Safaa Hakim is a clinical counsellor in Melbourne. Many of her clients are migrants and she says some who speak little English have been struggling to cope during the latest wave of the COVID-19 pandemic.
Ms Hakim offers counselling in Arabic and five dialects, which she says enables better understanding.
"When they speak in their language or their own dialect, they ask, 'did you get me? Did you understand what I said?'" she says.
"I say, 'yes, I did,' and then, of course, I summarise what they told me. It is very important."
But, she says, she fears other migrants in the local community and across Australia are unable to access mental health support due to a combination of language and technical barriers.
“They may have a smartphone but they don’t know how to use the app for Telehealth [the federal government's phone or video call healthcare model] or to ask for an interpreter.
Ms Hakim is herself a migrant. She was born in Kuwait and moved to Australia in 1993 where she studied psychology.
Safaa Hakim grew up in Kuwait. Source: Supplied / Safaa Hakim
She is particularly concerned for her older clients at the moment.
“One client I spoke with today is a refugee from Iraq. She is in her 50s and has a range of mental health and physical problems and is self-isolating."
“She has been in the country for 12 years and has no family and no support.”
One client ... has been in the country for 12 years and has no family and no support. - Safaa Hakim, Counsellor
Victoria currently has more than 48,000 active cases of COVID-19 and has lost more than 2,000 lives since the pandemic hit.
“Many know someone who's suffering [with COVID-19] or they know someone who has died. So now they talk more about death,” Ms Hakim says of her clients.
“Many ... have more fear of death at this time.”
Ms Hakim is conducting sessions by phone for those who want to avoid face-to-face appointments but says she is aware of clients missing out on any social interaction and struggling with loneliness.
Safaa Hakim offers counselling by phone. Source: SBS News / Scott Cardwell
“I fear for those living alone at this time, it is very worrying.”
One of her clients says: “For me to go out, I would stay in the car".
"If they want to take me to the supermarket, I stay in the car. If they take me to the mall, you will also find me sitting in the car.”
Technology barriers
This year, Telehealth accounted for 30 per cent of all medical consultations, up from 23 per cent the year before. Demand for interpreter services has also surged.
A range of mental health platforms now offer interpreters, but getting people with limited technical skills to be able to access them can be a challenge.
“People may have a smartphone, but some do not have access to the internet. They do not know how to access apps whatsoever,” says Melbourne-based psychologist Muradiye Selvi.
Her Coburg practice, Selvi Psychological Services, serves a diverse community. Ms Selvi counsels some clients in Turkish and her practice offers counselling in five other languages.
She says conducting sessions in the same language is key to forming a good connection with the client.
“People think in a particular language, they have a history in a particular language, so with someone from a similar background is when the connection happens.”
But migrants unable to use a mobile phone to access a Telehealth consultation with an interpreter will often ask a family member to translate which can lead to confusion, she says.
“Some patients walk away saying, ‘I only have half the information,’ and that causes anxiety.”
And despite COVID-19 information being made available in multiple languages by state and federal governments, she says even checking in using QR codes has been challenging for some.
“To our surprise, some clients were just taking photos [of the QR code] or just holding their smartphones up to scanners. And when we told them why it was so important to sign in, they became quite alarmed,” she says.
To our surprise, some clients were just taking photos [of the QR code]. - Muradiye Selvi, Psychologist
Like Ms Hakim, she fears for those living alone and not being able to access the support they need.
“We hear of people who had COVID and had no visitors. They didn't have food. They were unable to access any form of information.
“Others use satellite to watch television news in their language in their country of origin and get information that way. But it is not our news, it is not Australian health advice.”
Communication gaps
Dr Silvia Pfeiffer knows first-hand how important it is to get medical information in your own language.
“When I migrated from Germany, my English was actually alright. But I still felt compelled, particularly as the mother of a small child, to find a doctor who spoke German, so that I could actually talk about the issues that I was facing,” she says.
Dr Pfeiffer, who is based in Surry Hills, Sydney, co-founded Telehealth platform Coviu which has delivered more than six million online consultations during the pandemic.
She developed the platform while working at the government's science organisation CSIRO and says it now delivers 20,000 daily consultations and offers interpreter services in up to 300 languages.
Dr Silvia Pfeiffer co-founded Telehealth platform Coviu. Source: SBS News / Sandra Fulloon
More than 70,000 clinicians are available via Coviu Australia-wide, and most practitioners take a subscription starting from $20 per month, a system similar to a mobile phone plan, she says.
Despite welcoming the government's indefinite extension of Telehealth, she says the surge in COVID-19 cases during the most recent Omicron wave presented serious challenges for people with limited English.
“It highlighted the need for competent interpreters to pass on accurate medical information,” she says.
The NSW Health website says where communication is essential, health practitioners must engage professional health care interpreters for patients, families and carers who are not fluent in English.
Dr Silvia Pfeiffer grew up in Germany. Source: Supplied Dr Pfeiffer
But Ms Hakim says some migrants are afraid to utilise available services.
“It takes time for us to gain their trust and explain to them how the technology works.
“Many have lost trust in their own government because of what happened to them overseas. So it also takes them time to trust the government in this new country.”
Telehealth has helped millions of Australians access medical care online, particularly those living in remote and rural communities.
Safaa Hakim at her Melbourne home. Source: SBS News / Scott Cardwell
“Patients are reimbursed for video Telehealth or phone Telehealth consultations, and many clinicians also bulk bill,” Dr Pfeiffer says.
And, she adds, the pandemic has driven sweeping changes in the "delivery of healthcare, because so many people have looked to digital tools including video consultations”.
A trial of Coviu and its interpreter service is currently underway in the emergency department of a major Melbourne hospital, supporting people from non-English speaking backgrounds as they are triaged.
Dr Pfeiffer demonstrates the interpreter service at her Sydney office. Source: SBS News / Sandra Fulloon
“They can call in an interpreter through our application which helps the medical teams to assess a patient, and that's just unheard of, it is something completely new,” Dr Pfeiffer says.
For Ms Hakim and many others seeing clients each day, education is key.
“Many of those speaking a language other than English need more explanation about these online and interpreter services.
“Many still don't trust the system, they don't trust the process. They still don't have enough information about how it works.”
International Mother Language Day is marked on 21 February.
SBS is committed to informing Australia's multilingual communities about the latest coronavirus developments. The provides information and updates in 60 languages.
