ENGLISH-LANGUAGE ABILITY AND MENTAL-HEALTH-SERVICE UTILIZATION - A CENSUS

Objective: To explore the relationship between English language profic iency and mental health service utilisation. Methods: In September 199 3, a sample census was conducted of ail mental health services in the State of Victoria, including public and private hospital wards, outpat ient consultations provided by psychiatrists and clinical psychologist s, and primary mental health care provided by general practitioners, R esponse rates ranged from 37% for monolingual general practitioners (G Ps) to 96% for inpatient units, Particular emphasis was placed on pati ents' English language proficiency and the role played by bilingual cl inicians. Results: Over 80% of inpatients received a diagnosis of eith er dementia or psychosis, This proportion was even greater in the case of patients with English language difficulties, The latter group of p atients underutilised specialist outpatient services, and those using these services were less likely to receive psychotherapy than fluent E nglish speakers. They utilised GPs for mental disorder at at least the same rate as other patients. There was a marked preference for biling ual GPs, with 80% of patients with poor English language skills consul ting GPs who spoke their native language. Conclusion: There appears to be considerable underutilisation of specialist mental health services by patients who are not fluent in English, The liaison-consultation m odel of psychiatric care may be an effective way of addressing this pr oblem, given the important role already played by bilingual GPs in the psychiatric care of those whose native language is not English.