Profile of transcultural patients in a regional Child and Adolescent Mental Health Service in Gippsland, Australia: The need for a multidimensional understanding of the complexities.

Background: Several childhood stressors related to immigration have been documented, and it is important for clinicians to understand and address the various factors that may lead to or act as maintaining factors of mental disorders in children and adolescents.

Aims: To describe the cultural profile of transcultural patients presenting to a Child and Adolescent Mental Health Service (CAMHS) in regional Victoria and identify the most common disorders and psychosocial stressors they presented with.

Method: Descriptive analysis was applied to 101 case records of patients with a transcultural background who attended the CAMHS of Latrobe Regional Hospital in Gippsland Victoria from 2013 to 2017. The Adverse Childhood Experience questionnaire was retrospectively applied to capture psychosocial stressors such as 'bullying', 'racism' and 'family conflict', sexual abuse, physical violence, parents with mental illness and parental substance use.

Results: Almost 60% of patients were male and over 46% Aboriginal. Those from a non-Aboriginal background belonged to 19 different cultural entities, the most common of which was a mixed Asian and European heritage. The most common diagnoses were disruptive mood dysregulation disorder (38.6%), attention-deficit hyperactivity disorder (32.7%) and developmental trauma disorder (26.7%). The most common psychosocial stressors were conflict and death in the family (44.6%), domestic violence (41.6%) and emotional abuse (34.7%). 'Parent in jail' and 'domestic violence' were associated with having an Aboriginal background ( p < .005). 'Cultural differences with parent' was associated with a non-Aboriginal background ( p < .005).

Conclusion: This study provides a snapshot of challenges faced by children from different cultural backgrounds while adjusting in a rural area in Australia. A broad-based formulation and cultural awareness by clinicians can enable a better understanding of the complexities, guide management plans and inform public health policies for primary prevention and early intervention.