Mental health professionals’ perspectives of the role of spirituality, religion and culture on the mental health of African Australians

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Among this diversity, African Australians now number nearly 400,000, reflecting global migration trends. Research indicates that people from the Horn of Africa and East Africa are at higher risk of developing psychosis, yet they face significant disparities in mental health care access and quality in Australia. This qualitative study investigates the experiences of 15 healthcare professionals who have worked with African Australian consumers. Using semi-structured interviews and thematic analysis, the study explores the influence of spirituality, religion, and culture on mental health outcomes. Three key themes emerged: the consumer experience (including both positive and negative influences), sociocultural factors (stigma, mental health literacy, family roles, and language barriers), and systemic inadequacies (lack of cultural training, exclusion of traditional healers, and limited peer support). The findings highlight a growing disconnect between mainstream mental health services and the specific needs of African Australians. Participants stressed the importance of culturally informed assessments, community engagement, and the inclusion of African liaison officers and workers with lived experience to improve trust and care delivery. They also advocated for increasing workforce diversity and enhancing cultural competence training for practitioners. Such training should include understanding religious and cultural values, using interpreters effectively, and involving families in treatment planning. Overall, the study reveals the urgent need for a culturally responsive mental health framework that addresses systemic barriers and promotes equitable care for African Australians. Figures Figure 1 Introduction Australia is one of the most culturally diverse nations globally, with nearly half its population identifying as culturally and linguistically diverse (CALD) [ 1 ]. CALD individuals are typically those born overseas who speak languages other than English [ 2 ]. Among this population are African Australians almost 400,000 of whom were identified in the latest census [ 1 ]. African migration to Australia has increased significantly in recent decades, driven by factors such as the Refugee Humanitarian Program, skilled migration, and family reunification [3;4]. Mental health is a key component of overall wellbeing [ 5 ]. Research shows that African migrants face elevated risks of mental health issues, including depression, anxiety, and post-traumatic stress disorder [ 6 ]. In Australia, African youth from North and Sub-Saharan Africa experience first-episode psychosis at rates three times higher than their Australian-born peers [ 7 ]. First-generation migrants from the Horn of Africa and East Africa are particularly at risk. Additionally, significant disparities exist in mental health service access and quality for African Australians [ 8 ]. Barriers include individual, systemic, and policy-level factors, with culturally incongruent care and lack of cultural competence among clinicians frequently cited [4;9]. Somali women, for instance, report mistrust in the health system and a perceived lack of cultural understanding by professionals [ 10 ]. Furthermore, there is a notable absence of cultural awareness training for healthcare staff [ 8 ], and the spiritual and religious needs of CALD consumers are often overlooked in mental health care [ 11 ]. This qualitative study explores the experiences of healthcare professionals with regards to the mental health of African Australians and is couched within a larger phenomenological study investigating the role of spirituality religion and culture on the role of spirituality, religion, and culture on the mental health of African Australians. Recent Australian based primary studies were conducted with service users only [10; 12; 13; 14;15;16]. While studies which included professionals or service providers did not specifically explore the role of spirituality religion and culture in mental health of African Australians [8; 14; 4; 17]. Methods Theoretical Framework This study is guided by Leininger’s Transcultural Nursing Theory, which emphasises the importance of culturally congruent, holistic care in health promotion and healing [ 18 ]. The framework involves three phases: developing cultural awareness, applying theoretical models to understand transcultural phenomena, and integrating this knowledge into practice [ 19 ]. Leininger’s theory supports the exploration of how spirituality, religion, and culture influence mental health care, making it well-suited for examining the experiences of mental health professionals working with African Australian populations [ 20 ]. Research Approach A Heideggerian interpretive phenomenological approach underpins this study, aiming to explore the lived experiences and perspectives of mental health professionals regarding the role of spirituality, religion, and culture in caring for CALD populations. Interpretative Phenomenological Analysis (IPA) is distinctive in its focus on participants’ own interpretations [ 36 ], making it particularly valuable for exploring the personal meanings they assign to their experiences. Participants and Data Collection Participants Fifteen mental health professionals with a minimum of five years' experience in Australian mental health settings were recruited. Recruitment was conducted via email-distributed flyers sent to directors of nursing and through snowball sampling [ 21 ]. Data Collection and Management Data were collected through semi-structured interviews guided by an interview schedule, allowing flexibility to explore emerging themes [ 22 ]. Interviews averaging 30 minutes, were audio-recorded with participant consent, and supplemented with field notes. Recordings were transcribed verbatim using transcription software. Ethical Considerations Ethical approval was granted by [Blinded for Review] Federation University Australia, Human Research Ethics Committee (Approval number: 2023/116). Participants were assured of anonymity and confidentiality; all recordings were coded and de-identified. They were also informed of their right to withdraw at any time, although none chose to do so. Data Analysis Thematic analysis was conducted on the interview transcripts. Avid note software was used for verbatim transcription of translating recording into written text. The analysis was guided by Colaizzi’s seven steps descriptive phenomenological method [ 23 ]. At the first step, familiarisation, to acquaint with the data, data was read through several times. This was followed by identifying significant statements (step 2), which entailed identification of relevant statements, this involved the extraction of relevant excerpts that directly related to the research focus. The next step (step 3) involved developing an exhaustive description where descriptions of the phenomenon which incorporated all the themes were identified. The next step involved producing the fundamental structure and this included condensing the data to essential statements. Finally, the seeking verification of the fundamental structure state (was done concurrently with data collection), respondents were asked if the data reflected their experiences. The final stage involved transcribing specific quotes of interest from the audio recordings. Results Fifteen participants (8 females and 7 males) were included in the study. Participants’ ages ranged between 26 and 63 years old with a mean age of 17.8 years. The average working experience of participants is 17 years. The sociodemographic profile of participants is depicted in Table 1 below. Table 1 Demography of participants Sociodemographic participants’ profile N = 15 Age Country of birth Gender Profession Primary workplace Experience in years 45–55 Zimbabwe Male Nurse CCU Community care unit 17 45–55 Ethiopia Female Nurse CCU Community care unit 15 > 55 Australian Male Social Worker Community > 30 36–45 Australia Female Nurse Community 5 26–35 Philippines Female Occupational Therapist Community 16 45–55 India Male Psychiatrist Community 17 26–35 United Kingdom Female Nurse Community 9 > 55 Ethiopia Male Nurse Community 17 36–45 Zimbabwe Female Nurse In patient 15 26–35 Malaysian/Chinese Male Psychologist Community 5 > 55 Nigeria Female Nurse Acute mental health > 30 45–55 Zimbabwe Male Nurse ED Mental Health > 20 26–35 Ireland Female Nurse Community 9 > 55 Australian Male Nurse Community 36 45–55 Bangladesh Female Psychiatrist Community/In Patient 27 INSERT Table 1 Three themes were identified from the study as depicted in Fig. 1 , namely, “the impact on consumer experience (benefits or salutary factors, challenges or deleterious ), sociocultural factors (role of stigma, family, mental health literacy, language) and systemic inadequacies in addressing diversity (consumer and professionals, peer supports, offering space, utilising, traditional healers, cultural formulation). INSERT FIGURE 1 Theme 1: Impact on Consumer Experience Participants identified that spirituality, religion, and culture significantly influence the mental health experiences of African Australian consumers both positively and negatively. Two subthemes emerged: Salutary Factors and Deleterious Factors . Salutary Factors Some participants highlighted the protective role of religion and spirituality in promoting wellbeing and preventing harmful behaviours such as suicide and substance use. Religious practices were seen to foster hope, moral guidance, and resilience in the face of psychological distress. As one participant explained: “Religion doesn't allow you to use drugs and alcohol and even smoke, neither does it condone suicide... You must abstain from these things." (P9) Another participant noted the moral and spiritual deterrent against self-harm: “In some religions, it is taboo to talk about, discuss, or commit suicide as it is viewed as a cardinal sin... they believe that if one commits suicide, they will not enter heaven.” (P10) Additionally, spirituality was viewed as a coping mechanism with potential therapeutic benefits: “Those sorts of beliefs... can actually make someone feel better, especially if it’s got a psychological element to it... it can bring positive outcomes.” (P2) Deleterious Factors Despite the benefits, most participants reported that spiritual and religious beliefs can also hinder help-seeking. Mental illness is often relabelled as spiritual possession, delaying access to care and reducing engagement with mental health services, “Delayed referrals or calling it another name other than mental illness... just to avoid treatment.” (P10) There was concern that reliance on prayer and spiritual practices, while meaningful, could also exacerbate distress when not integrated with clinical support: “Sometimes those beliefs can really cause a lot of stress to someone.” (P2) Participants also described instances of misdiagnosis, where culturally or spiritually rooted experiences were misunderstood as clinical symptoms, furthermore, Similarly, spiritual practices like fasting were misconstrued: “A consumer reported that she was seeing ghosts and was subsequently diagnosed with psychosis... I think it was misinterpreted.” (P11) “Somebody who's more spiritual... wanted to fast and pray... was construed as neglecting themselves.” (P6) Overall, participants emphasised a lack of cultural competence in distinguishing between spiritual beliefs and mental illness, highlighting the need for more culturally attuned assessment and diagnostic practices. Theme 2: Sociocultural Factors This theme explores how stigma, family roles, mental health literacy, and language shape the mental health experiences and help-seeking behaviours of African Australians. These sociocultural influences can either facilitate or obstruct access to care. Stigma, Dishonour, and Labelling Participants consistently reported that mental illness is heavily stigmatised in African communities, often leading to denial, secrecy, and social exclusion. “There’s a lot of shame in our culture when it comes to mental illness... it’s seen as something that's meant to be treated, perhaps secretively, by family members.” (P4) “A family or individual can be dishonoured by the community... they decide, ‘let's hide this person.’ And by the time they know, it is too late.” (P10) “There's a lot of shame... one person’s family were very upset because it really affected that young person's marriage prospects.” (P1) Role of Family, Environment, and Community Families often play a central role in care decisions. Many families opt to send individuals back to their home countries for treatment, believing the cultural environment is more supportive. “It is very common for people to be sent back home to Ethiopia to be treated there, sometimes it’s better there.” (P9) “Africans will thrive where there is a lot of the communal attitude... they sent them back home, two of them are very well now.” (P10) “They eventually sent the person overseas to be with family in an attempt to take them away from drugs.” (P1) This approach, while offering community and cultural familiarity, may also reflect limited trust in local mental health systems. Mental Health Literacy Participants highlighted low mental health literacy as a barrier, with many families struggling to understand mental illness from a biomedical or chronic illness perspective. “Mental health literacy... health systems literacy, stigma, as well as mental illness being viewed as, you know, a cultural experience.” (P13) “It’s easier for the family to say it’s drug use than to accept the stigma of a schizophrenia diagnosis.” (P9) “They’ll say, well, just give a drug, they get better, and then we don’t want to see you again.” (P1) Such perspectives can lead to unrealistic expectations, treatment disengagement, or misattribution of symptoms. Language Language emerged as a critical barrier which impacts communication, understanding of symptoms, and access to appropriate care, “She hadn’t put him forward for detox because she felt he wouldn’t understand the program because he’s from an African background.” (P13) “They’re not going to say, ‘I think I’m having an auditory hallucination.’ No, they’ll say... ‘the Jinns are out to get me.’” (P1) “There are no words to describe depression, mood or most mental health diagnosis in many African cultures.” (P10) “The language used matters... it’s better to say ‘overthinking’ rather than ‘mental illness’.” (P14) This highlights the need for linguistically and culturally sensitive communication, particularly in assessments and therapy. Theme 3: Systemic Inadequacies in Addressing Cultural Diversity This theme highlights the systemic gaps within mental health services in catering to African Australian consumers. Key subthemes include l ack of community engagement, workforce diversity, inadequate training, the need for cultural liaisons, and limitations of diagnostic tools. Lack of Engagement with Family, Community, and Spiritual Leaders Many participants emphasised the absence of strong ties between mental health services and African communities, families, and spiritual leaders. “You're not just working with one person, you're working with the entire family or the community.” (P11) “We need to create more... stronger ties with the community and leaders. I feel like that’s the way forward.” (P13) Some participants highlighted environmental limitations and noted that the lack of incorporation of spiritual practices and engagement with religious leaders hindered efforts to reduce consumer distress and aggressive behaviours, “We facilitate engagement with spiritual leaders... if they want to go to church on Sunday, we say you can sign up... this reduces aggression.” (P15) “There is no prayer room in our facilities and no provision for prayer mats.” (P2) Diversity in the Mental Health Workforce The underrepresentation of African Australians in mental health roles was seen as a barrier to culturally sensitive care, “The workforce is not having enough diversity... cultural competence often is not optimal.” (P3) “Having people of your own culture makes a lot of difference.” (P15) Participants also reported, cultural concordance was especially important for gender-specific preferences, “Men prefer to talk to other men.” (P15) Cultural Training for Staff Participants reported limited training or awareness about African cultures, which hindered effective engagement, “I’ve not had any training in terms of working with people from an African background.” (P2) “More staff awareness and training... more resources to facilitate people’s cultural preferences.” (P5) Need for African Peer Support Workers / Cultural Liaisons There is a strong call by some participants for African liaison officers and recovery workers to help bridge cultural gaps, “I will advocate for an African liaison person... it would make a huge difference.” (P6) “I have never come across an African recovery worker... it will be good.” (P8) 5. Cultural Formulation and Diagnostic Limitations Participants criticised the one-size-fits-all nature of diagnostic tools like DSM-5 and ICD-10, which often failed to capture African cultural context, “DSM-5 and ICD-10... work very well for half the world. I don’t know how well they work for the other half.” (P1) “I use the ICD system... I think it is more culturally sensitive than DSM.” (P7) The DSM-5 Cultural Formulation Interview (CFI) was viewed as impractical in some clinical settings: “Sometimes if it's an acute situation... it’s not time efficient.” (P3) Discussion This qualitative study explored mental health professionals’ perspectives on the influence of spirituality, religion, and culture on the mental health of African Australians. It contributes to existing literature on the cultural and spiritual dimensions of mental illness [24; 25; 4]. The study identified three key themes: impact on consumer experience, sociocultural factors, and systemic inadequacies in addressing cultural diversity. Findings highlight the significant role of spiritual and religious beliefs in shaping mental health understanding, diagnosis, and treatment. Consistent with previous research, participants reported that spirituality and religion can both support and hinder mental health outcomes [26; 27; 28]. Religion was seen as a coping mechanism that may reduce depressive symptoms and suicidal ideation [29;30], and as a protective factor for overall wellbeing [ 31 ]. However, participants also noted that religious beliefs could delay access to mental health services, as individuals often rely first on prayer or traditional coping methods. This aligns with prior findings that some African communities, such as the Congolese, downplay mental health issues and initially turn to spiritual practices before seeking clinical support [ 12 ]. Additionally, participants emphasised that integrating spirituality and religion into mental health care could significantly improve outcomes for African Australians. However, current services often overlook these aspects. This highlights a gap in culturally responsive care. Practitioners also reiterated the importance of accommodating religious practices such as prayer times, fasting during Ramadan, or providing spaces for prayer and scripture reading as part of holistic, person-centred care. Participants raised concerns that such beliefs are often misunderstood or pathologised in clinical settings. For example, cultural concepts like spiritual possession or curses may be misinterpreted as symptoms of mental illness, increasing the risk of misdiagnosis. The study also highlighted concerns around the use of standard diagnostic tools such as the DSM-5 and ICD-10. While DSM-5 is widely used in Australia, participants preferred ICD-10, viewing it as more culturally sensitive. Both tools, however, were critiqued for their Western orientation and limited applicability to African cultural contexts. Time constraints and discomfort discussing religion further limited the use of culturally sensitive approaches like the DSM-5 Cultural Formulation Interview (CFI), echoing findings from earlier studies [ 32 ]. Overall, the findings point to a need for greater cultural competence in mental health assessments, improved use of culturally sensitive diagnostic tools, and deeper understanding of African cultural norms and spiritual practices in clinical care. Healthcare professionals in this study also identified stigma as a major barrier to mental health care within African communities. Mental illness is often denied or attributed to non-medical causes, such as substance abuse or spiritual possession (e.g., by Jinnis), resulting in reluctance to seek help. These findings align with previous studies [4;10; 12], which also reported stigma as a critical deterrent for African migrants accessing care. This study adds that stigma may not only discourage treatment but also jeopardise social status, particularly affecting marriage prospects and bringing shame or dishonour to families. Such consequences deepen the treatment gap between African Australians and the broader population. Additionally, health literacy and limited understanding of Australia’s mental health system were also highlighted as barriers to help-seeking. Participants noted that many African consumers are unfamiliar with available services or lack trust in them, further delaying engagement. The study revealed cultural dissonance between the healthcare system and African communities. African societies are often hierarchical and collectivist [ 33 ] with decision-making influenced by elders, spiritual leaders, and extended family. However, Western mental health systems tend to prioritise individual autonomy, often excluding family involvement. Participants emphasised the importance of recognising and integrating family and community networks in treatment planning, as this not only supports engagement but may also reduce behavioural crises. The lack of such culturally responsive care contributes to poor outcomes for African Australian consumers. Participants echoed findings from previous research, such as [ 16 ], which described the practice of "Dhaqan celis" , sending individuals back to their country of origin to promote mental wellbeing. The study also supports earlier work emphasising the importance of family, community, and spiritual leaders in mental health care [30;34;35]. However, participants acknowledged that such involvement can also hinder treatment, particularly when families or community leaders hold stigmatising views or lack understanding of mental illness. The study also revealed gender-based preferences in clinician selection. Some male consumers prefer male clinicians, while some female consumers avoid male providers, suggesting the need for gender-sensitive care aligned with cultural values [ 17 ]. Language barriers were discussed as a recurring issue. Participants noted that terms like “depression” often lack direct translations in African languages, making diagnosis and treatment more complex [28;8]. Some clinicians reportedly avoid offering psychotherapy to African consumers due to assumptions about language limitations, which contributes to inequities in treatment options and exclusion from therapeutic care. The findings demonstrate a significant cultural gap in understanding and addressing spiritual and cultural practices. Participants called for: culturally informed assessments, Increased diversity in the mental health workforce, particularly staff from African backgrounds, Inclusion of community engagement workers, African liaison officers, and individuals with lived experience to build trust and improve care delivery and lastly, the study highlighted the need for ongoing cultural competence training for mental health professionals. This includes understanding religious and cultural values, effective use of interpreters, and family inclusion in treatment planning, critical components for delivering equitable and respectful care. Conclusion This study examined mental health professionals’ perspectives on the role of spirituality, religion, and culture in the care of African Australians. Findings highlight the complex interplay between cultural beliefs and mental health, with spirituality and religion serving as both protective and obstructive factors. A key issue identified is the pervasive stigma surrounding mental illness in African communities, often linked to spiritual or supernatural explanations, which can delay help-seeking and lead to misdiagnosis. The study also underscores the lack of integration between mental health services and family, community, and religious leaders, as well as gaps in culturally informed training and resources for clinicians. There is a strong need for more culturally competent care models that include African liaison officers, peer support workers, and community engagement strategies. Lastly, involving individuals with lived experience may bridge existing service gaps and foster more inclusive, effective mental health care for African Australians. Declarations Funding Bekithemba Sibanda is supported by the Australian Government Research Training Program (RTP) Stipend and RTP Fee-Offset Scholarship through Federation University Australia. Author Contribution [Bekithemba Sibanda]: Conceptualisation, Methodology, Data Collection, Formal Analysis, Writing Original Draft.[Bindu Joseph]: Supervision, Writing – Review & Editing, Validation.[MIchael Olasoji]: Supervision, Writing – Review & Editing, Project Administration.All authors reviewed the manuscript Acknowledgement The researchers would like to extend their unreserved gratitude to the mental health professionals for their invaluable contribution to this study. Your contributions will certainly go a long way in enhancing mental health provisions to African Australians. References Australian Bureau of Statistics. (2022). Cultural diversity of Australia. ABS. https://www.abs.gov.au/articles/cultural-diversity-australia. Australian Institute of Health and Welfare [AIHW],(2018). Culturally and linguistically diverse Australians. https://www.aihw.gov.au/reports-data/population-groups/cald-australians/overview Australia. Parliament. 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Cite Share Download PDF Status: Published Journal Publication published 24 Apr, 2026 Read the published version in Journal of Immigrant and Minority Health → Version 1 posted Editorial decision: Revision requested 25 Dec, 2025 Reviews received at journal 02 Nov, 2025 Reviews received at journal 22 Oct, 2025 Reviews received at journal 21 Oct, 2025 Reviewers agreed at journal 14 Oct, 2025 Reviews received at journal 13 Oct, 2025 Reviewers agreed at journal 13 Oct, 2025 Reviewers agreed at journal 13 Oct, 2025 Reviewers agreed at journal 12 Oct, 2025 Reviewers agreed at journal 10 Oct, 2025 Reviewers invited by journal 09 Oct, 2025 Editor assigned by journal 03 Sep, 2025 Submission checks completed at journal 03 Sep, 2025 First submitted to journal 01 Sep, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Sibanda","email":"data:image/png;base64,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","orcid":"","institution":"Federation University","correspondingAuthor":true,"prefix":"","firstName":"Bekithemba","middleName":"","lastName":"Sibanda","suffix":""},{"id":533606298,"identity":"f504fed4-ca5b-4e89-98ec-301e18566a8e","order_by":1,"name":"Bindu Joseph","email":"","orcid":"","institution":"Federation University","correspondingAuthor":false,"prefix":"","firstName":"Bindu","middleName":"","lastName":"Joseph","suffix":""},{"id":533606299,"identity":"cbcaec87-4f7a-4b84-82fe-4ec422e1e0c5","order_by":2,"name":"Michael Olasoji","email":"","orcid":"","institution":"Federation University","correspondingAuthor":false,"prefix":"","firstName":"Michael","middleName":"","lastName":"Olasoji","suffix":""}],"badges":[],"createdAt":"2025-09-01 05:08:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7504412/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7504412/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s10903-026-01920-0","type":"published","date":"2026-04-24T16:00:15+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":94207853,"identity":"b15f74dd-4097-4cf0-8694-75e1e896ea6d","added_by":"auto","created_at":"2025-10-23 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15:02:03","extension":"html","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":99043,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7504412/v1/c01688e036488177f7d89cec.html"},{"id":94207848,"identity":"ff154d23-15d0-4556-be74-a7449a65d1b6","added_by":"auto","created_at":"2025-10-23 15:02:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":59000,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThemes and sub-themes\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7504412/v1/1093915ea9dabac05bbaa9dc.png"},{"id":107927964,"identity":"7a4c18f5-dce4-4f3e-ae45-2e2f5ed9fab7","added_by":"auto","created_at":"2026-04-27 16:06:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":321495,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7504412/v1/29e87791-f93b-4b19-b511-ce5f2a302f02.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eMental health professionals’ perspectives of the role of spirituality, religion and culture on the mental health of African Australians\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eAustralia is one of the most culturally diverse nations globally, with nearly half its population identifying as culturally and linguistically diverse (CALD) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. CALD individuals are typically those born overseas who speak languages other than English [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Among this population are African Australians almost 400,000 of whom were identified in the latest census [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. African migration to Australia has increased significantly in recent decades, driven by factors such as the Refugee Humanitarian Program, skilled migration, and family reunification [3;4].\u003c/p\u003e\u003cp\u003eMental health is a key component of overall wellbeing [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Research shows that African migrants face elevated risks of mental health issues, including depression, anxiety, and post-traumatic stress disorder [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. In Australia, African youth from North and Sub-Saharan Africa experience first-episode psychosis at rates three times higher than their Australian-born peers [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. First-generation migrants from the Horn of Africa and East Africa are particularly at risk. Additionally, significant disparities exist in mental health service access and quality for African Australians [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Barriers include individual, systemic, and policy-level factors, with culturally incongruent care and lack of cultural competence among clinicians frequently cited [4;9]. Somali women, for instance, report mistrust in the health system and a perceived lack of cultural understanding by professionals [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Furthermore, there is a notable absence of cultural awareness training for healthcare staff [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e], and the spiritual and religious needs of CALD consumers are often overlooked in mental health care [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis qualitative study explores the experiences of healthcare professionals with regards to the mental health of African Australians and is couched within a larger phenomenological study investigating the role of spirituality religion and culture on the role of spirituality, religion, and culture on the mental health of African Australians. Recent Australian based primary studies were conducted with service users only [10; 12; 13; 14;15;16]. While studies which included professionals or service providers did not specifically explore the role of spirituality religion and culture in mental health of African Australians [8; 14; 4; 17].\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eTheoretical Framework\u003c/h2\u003e\u003cp\u003eThis study is guided by Leininger\u0026rsquo;s Transcultural Nursing Theory, which emphasises the importance of culturally congruent, holistic care in health promotion and healing [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The framework involves three phases: developing cultural awareness, applying theoretical models to understand transcultural phenomena, and integrating this knowledge into practice [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Leininger\u0026rsquo;s theory supports the exploration of how spirituality, religion, and culture influence mental health care, making it well-suited for examining the experiences of mental health professionals working with African Australian populations [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eResearch Approach\u003c/h3\u003e\n\u003cp\u003eA Heideggerian interpretive phenomenological approach underpins this study, aiming to explore the lived experiences and perspectives of mental health professionals regarding the role of spirituality, religion, and culture in caring for CALD populations. Interpretative Phenomenological Analysis (IPA) is distinctive in its focus on participants\u0026rsquo; own interpretations [\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e], making it particularly valuable for exploring the personal meanings they assign to their experiences.\u003c/p\u003e\n\u003ch3\u003eParticipants and Data Collection\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003eParticipants\u003c/h2\u003e\u003cp\u003eFifteen mental health professionals with a minimum of five years' experience in Australian mental health settings were recruited. Recruitment was conducted via email-distributed flyers sent to directors of nursing and through snowball sampling [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eData Collection and Management\u003c/h3\u003e\n\u003cp\u003eData were collected through semi-structured interviews guided by an interview schedule, allowing flexibility to explore emerging themes [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Interviews averaging 30 minutes, were audio-recorded with participant consent, and supplemented with field notes. Recordings were transcribed verbatim using transcription software.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eEthical Considerations\u003c/h2\u003e\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003cp\u003e was granted by [Blinded for Review] Federation University Australia, Human Research Ethics Committee (Approval number: 2023/116). Participants were assured of anonymity and confidentiality; all recordings were coded and de-identified. They were also informed of their right to withdraw at any time, although none chose to do so.\u003c/p\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eThematic analysis was conducted on the interview transcripts. Avid note software was used for verbatim transcription of translating recording into written text. The analysis was guided by Colaizzi\u0026rsquo;s seven steps descriptive phenomenological method [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. At the first step, familiarisation, to acquaint with the data, data was read through several times. This was followed by identifying significant statements (step 2), which entailed identification of relevant statements, this involved the extraction of relevant excerpts that directly related to the research focus. The next step (step 3) involved developing an exhaustive description where descriptions of the phenomenon which incorporated all the themes were identified. The next step involved producing the fundamental structure and this included condensing the data to essential statements. Finally, the seeking verification of the fundamental structure state (was done concurrently with data collection), respondents were asked if the data reflected their experiences. The final stage involved transcribing specific quotes of interest from the audio recordings.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eFifteen participants (8 females and 7 males) were included in the study. Participants\u0026rsquo; ages ranged between 26 and 63 years old with a mean age of 17.8 years. The average working experience of participants is 17 years. The sociodemographic profile of participants is depicted in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e below.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemography of participants\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e\u003cp\u003eSociodemographic participants\u0026rsquo; profile N\u0026thinsp;=\u0026thinsp;15\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountry of birth\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGender\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eProfession\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePrimary workplace\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eExperience in years\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZimbabwe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCCU Community care unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEthiopia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCCU Community care unit\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAustralian\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSocial Worker\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36\u0026ndash;45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAustralia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePhilippines\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eOccupational Therapist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychiatrist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUnited Kingdom\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEthiopia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e36\u0026ndash;45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZimbabwe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eIn patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMalaysian/Chinese\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychologist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNigeria\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eAcute mental health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;30\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eZimbabwe\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eED Mental Health\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;20\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e26\u0026ndash;35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIreland\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAustralian\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003eNurse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBangladesh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePsychiatrist\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eCommunity/In Patient\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eINSERT Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/h2\u003e\u003cp\u003eThree themes were identified from the study as depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, namely, \u003cem\u003e\u0026ldquo;the impact on consumer experience\u003c/em\u003e (benefits or salutary factors, challenges or deleterious\u003cem\u003e), sociocultural factors\u003c/em\u003e (role of stigma, family, mental health literacy, language) and \u003cem\u003esystemic inadequacies in addressing diversity\u003c/em\u003e (consumer and professionals, peer supports, offering space, utilising, traditional healers, cultural formulation).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eINSERT FIGURE \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003c/h2\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003eTheme 1: Impact on Consumer Experience\u003c/h2\u003e\u003cp\u003eParticipants identified that spirituality, religion, and culture significantly influence the mental health experiences of African Australian consumers both positively and negatively. Two subthemes emerged: \u003cem\u003eSalutary Factors\u003c/em\u003e and \u003cem\u003eDeleterious Factors\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eSalutary Factors\u003c/h2\u003e\u003cp\u003eSome participants highlighted the protective role of religion and spirituality in promoting wellbeing and preventing harmful behaviours such as suicide and substance use. Religious practices were seen to foster hope, moral guidance, and resilience in the face of psychological distress.\u003c/p\u003e\u003cp\u003eAs one participant explained:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Religion doesn't allow you to use drugs and alcohol and even smoke, neither does it condone suicide... You must abstain from these things.\" (P9)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAnother participant noted the moral and spiritual deterrent against self-harm:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;In some religions, it is taboo to talk about, discuss, or commit suicide as it is viewed as a cardinal sin... they believe that if one commits suicide, they will not enter heaven.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAdditionally, spirituality was viewed as a coping mechanism with potential therapeutic benefits:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;Those sorts of beliefs... can actually make someone feel better, especially if it\u0026rsquo;s got a psychological element to it... it can bring positive outcomes.\u0026rdquo; (P2)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eDeleterious Factors\u003c/h2\u003e\u003cp\u003eDespite the benefits, most participants reported that spiritual and religious beliefs can also hinder help-seeking. Mental illness is often relabelled as spiritual possession, delaying access to care and reducing engagement with mental health services,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;Delayed referrals or calling it another name other than mental illness... just to avoid treatment.\u0026rdquo; (P10)\u003c/p\u003e\u003cp\u003eThere was concern that reliance on prayer and spiritual practices, while meaningful, could also exacerbate distress when not integrated with clinical support:\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes those beliefs can really cause a lot of stress to someone.\u0026rdquo; (P2)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eParticipants also described instances of misdiagnosis, where culturally or spiritually rooted experiences were misunderstood as clinical symptoms, furthermore, Similarly, spiritual practices like fasting were misconstrued:\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;A consumer reported that she was seeing ghosts and was subsequently diagnosed with psychosis... I think it was misinterpreted.\u0026rdquo; (P11)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Somebody who's more spiritual... wanted to fast and pray... was construed as neglecting themselves.\u0026rdquo; (P6)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eOverall, participants emphasised a lack of cultural competence in distinguishing between spiritual beliefs and mental illness, highlighting the need for more culturally attuned assessment and diagnostic practices.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eTheme 2: Sociocultural Factors\u003c/h2\u003e\u003cp\u003eThis theme explores how stigma, family roles, mental health literacy, and language shape the mental health experiences and help-seeking behaviours of African Australians. These sociocultural influences can either facilitate or obstruct access to care.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eStigma, Dishonour, and Labelling\u003c/h2\u003e\u003cp\u003eParticipants consistently reported that mental illness is heavily stigmatised in African communities, often leading to denial, secrecy, and social exclusion.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;There\u0026rsquo;s a lot of shame in our culture when it comes to mental illness... it\u0026rsquo;s seen as something that's meant to be treated, perhaps secretively, by family members.\u0026rdquo; (P4)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;A family or individual can be dishonoured by the community... they decide, \u0026lsquo;let's hide this person.\u0026rsquo; And by the time they know, it is too late.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;There's a lot of shame... one person\u0026rsquo;s family were very upset because it really affected that young person's marriage prospects.\u0026rdquo; (P1)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003ch2\u003eRole of Family, Environment, and Community\u003c/h2\u003e\u003cp\u003eFamilies often play a central role in care decisions. Many families opt to send individuals back to their home countries for treatment, believing the cultural environment is more supportive.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u0026ldquo;It is very common for people to be sent back home to Ethiopia to be treated there, sometimes it\u0026rsquo;s better there.\u0026rdquo; (P9)\u003c/p\u003e\u003cp\u003e\u0026ldquo;Africans will thrive where there is a lot of the communal attitude... they sent them back home, two of them are very well now.\u0026rdquo; (P10)\u003c/p\u003e\u003cp\u003e\u0026ldquo;They eventually sent the person overseas to be with family in an attempt to take them away from drugs.\u0026rdquo; (P1)\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThis approach, while offering community and cultural familiarity, may also reflect limited trust in local mental health systems.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eMental Health Literacy\u003c/h2\u003e\u003cp\u003eParticipants highlighted low mental health literacy as a barrier, with many families struggling to understand mental illness from a biomedical or chronic illness perspective.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Mental health literacy... health systems literacy, stigma, as well as mental illness being viewed as, you know, a cultural experience.\u0026rdquo; (P13)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;It\u0026rsquo;s easier for the family to say it\u0026rsquo;s drug use than to accept the stigma of a schizophrenia diagnosis.\u0026rdquo; (P9)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;They\u0026rsquo;ll say, well, just give a drug, they get better, and then we don\u0026rsquo;t want to see you again.\u0026rdquo; (P1)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eSuch perspectives can lead to unrealistic expectations, treatment disengagement, or misattribution of symptoms.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec20\" class=\"Section2\"\u003e\u003ch2\u003eLanguage\u003c/h2\u003e\u003cp\u003eLanguage emerged as a critical barrier which impacts communication, understanding of symptoms, and access to appropriate care,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;She hadn\u0026rsquo;t put him forward for detox because she felt he wouldn\u0026rsquo;t understand the program because he\u0026rsquo;s from an African background.\u0026rdquo; (P13)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;They\u0026rsquo;re not going to say, \u0026lsquo;I think I\u0026rsquo;m having an auditory hallucination.\u0026rsquo; No, they\u0026rsquo;ll say... \u0026lsquo;the Jinns are out to get me.\u0026rsquo;\u0026rdquo; (P1)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;There are no words to describe depression, mood or most mental health diagnosis in many African cultures.\u0026rdquo; (P10)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;The language used matters... it\u0026rsquo;s better to say \u0026lsquo;overthinking\u0026rsquo; rather than \u0026lsquo;mental illness\u0026rsquo;.\u0026rdquo; (P14)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThis highlights the need for linguistically and culturally sensitive communication, particularly in assessments and therapy.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec21\" class=\"Section2\"\u003e\u003ch2\u003eTheme 3: Systemic Inadequacies in Addressing Cultural Diversity\u003c/h2\u003e\u003cp\u003eThis theme highlights the systemic gaps within mental health services in catering to African Australian consumers. Key subthemes include l\u003cem\u003eack of community engagement, workforce diversity, inadequate training, the need for cultural liaisons, and limitations of diagnostic tools.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e\u003ch2\u003eLack of Engagement with Family, Community, and Spiritual Leaders\u003c/h2\u003e\u003cp\u003eMany participants emphasised the absence of strong ties between mental health services and African communities, families, and spiritual leaders.\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;You're not just working with one person, you're working with the entire family or the community.\u0026rdquo; (P11)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;We need to create more... stronger ties with the community and leaders. I feel like that\u0026rsquo;s the way forward.\u0026rdquo; (P13)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eSome participants highlighted environmental limitations and noted that the lack of incorporation of spiritual practices and engagement with religious leaders hindered efforts to reduce consumer distress and aggressive behaviours,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;We facilitate engagement with spiritual leaders... if they want to go to church on Sunday, we say you can sign up... this reduces aggression.\u0026rdquo; (P15)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;There is no prayer room in our facilities and no provision for prayer mats.\u0026rdquo; (P2)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec23\" class=\"Section3\"\u003e\u003ch2\u003eDiversity in the Mental Health Workforce\u003c/h2\u003e\u003cp\u003eThe underrepresentation of African Australians in mental health roles was seen as a barrier to culturally sensitive care,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;The workforce is not having enough diversity... cultural competence often is not optimal.\u0026rdquo; (P3)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Having people of your own culture makes a lot of difference.\u0026rdquo; (P15)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eParticipants also reported, cultural concordance was especially important for gender-specific preferences,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Men prefer to talk to other men.\u0026rdquo; (P15)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec24\" class=\"Section2\"\u003e\u003ch2\u003eCultural Training for Staff\u003c/h2\u003e\u003cp\u003eParticipants reported limited training or awareness about African cultures, which hindered effective engagement,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I\u0026rsquo;ve not had any training in terms of working with people from an African background.\u0026rdquo; (P2)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;More staff awareness and training... more resources to facilitate people\u0026rsquo;s cultural preferences.\u0026rdquo; (P5)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cdiv id=\"Sec25\" class=\"Section3\"\u003e\u003ch2\u003eNeed for African Peer Support Workers / Cultural Liaisons\u003c/h2\u003e\u003cp\u003eThere is a strong call by some participants for African liaison officers and recovery workers to help bridge cultural gaps,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I will advocate for an African liaison person... it would make a huge difference.\u0026rdquo; (P6)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I have never come across an African recovery worker... it will be good.\u0026rdquo; (P8)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003e5. Cultural Formulation and Diagnostic Limitations\u003c/b\u003e\u003c/p\u003e\u003cp\u003eParticipants criticised the one-size-fits-all nature of diagnostic tools like DSM-5 and ICD-10, which often failed to capture African cultural context,\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;DSM-5 and ICD-10... work very well for half the world. I don\u0026rsquo;t know how well they work for the other half.\u0026rdquo; (P1)\u003c/em\u003e\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;I use the ICD system... I think it is more culturally sensitive than DSM.\u0026rdquo; (P7)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe DSM-5 Cultural Formulation Interview (CFI) was viewed as impractical in some clinical settings:\u003c/p\u003e\u003cp\u003e\u003cem\u003e\u0026ldquo;Sometimes if it's an acute situation... it\u0026rsquo;s not time efficient.\u0026rdquo; (P3)\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis qualitative study explored mental health professionals\u0026rsquo; perspectives on the influence of spirituality, religion, and culture on the mental health of African Australians. It contributes to existing literature on the cultural and spiritual dimensions of mental illness [24; 25; 4]. The study identified three key themes: impact on consumer experience, sociocultural factors, and systemic inadequacies in addressing cultural diversity. Findings highlight the significant role of spiritual and religious beliefs in shaping mental health understanding, diagnosis, and treatment. Consistent with previous research, participants reported that spirituality and religion can both support and hinder mental health outcomes [26; 27; 28]. Religion was seen as a coping mechanism that may reduce depressive symptoms and suicidal ideation [29;30], and as a protective factor for overall wellbeing [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. However, participants also noted that religious beliefs could delay access to mental health services, as individuals often rely first on prayer or traditional coping methods. This aligns with prior findings that some African communities, such as the Congolese, downplay mental health issues and initially turn to spiritual practices before seeking clinical support [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAdditionally, participants emphasised that integrating spirituality and religion into mental health care could significantly improve outcomes for African Australians. However, current services often overlook these aspects. This highlights a gap in culturally responsive care. Practitioners also reiterated the importance of accommodating religious practices such as prayer times, fasting during Ramadan, or providing spaces for prayer and scripture reading as part of holistic, person-centred care. Participants raised concerns that such beliefs are often misunderstood or pathologised in clinical settings. For example, cultural concepts like spiritual possession or curses may be misinterpreted as symptoms of mental illness, increasing the risk of misdiagnosis.\u003c/p\u003e\u003cp\u003eThe study also highlighted concerns around the use of standard diagnostic tools such as the DSM-5 and ICD-10. While DSM-5 is widely used in Australia, participants preferred ICD-10, viewing it as more culturally sensitive. Both tools, however, were critiqued for their Western orientation and limited applicability to African cultural contexts. Time constraints and discomfort discussing religion further limited the use of culturally sensitive approaches like the DSM-5 Cultural Formulation Interview (CFI), echoing findings from earlier studies [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Overall, the findings point to a need for greater cultural competence in mental health assessments, improved use of culturally sensitive diagnostic tools, and deeper understanding of African cultural norms and spiritual practices in clinical care.\u003c/p\u003e\u003cp\u003eHealthcare professionals in this study also identified stigma as a major barrier to mental health care within African communities. Mental illness is often denied or attributed to non-medical causes, such as substance abuse or spiritual possession (e.g., by Jinnis), resulting in reluctance to seek help. These findings align with previous studies [4;10; 12], which also reported stigma as a critical deterrent for African migrants accessing care. This study adds that stigma may not only discourage treatment but also jeopardise social status, particularly affecting marriage prospects and bringing shame or dishonour to families. Such consequences deepen the treatment gap between African Australians and the broader population. Additionally, health literacy and limited understanding of Australia\u0026rsquo;s mental health system were also highlighted as barriers to help-seeking. Participants noted that many African consumers are unfamiliar with available services or lack trust in them, further delaying engagement. The study revealed cultural dissonance between the healthcare system and African communities. African societies are often hierarchical and collectivist [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] with decision-making influenced by elders, spiritual leaders, and extended family. However, Western mental health systems tend to prioritise individual autonomy, often excluding family involvement. Participants emphasised the importance of recognising and integrating family and community networks in treatment planning, as this not only supports engagement but may also reduce behavioural crises. The lack of such culturally responsive care contributes to poor outcomes for African Australian consumers.\u003c/p\u003e\u003cp\u003eParticipants echoed findings from previous research, such as [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], which described the practice of \u003cem\u003e\"Dhaqan celis\"\u003c/em\u003e, sending individuals back to their country of origin to promote mental wellbeing. The study also supports earlier work emphasising the importance of family, community, and spiritual leaders in mental health care [30;34;35]. However, participants acknowledged that such involvement can also hinder treatment, particularly when families or community leaders hold stigmatising views or lack understanding of mental illness. The study also revealed gender-based preferences in clinician selection. Some male consumers prefer male clinicians, while some female consumers avoid male providers, suggesting the need for gender-sensitive care aligned with cultural values [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Language barriers were discussed as a recurring issue. Participants noted that terms like \u0026ldquo;depression\u0026rdquo; often lack direct translations in African languages, making diagnosis and treatment more complex [28;8]. Some clinicians reportedly avoid offering psychotherapy to African consumers due to assumptions about language limitations, which contributes to inequities in treatment options and exclusion from therapeutic care.\u003c/p\u003e\u003cp\u003eThe findings demonstrate a significant cultural gap in understanding and addressing spiritual and cultural practices. Participants called for: culturally informed assessments, Increased diversity in the mental health workforce, particularly staff from African backgrounds, Inclusion of community engagement workers, African liaison officers, and individuals with lived experience to build trust and improve care delivery and lastly, the study highlighted the need for ongoing cultural competence training for mental health professionals. This includes understanding religious and cultural values, effective use of interpreters, and family inclusion in treatment planning, critical components for delivering equitable and respectful care.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study examined mental health professionals\u0026rsquo; perspectives on the role of spirituality, religion, and culture in the care of African Australians. Findings highlight the complex interplay between cultural beliefs and mental health, with spirituality and religion serving as both protective and obstructive factors. A key issue identified is the pervasive stigma surrounding mental illness in African communities, often linked to spiritual or supernatural explanations, which can delay help-seeking and lead to misdiagnosis.\u003c/p\u003e\u003cp\u003eThe study also underscores the lack of integration between mental health services and family, community, and religious leaders, as well as gaps in culturally informed training and resources for clinicians. There is a strong need for more culturally competent care models that include African liaison officers, peer support workers, and community engagement strategies. Lastly, involving individuals with lived experience may bridge existing service gaps and foster more inclusive, effective mental health care for African Australians.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eBekithemba Sibanda is supported by the Australian Government Research Training Program (RTP) Stipend and RTP Fee-Offset Scholarship through Federation University Australia.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e[Bekithemba Sibanda]: Conceptualisation, Methodology, Data Collection, Formal Analysis, Writing Original Draft.[Bindu Joseph]: Supervision, Writing \u0026ndash; Review \u0026amp; Editing, Validation.[MIchael Olasoji]: Supervision, Writing \u0026ndash; Review \u0026amp; Editing, Project Administration.All authors reviewed the manuscript\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThe researchers would like to extend their unreserved gratitude to the mental health professionals for their invaluable contribution to this study. Your contributions will certainly go a long way in enhancing mental health provisions to African Australians.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAustralian Bureau of Statistics. (2022). Cultural diversity of Australia. ABS. https://www.abs.gov.au/articles/cultural-diversity-australia.\u003c/li\u003e\n\u003cli\u003eAustralian Institute of Health and Welfare [AIHW],(2018). Culturally and linguistically diverse Australians. https://www.aihw.gov.au/reports-data/population-groups/cald-australians/overview\u003c/li\u003e\n\u003cli\u003eAustralia. Parliament. Joint Standing Committee on Foreign Affairs, Defence, and Trade, \u0026amp; Forshaw, M. (2011). Inquiry into Australia\u0026apos;s Relationship with the Countries of Africa. Commonwealth of Australia\u003c/li\u003e\n\u003cli\u003eFauk, N. K., Ziersch, A., Gesesew, H., Ward, P., Green, E., Oudih, E., \u0026amp; Mwanri, L. (2021). 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International Journal of Social Psychiatry, 68(4), pp.881-890.\u003c/li\u003e\n\u003cli\u003eMihtsintu, Y., Yohannes, K. and Gebrat, A., 2023. Knowledge, attitudes and practices towards suicide among immigrants from the horn of Africa in Victoria, Australia. International journal of social psychiatry, 69(6), pp.1510-1519.\u003c/li\u003e\n\u003cli\u003eLorenz, L., Doherty, A., \u0026amp;amp; Casey, P. (2019). The role of religion in buffering the impact of stressful life events on depressive symptoms in patients with depressive episodes or adjustment disorder. International journal of environmental research and public health, 16(7), 1238.\u003c/li\u003e\n\u003cli\u003eFante-Coleman, T., Jackson-Best, F., Booker, M., \u0026amp; Worku, F. (2023). Organizational and practitioner challenges to Black youth accessing mental health care in Canada: Problems and solutions. Canadian Psychology/Psychologie canadienne, 64(4), 259.\u003c/li\u003e\n\u003cli\u003eLopez, D., Saenz Escalante, G., \u0026amp;amp; Weisman de Mamani, A. (2023). The role of religious coping on suicidality among Latinx and Black/African American individuals with schizophrenia spectrum disorders. Spirituality in Clinical Practice, 10(3), 219.\u003c/li\u003e\n\u003cli\u003eJarvis, G. E., Kirmayer, L. J., G\u0026oacute;mez-Carrillo, A., Aggarwal, N. K., \u0026amp; Lewis-Fern\u0026aacute;ndez, R. (2020). Update on the cultural formulation interview. Focus, 18(1), 40-46.\u003c/li\u003e\n\u003cli\u003eDarley, W. K., \u0026amp; Blankson, C. (2020). Sub-Saharan African cultural belief system and entrepreneurial activities: A Ghanaian perspective. Africa Journal of Management, 6(2), 67-84\u003c/li\u003e\n\u003cli\u003eSavic, M., Chur-Hansen, A., Mahmood, M.A. and Moore, V.M., 2016. \u0026lsquo;We don\u0026rsquo;t have to go and see a special person to solve this problem\u0026rsquo;: Trauma, mental health beliefs and processes for addressing \u0026lsquo;mental health issues\u0026rsquo; among Sudanese refugees in Australia. International Journal of Social Psychiatry, 62(1), pp.76-83.\u003c/li\u003e\n\u003cli\u003eMafuriranwa, R., Watts, L. and Hodgson, D., 2024. A phenomenological study into Zimbabwean-Australian clergy\u0026rsquo;s understandings of the causes and their responses to mental health problems among Zimbabwean-Australians. Journal of Religion \u0026amp; Spirituality in Social Work: Social Thought, 43(3), pp.300-329\u003c/li\u003e\n\u003cli\u003eMacLeod, A. (2019). Interpretative phenomenological analysis (IPA) as a tool for participatory research within critical autism studies: A systematic review. Research in Autism Spectrum Disorders, 64, 49-62.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"journal-of-immigrant-and-minority-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"joih","sideBox":"Learn more about [Journal of Immigrant and Minority Health](http://link.springer.com/journal/10903)","snPcode":"10903","submissionUrl":"https://submission.springernature.com/new-submission/10903/3","title":"Journal of Immigrant and Minority Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7504412/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7504412/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAustralia is one of the most culturally diverse countries, with nearly half its population identifying as culturally and linguistically diverse (CALD). Among this diversity, African Australians now number nearly 400,000, reflecting global migration trends. Research indicates that people from the Horn of Africa and East Africa are at higher risk of developing psychosis, yet they face significant disparities in mental health care access and quality in Australia.\u003c/p\u003e\n\u003cp\u003eThis qualitative study investigates the experiences of 15 healthcare professionals who have worked with African Australian consumers. Using semi-structured interviews and thematic analysis, the study explores the influence of spirituality, religion, and culture on mental health outcomes. Three key themes emerged: the consumer experience (including both positive and negative influences), sociocultural factors (stigma, mental health literacy, family roles, and language barriers), and systemic inadequacies (lack of cultural training, exclusion of traditional healers, and limited peer support).\u003c/p\u003e\n\u003cp\u003eThe findings highlight a growing disconnect between mainstream mental health services and the specific needs of African Australians. Participants stressed the importance of culturally informed assessments, community engagement, and the inclusion of African liaison officers and workers with lived experience to improve trust and care delivery. They also advocated for increasing workforce diversity and enhancing cultural competence training for practitioners. Such training should include understanding religious and cultural values, using interpreters effectively, and involving families in treatment planning. Overall, the study reveals the urgent need for a culturally responsive mental health framework that addresses systemic barriers and promotes equitable care for African Australians.\u003c/p\u003e","manuscriptTitle":"Mental health professionals’ perspectives of the role of spirituality, religion and culture on the mental health of African Australians","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-23 15:01:58","doi":"10.21203/rs.3.rs-7504412/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-25T14:47:53+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-02T08:58:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-22T21:42:23+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-21T07:25:53+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"236439554636048402053194075809874034126","date":"2025-10-14T19:25:17+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-10-13T16:32:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"88494399782376352234778103291797569228","date":"2025-10-13T13:55:48+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"23692455830311884406792030429587405093","date":"2025-10-13T07:59:16+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"180305415777539441842712884235289566686","date":"2025-10-12T11:25:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"131792386857025179266258401179360915614","date":"2025-10-10T07:59:39+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-09T15:56:51+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-03T07:09:59+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-03T07:08:29+00:00","index":"","fulltext":""},{"type":"submitted","content":"Journal of Immigrant and Minority Health","date":"2025-09-01T05:01:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"journal-of-immigrant-and-minority-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"joih","sideBox":"Learn more about [Journal of Immigrant and Minority Health](http://link.springer.com/journal/10903)","snPcode":"10903","submissionUrl":"https://submission.springernature.com/new-submission/10903/3","title":"Journal of Immigrant and Minority Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"2e160393-1646-43c5-9854-a8716abcfc62","owner":[],"postedDate":"October 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2026-04-27T16:04:03+00:00","versionOfRecord":{"articleIdentity":"rs-7504412","link":"https://doi.org/10.1007/s10903-026-01920-0","journal":{"identity":"journal-of-immigrant-and-minority-health","isVorOnly":false,"title":"Journal of Immigrant and Minority Health"},"publishedOn":"2026-04-24 16:00:15","publishedOnDateReadable":"April 24th, 2026"},"versionCreatedAt":"2025-10-23 15:01:58","video":"","vorDoi":"10.1007/s10903-026-01920-0","vorDoiUrl":"https://doi.org/10.1007/s10903-026-01920-0","workflowStages":[]},"version":"v1","identity":"rs-7504412","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7504412","identity":"rs-7504412","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}