Culturally Matched NDIS Support in Melbourne: Where to Start

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Language is the primary focus of most disability discussions in relation to culturally appropriate disability support. The obvious component is language, and that is important, but families who have experienced this will tell you that it is not the only component of the match.

Melbourne is a place to think about here, as it is an enormously diverse place and it is mapped. Victoria's Department of Families, Fairness and Housing 2021 Census data shows that over one third of Melbourne's metropolitan residents speak a language other than English at home, while approximately 26 per cent were born overseas.

The department's language mapping also indicates that English proficiency is lowest in those areas where matched support is most needed. For larger communities: Vietnamese (103,465 speakers, 31 per cent low English proficiency); Mandarin (184,348 speakers, 26 per cent); Khmer (15,393 speakers, 34 per cent); and Cantonese (74,628 speakers, 23 per cent). The rates are even higher for smaller and newer communities: Zomi 48 per cent, Karen 46 per cent, Chin Haka 44 per cent, Rohingya 39 per cent.

Geographically, the highest concentrations are in Wyndham, Casey, Greater Dandenong, Brimbank, Melton, Hume and Whittlesea. There are 36,023 Vietnamese speakers in Brimbank, of which 35.8 per cent have low English proficiency. In Casey, there are 16,859 Punjabi speakers.

What Cultural Matching Actually Covers

There are four things that occur again and again, apart from the language.

Food. Meal preparation is a core support, and it fails quietly. If a worker is unaware of the taste of a dish, or of ingredients that are avoided, they will prepare a dish that will be politely rejected. That becomes apparent over months in the form of weight loss, and it's investigated as a medical issue when it's actually a kitchen issue.

Religious observance. To many, prayer times give direction to the day. Fasting times shift when medication can be taken and when a person has the energy to care for themselves. A worker who plans a shower at prayer time, or who doesn't know the person has been fasting, isn't being disrespectful, they just weren't told, and nobody asked.

Gendered care norms. For many families, a same-gender worker for personal care is not a preference to be accommodated where available. It is the condition on which support is accepted at all. The alternative isn't a slightly worse match, it's refused showers.

Who makes decisions. In western service design, it is assumed that the participant makes their own decisions. In many families decisions are often made collectively, and if a worker or coordinator engages only the participant (or only the eldest son), there will be agreements which are not upheld.

Where To Start, Practically

List what is really important, one by one. It's impossible for most people to get a perfect match on every dimension. Knowing ahead of time that there is greater importance placed on gender than language, or that religion is more important than country of origin, makes the shortlist decision much quicker when it comes.

Request numbers, not values statements. Everyone responds with a yes to the question 'do you support CALD participants?' A better question: how many Punjabi-speaking women workers do you have available on a weekday morning in Casey? The answer is a number or an evasion, both of which provide information.

Don't ask the regional question, ask the specific one. Mandarin and Cantonese are two different languages. So are Dari and Farsi, Karen and Burmese, Punjabi and Hindi. A NDIS provider in Melbourne which claims 'Asian languages' has not considered this.

Take short cuts through community organisations. In Melbourne's west and south-east, ethno-specific community groups and multicultural health services frequently know which NDIS providers in Melbourne actually deliver and which simply offer a translated version of their brochure. That is not to be found in any publication.

Use an interpreter for assessments. TIS National (131 450) provides free interpreting services. Carried out without one, assessments consistently underestimate need, because a person who cannot fully explain how often they fall is recorded as more independent than they are.

One Thing Worth Knowing About Progressive Conditions

Language needs are different for participants who have dementia or other progressive conditions. Later-acquired languages will go first, a person who has spoken confident English for decades can slip back largely into their first language over the course of a year.

Planning from the outset, families manage the transition. Families that don't are left looking for a matched support worker at the worst possible moment. Language matching should be approached as something that must be secured, not something to be considered later if it is a problem.

Source: Department of Families, Fairness and Housing (Vic), Mapping languages spoken in Victoria, metropolitan Melbourne, 2021 Census data.