Identify the need for professional interpreters and use them effectively, including for patients who are more comfortable discussing health issues in their primary language.
Identify useful resources, including multilingual patient information, online explanatory videos, and visual aids to assist in communication about health issues and management.
Provide culturally safe care, including undertaking a cultural assessment, and understand:
the meaning of culturally safe care and the skills and knowledge required to support this
the role of a cultural assessment in establishing rapport and informing future shared decision-making and improved communication
the barriers to care for people from culturally and linguistically diverse communities and specifically for those who have had refugee experiences or are seeking asylum.
Understand the terms ‘cultural bias’ and ‘cultural lens’ and be able to reflect on own cultural lens and bias and how these affect consultations.
Identify and respond to a disclosure of torture or trauma.
Use reflective practice to identify when you have found a consultation challenging; seek help from colleagues and practise self-care.
Provide preventive care and conduct screening
Consider risk factors and screen for high prevalence communicable diseases common in particular geographical regions:
hepatitis B
hepatitis C
helicobacter pylori
human immunodeficiency virus (HIV) and other sexually transmissible infections
tuberculosis
intestinal parasites.
Consider risk factors and conduct age-based screening for high prevalence non-communicable conditions common in countries of origin:
vitamin D deficiency
age and ethnicity-appropriate cardiovascular, type 2 diabetes, and renal disease risk assessment
dental disease.
Identify common health conditions and understand referral pathways, if required:
nutritional disorders (eg iron, B12 and folate deficiencies)
mental health conditions (eg post-traumatic stress disorder, somatisation, complicated grief)
female genital cutting or circumcision, particularly in prenatal and antenatal settings
visual and hearing assessments
low immunisation rate/catch-up immunisation
in children and adolescents consider impacts of disrupted schooling, assessment of developmental delay and lead exposure, where appropriate.
Identify and address barriers to care
Identify Medicare item numbers that may assist in provision of holistic care to people from culturally and linguistically diverse communities (eg refugee health assessment).
Identify online multilingual resources and local community referral pathways that might be appropriate for your patients from culturally and linguistically diverse communities and/or who have had refugee-like experiences.
Identify whether your practice demonstrates that it is ‘migrant, refugee and asylum seeker friendly’; for example, through displaying posters about availability of interpreters and provision of multilingual resources.