plans. An MHTP is a document that, once written, entitles you to up to 10 subsidised psychology sessions per calendar year under Medicare. The rebate covers a portion of the session cost. Most psychologists charge above the rebate, and the out-of-pocket "gap" can be significant. The Australian Psychological Society recommended fee is around $318 per session, and the typical gap payment after Medicare rebate sits between $173 and $219 for a psychologist.

Medicare and the counsellor question. Counselling with a registered counsellor (such as a member of the Australian Counselling Association) is currently not Medicare-rebatable. That is a funding decision, not a measure of quality. Counsellors often charge less than the gap a client would pay for a psychologist, have no session cap, and do not require a GP referral or a written plan to begin. For some women, especially those who do not want a mental health record on their Medicare history, this is a relief.

Private health insurance. Some private health extras cover counselling and some cover psychology. The details vary by fund and product. Reading the fine print matters.

Public mental health services. State-funded community mental health services and hospital-based services exist for people with severe or acute mental health needs. They are free at point of use, stretched thin, and generally not the first port of call for a woman experiencing moderate anxiety, grief, or perinatal distress.

Free and low-cost services. Lifeline, Beyond Blue, 1800RESPECT, PANDA, and many community-based services offer free phone and online support. Several state multicultural mental health services offer bilingual counselling at no cost. Headspace supports young people aged 12 to 25. There is more free support than people realise.

Telehealth as an equaliser. Since 2020, telehealth has become a standard way to see a counsellor or psychologist. For migrant women, telehealth is a practical game-changer. It removes travel, lets you see a practitioner outside your local community (which matters when your community is small and confidentiality feels fragile), and lets you choose a counsellor based on fit rather than geography. A woman in a regional area can see a Mandarin-speaking counsellor in Melbourne. A Muslim woman in Sydney can choose a practitioner on the basis of approach rather than the nearest office.

4. Finding culturally appropriate support

"Cultural safety" is a phrase that gets used often and sometimes loosely. Here is what it means in practice.

A culturally safe practitioner does not need to share your background. She needs to recognise that your background exists, that it shapes your experience, and that her own background shapes how she sees you. She asks rather than assumes. She reads about the histories, migrations, and religions that shape her clients' lives. She notices when her clinical framework does not fit and is willing to adjust. She does not treat your culture as an interesting add-on to a standard Western therapy. Cultural safety is measured by the client, not by the practitioner. If you leave sessions feeling understood in the whole of who you are, that is a good sign. If you leave feeling translated, flattened, or subtly corrected, that is worth naming.

Bilingual and bicultural practitioners. A bilingual practitioner speaks your language. A bicultural practitioner shares enough of your cultural context to understand the texture of your life without long explanations. Both are valuable and they are not the same thing. For some women, having a counsellor from their own community feels like relief. For others, the smaller the community, the more complicated confidentiality becomes, and a practitioner from outside feels safer. Either preference is legitimate.

Interpreter services. The Translating and Interpreting Service (TIS National, 131 450) is a free, confidential, government-funded service that can provide a qualified interpreter for medical and allied health appointments, including mental health. Many counsellors and psychologists are happy to work with an interpreter. If you are more comfortable speaking a language other than English, say so up front. Using an interpreter in therapy takes a little getting used to, and many women find that what they lose in directness they gain in precision.

Services run by and for specific communities. Organisations such as Ishar Multicultural Women's Health Services in Perth, the Multicultural Centre for Women's Health in Melbourne, and a range of state-based transcultural mental health centres provide counselling, case work, peer support, and health information designed with specific communities in mind. These services are often free or low-cost. Several have specific programs for women from East Asian, South Asian, Middle Eastern, African, Pacific, and Latin American backgrounds. A full list sits in the resources section.

A note on choosing a practitioner. When you are researching, a 15-minute phone or video call to see whether the fit is right is a reasonable thing to ask for. You are allowed to ask a counsellor how she thinks about culture, whether she has worked with women from your background, and what she would do if she noticed her framework was not fitting. A good practitioner welcomes those questions.

5. When to seek help for specific presentations

There is no single threshold where a difficult period becomes something worth seeking support for. The practical test is closer to: has this been going on for a while, is it affecting how you sleep, eat, work, parent, or relate to people you love, and would a conversation with a skilled outsider help you understand it better? If the answer is broadly yes, it is a reasonable time to reach out.

Anxiety and depression through a multicultural lens. Research shows that men and women from non-English speaking backgrounds often experience higher rates of depression than the Australian-born population, and that many of these experiences are under-recognised because they present somatically (headaches, gut issues, chronic fatigue) rather than in the "sad mood, loss of interest" language of Western diagnostic manuals. For a South Asian woman, depression may show up first as exhaustion and irritability with family. For an East Asian woman, anxiety may show up as sleeplessness and a pervasive sense of failing to meet expectations. Neither presentation is less real for being different from the textbook.

Perinatal mental health and the cultural pressure on new mothers. Roughly 1 in 5 Australian women experience anxiety or depression during pregnancy or the year after birth. For migrant mothers, the numbers appear to be higher, and the drivers are specific: isolation from extended family, the loss of the postpartum rituals and confinement practices that structured early motherhood in the home culture, the pressure to raise a bilingual or bicultural child without the village that would ordinarily help, and the difficulty of finding a maternal and child health nurse who understands the context. The Multicultural Centre for Women's Health has written extensively on this, and their literature is a useful starting point. PANDA (1300 726 306) is a free perinatal helpline with multilingual support.

Grief and loss across cultures and diaspora. Migration is, among other things, a long series of losses. The grief of leaving a country, the grief of parents ageing far away, the grief of not being able to attend funerals, the grief of children who will grow up with a thinner connection to a homeland, the grief of a version of yourself that existed in another language. These losses are rarely named, and rarely grieved in community. "Disenfranchised grief" is the technical term for grief that a culture does not recognise. Much of migrant grief is disenfranchised by default.

Intergenerational trauma. Women whose families carry histories of war, displacement, famine, colonisation, or political persecution often find that their own mental health sits on top of a longer inheritance. Intergenerational trauma is now a well-documented field. It does not mean a woman is broken. It means she is carrying more than her own life, and naming that can be part of what makes therapy useful.

The mental health impact of racism. Racism, whether overt or subtle, affects mental health. A 2022 review of Australian evidence linked experiences of racial discrimination with higher rates of psychological distress, particularly among women from Asian, African, and Middle Eastern backgrounds. A counsellor who can hold both the internal and external dimensions of racism (what it does inside a person, and what it is, out there, as a fact) is more useful than one who treats it as a personal issue to reframe.

6. Talking to family about mental health

For many migrant and CALD women, the decision to seek support is not only personal. It is relational. A husband, a mother, a mother-in-law, adult children, or siblings may have views. Some views will be supportive. Others will be frightened, dismissive, or actively opposed. Here are some starting points, not scripts.

The generational gap. In many families, the generations hold different vocabularies. A first-generation mother may speak of mental distress in spiritual or moral terms. A second-generation daughter may speak of it in clinical terms. Both are reaching for the same thing, which is the desire to be well and to love each other. It can help to translate gently rather than correct. "Ma, I am going to talk to a counsellor, like a doctor for feelings" is more useful than "I have clinical depression and I need therapy."

Navigating the gap between Australian clinical framing and home-culture framing. You do not have to choose one framework. Many women hold both. A Catholic South American woman may pray, see a counsellor, and take medication, and each of these is part of how she looks after herself. A Buddhist Vietnamese woman may work with a counsellor and continue the practices her grandmother taught her, and each supports the other. A skilled counsellor will not ask you to pick.

Protecting privacy while seeking support. You are entitled to privacy. Telehealth makes it easier to keep sessions private from housemates or extended family. Paying privately rather than using an MHTP keeps your mental health work off your Medicare record. Some counsellors will schedule sessions outside business hours for women who cannot explain a midday absence. These are reasonable accommodations to ask for.

If family support is a risk rather than a resource. For some women, family is part of the distress rather than part of the solution. Coercive control, family violence, and financial abuse all happen inside migrant families and outside them. If this is part of your situation, 1800RESPECT (1800 737 732) has multilingual support and can connect you with services that understand the immigration dimensions. The in Touch Multicultural Centre Against Family Violence (1800 755 988, Victoria-based but supports nationally via phone) is a specialist service in this space.

7. A note from Aana

I am Singaporean-Australian. My mother's family speaks Cantonese and English. I grew up moving between the registers of a migrant family and the registers of Australian life, speaking slightly different versions of myself in each. I understand, at the level of lived experience, the way a second language can feel like a slightly stiffer version of yourself, and the way the home language can hold things you cannot easily explain to an Australian friend. I understand the particular loneliness of being the generation that translates for the parents and also translates for the children, and the particular guilt of not being home when someone is ill.

I am a practising Catholic, a mother, and I came to counselling after a background in biomedical science. I am a registered counsellor with the Australian Counselling Association (Level 1). I am not a psychologist, I do not diagnose, and I do not promise transformation. What I offer is a grounded, trauma-informed, women-specific space to work through the things that are hard, including the things that are hard because they sit at the intersection of cultures. I work with women from a wide range of backgrounds, and I work in English. Where a woman would be better served by a counsellor who shares her first language, I say so, and I help her find one.

If you have read this guide and something has felt like it was speaking to you, a free Discovery Call is a low-commitment way to see whether we would be a good fit. No referral, no diagnosis, no Mental Health Treatment Plan required. Sessions are $140 (or $125 prepaid in blocks), available online nationally and in person in Mount Barker, South Australia. A small number of concession places are held for women in financial hardship.

8. Resources

National multicultural mental health services

• Embrace Multicultural Mental Health. National resource hub with translated mental health information in more than 40 languages, service directories, and guidance for both individuals and practitioners. Funded by the Australian Government Department of Health and delivered by Mental Health Australia. embracementalhealth.org.au
• Multicultural Centre for Women's Health (MCWH). Melbourne-based national organisation focused on migrant and refugee women's health and rights. Publishes policy briefs and literature reviews on women's mental health, perinatal mental health, and family violence. mcwh.com.au
• Ishar Multicultural Women's Health Services. Perth-based service offering counselling, case management, and group support for women from CALD backgrounds. ishar.org.au
• Asian Australian Alliance. Advocacy organisation and community network with resources on racism, mental health, and belonging for Asian Australian women. asianaustralianalliance.net
• Transcultural Mental Health Centre (NSW). Statewide specialist service offering consultation, assessment, and clinical support for people from CALD backgrounds. dhi.health.nsw.gov.au/tmhc
• Victorian Transcultural Mental Health. Education, research, and clinical support in Victoria. vtmh.org.au
• Multicultural Australia (Queensland). Settlement support with links to mental health services. multiculturalaustralia.org.au

Interpreter and language access

• Translating and Interpreting Service (TIS National). Free for people seeking medical and allied health services. 131 450. tisnational.gov.au

Helplines with multilingual support

• Lifeline. 24/7 crisis support. 13 11 14. lifeline.org.au
• Beyond Blue. Mental health support, multilingual information. 1300 22 4636. beyondblue.org.au
• PANDA (Perinatal Anxiety and Depression Australia). 1300 726 306. panda.org.au
• 1800RESPECT. National sexual assault, domestic and family violence counselling service, interpreters available. 1800 737 732.
• in Touch Multicultural Centre Against Family Violence. 1800 755 988. intouch.org.au

For Aboriginal and Torres Strait Islander women

• 13YARN. Free, confidential, 24/7 support line staffed by Aboriginal and Torres Strait Islander Lifeline-trained Crisis Supporters. 13 92 76. 13yarn.org.au
• Gayaa Dhuwi (Proud Spirit) Australia. National Aboriginal and Torres Strait Islander mental health and suicide prevention leadership body. gayaadhuwi.org.au

Further reading

• Sullivan, C., Vaughan, C., and Wright, J. (2020). Migrant and refugee women's mental health in Australia: a literature review. Commissioned by the Multicultural Centre for Women's Health.
• Australian Institute of Health and Welfare (2024). Social determinants of health among culturally and linguistically diverse people in Australia.
• Minas, H., Kakuma, R., et al. (2013). Mental health research and evaluation in multicultural Australia: developing a culture of inclusion. International Journal of Mental Health Systems.

9. If you need support right now

If you are in immediate danger, call 000.

If you are in distress and need to talk to someone now, call:

• Lifeline on 13 11 14 (24/7). Interpreter available through TIS National on 131 450.
• Beyond Blue on 1300 22 4636 (24/7).
• 13YARN on 13 92 76 if you are Aboriginal or Torres Strait Islander.
• 1800RESPECT on 1800 737 732 if you are experiencing family violence or sexual assault.
• PANDA on 1300 726 306 if you are pregnant or in the first year after birth.

Reaching out once, in one language, to one service, is enough. You do not have to explain your whole life on the first call. A counsellor, a helpline worker, or a GP is trained to start wherever you are.

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When the mental health system was not built with you in mind

At the 2021 Census, 27.7% of people counted in Australia were born overseas. Another 22.3% spoke a language other than English at home. Almost half the country carries some experience of migration or bilingual life. Despite those numbers, a review of three major Australian health journals found only around 2.2% of published articles were primarily focused on multicultural health, and more recent counts suggest that figure has fallen, not risen. In plain terms, the mental health system migrant and CALD women are being asked to trust has not studied us very closely.

The barriers are not simply general mental health barriers with a language issue attached. Stigma inherited from a home culture that framed distress as private, spiritual, or a weakness. The flattening that happens when grief or shame or overwhelm has to be described in a second language. Differing cultural concepts of what mental health even is, where a South Asian woman's depression may arrive as exhaustion and irritability rather than sadness, and an East Asian woman's anxiety may arrive as sleeplessness and a pervasive sense of failing. The practical maze of GPs, Mental Health Treatment Plans, Medicare rebates, and the private-public split. The fear, rational given the stakes, that mental health records might affect a visa outcome. The isolation from the aunts, cousins, and neighbours who would have carried part of the load in the home country. The daily weight of racism, and the exhaustion of explaining yourself in rooms where you are the only one.

None of this means migrant women should not seek support. It means the support needs to meet us where we are. Telehealth has quietly become an equaliser. A Mandarin-speaking woman in regional South Australia can see a counsellor in Melbourne. A Muslim woman in Sydney can choose a practitioner on the basis of fit rather than the nearest office. Free interpreter services through TIS National, bilingual and bicultural counsellors, community-specific services such as the Multicultural Centre for Women's Health and Ishar, and the national Embrace resource hub all exist. So do faith-informed practitioners, for women who want their spiritual life to be part of the work rather than something left at the door.

The system is imperfect. It is also more navigable than it looks. A full guide, including resources, help-seeking information, and a specific note on perinatal mental health and grief in diaspora, is available at saferefuge.com.au.

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Safe Refuge Counselling is a private online and in-person counselling practice for women, founded by Aana Carpenter, a registered counsellor (ACA Level 1). This guide is general information and is not a substitute for personalised clinical advice. A free Discovery Call can be booked at saferefuge.com.au.