Changes in health-seeking behaviours and challenges in accessing care have been reported during the COVID-19 pandemic. This qualitative study examines Australian experiences related to healthcare access during the early months of the pandemic. The study aimed to identify key areas of concern as well as opportunities for services to prevent, manage and treat health concerns when normal access was disrupted. Fifty-nine semi-structured interviews were analysed. Participants were interviewed between August and December in 2020 over telephone or Zoom and were located across Australia. Rapid identification of themes with an audio recordings technique was used to generate themes from the data. Participants described a variety of influences on their health-seeking behaviours, resulting in decisions to delay care or being unable to reach care. Many individuals accessed health services via telehealth and offered a range of perceptions and views on its effectiveness and appropriateness. The findings illustrate that maintenance of health and access to healthcare and psychosocial support were compromised for some individuals, leading to negative impacts on both mental and physical health. This highlights the need to provide mechanisms to facilitate a person’s ability to access care in a timely manner during a pandemic.

What Is Known about the Subject?: Immigrant, refugee and asylum seeker populations worldwide are at high risk of mental health issues National mental health policies call for recognising Australian society's multicultural characteristics to ensure adequate mental health services to CALD communities Several barriers exist for people from CALD communities in Victoria to access and utilise mental health services Improving mental health professionals' knowledge of mental health service provision and cultural responsiveness can enhance CALD community access to services. What Does this Paper Add to Existing Knowledge?: We analysed the perspectives of people from CALD communities in Victoria regarding their needs and experiences with mental health services. Participants reported diverse perceptions and understanding of mental health issues and services Various challenges were identified regarding health service utilisation for the CALD community in Victoria, including language barriers, stigma towards mental health issues, mental health illiteracy, distrust and lack of familiarity with mainstream mental health services. These challenges were acknowledged by community members even after a long residence in Australia The data generated on the beliefs about mental health issues and consequent help‐seeking behaviours highlight the importance of culturally sensitive targeted prevention and early intervention strategies and ongoing commitment to building mental health literacy in the wider community What Are the Implications for Practice?: The information from the study can be adapted for quality improvement and culturally responsive practices The strategies for effective service delivery drawn by this paper can be a comprehensive resource tool for mental health professionals, organisations and policymakers The findings imply that CALD mental health service users and their families will likely benefit from improved service assessment and quality of mental health care and equity when MHNs undertake cultural competence training and bring that into their practice. Introduction: Victoria is one of the most multicultural states in Australia. Many CALD communities in Victoria may have encountered complicated migration journeys and complex life stressors during their initial settlement, leading to adverse mental health concerns. This diversity necessitates public policy settings to ensure equity and access in health services planning and delivery. While the MH policies and services take cultural diversity into account, there needs to be more implementation of those components of MH policies that relate to the particular needs of various CALD communities in Victoria. Even though mental health services prevent and address mental health issues, many barriers can impair CALD community access and utilisation of mental health services. Furthermore, the recent Royal Commission inquiry into the Victorian Mental Health system drives a renewed policy imperative to ensure meaningful engagement and cultural safety of all people accessing and utilising mental health services (Department of Health, 2023).Aim: This study focused on the perspectives of people from CALD communities in Victoria regarding their mental health service needs, understandings of and experiences with mental health services to prepare an education package for mental health nurses as part of a larger multi‐method research project.Method: A qualitative descriptive design was used to collect and analyse the perspectives of 21 participants in Victoria, using telephone interviews, followed by thematic analysis.Results: The themes and sub‐themes identified were: Settling issues; Perceptions of understanding of mental health issues (help‐seeking attitudes toward mental health issues; the need for CALD community education); perceived barriers to accessing and utilising mental health services in Victoria (socio‐cultural and language barriers; stigma, labelling and discrimination; knowledge and experience of accessing health facilities); experience with mental health services and professionals.Discussion: Community participation, mental health professional education and robust research regarding the mental health needs of CALD people are some of the recommended strategies to improve access and utilisation of mental health services in Victoria.Implications for practice: The current study can contribute to the existing knowledge, understanding, practice and quality improvement as it vividly portrays the issues of various CALD communities in Victoria. The findings of this study imply that CALD MH service users and their families are likely to benefit in terms of improved service assessment and quality of MH care and equity when MHNs undertake CC training and bring that into their practice.

National mental health policies accentuate the importance of having positive attitudes, skills, and knowledge among mental health professionals to facilitate recovery‐oriented practices in all areas of mental health care. However, evidence suggests that mental health professionals' negative attitudes towards mental illness are still evident and that recovery‐oriented practice in acute inpatient units may be poorly implemented. At the same time, there is also a paucity of research to understand Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice specifically. Therefore, this non‐participant observation study aimed to explore Mental Health Nurses' attitudes towards mental illness and recovery‐oriented practice in acute inpatient units by observing the interactions between the consumers and nurses. The Mental Illness Clinicians Attitudes Scale‐v4 and The Recovery Attitudes Questionnaire inspired the development of a non‐participant observation chart for this study and the observations were recorded on the chart. Six observations were conducted in three acute inpatient units. Observations focused on Mental Health Nurses' knowledge about mental illness, communication, dignity, respect, anxiety, fear, punishment, facilitation of real choices for consumers, physical care, cooperation with consumers' families and others and recovery orientation. Interpretive descriptive analysis was used to analyse the data. The results show that Mental Health Nurses generally have positive attitudes towards mental illness and recovery‐oriented practice. Some deficits in the physical care of people with mental illness in the acute inpatient units were observed. Therefore, future research could address the adequate preparation of Mental Health Nurses to provide physical care to people with mental illnesses.

Andersen's Behavioural Model of Health Service Use (ABMHSU) is a multilevel model that helps understand the factors influencing health service access and utilisation. This framework is a widely used model for health service use in general, as well as in immigrant populations and vulnerable populations. ABMHSU, in this project, provided a framework to explain how the mental health nurses' cultural competence can influence the Victorian CALD community members' mental health care access and utilisation. A unique model of ABMHSU in the current multiple-method project provided a theoretical framework for examining the factors associated with people from the CALD community accessing mental health services in an Australian context to answer the research questions. The key findings of the research were discussed with reference to the extant literature and with triangulation of research results with the ABMHSU in the context of Victoria. The researchers argue that even though predisposing, enabling, and need factors are necessary to determine whether a person is selected for expert care for mental health issues, these factors alone are insufficient. Ongoing research is essential to ascertain the potential of mental health nurses' cultural competence education and cultural responsiveness in addressing the mental health service access and utilisation of the heterogeneous CALD communities. Additional research is advocated to identify the supplementary factors, as there is a dearth of research exploring the potential of ABMHSU worldwide.