Why Race and Culture Matter in Australian Mental Health

A psychologist’s reflection on belonging, identity, and the emotional landscapes we inherit

Introduction

Australia often imagines itself as a place where everyone can belong. After all, this is the lucky country stitched together by diversity, opportunity, and the promise of a fair go. But belonging is not evenly felt. It is shaped by history, by culture, by the stories we inherit and the ones we learn to tell about ourselves. And in the therapy room, these stories matter more than we often acknowledge.

For many Asian Australians, the emotional landscape of life here is shaped not only by migration or intergenerational trauma, but by the quieter, subtler forces of race and culture. These forces shape how we speak, how we relate, how we understand distress, and how we seek help.

This is a landscape I know intimately. I have lived it, worked within it, and sat across from clients who carry similar tensions in their bodies and their relationships. What follows is not a theory, but a reflection on what it means to navigate mental health in a country that celebrates diversity while still learning how to understand it.

The First Shock: Learning a New Emotional Language

My first lessons in cultural difference were not dramatic. They were small, almost forgettable moments that accumulated quietly.

One of them happened in a university tutorial. The tutor was warm, approachable, around my parents’ age. She welcomed our class of fresh-faced 16-20 year olds, smiled and said, “Call me Sarah.”*not her real name.

I remember the jolt in my chest and the hesitation that followed. In the world I grew up in, addressing an elder by their first name would be unthinkably disrespectful. But everyone else nodded casually because we were also taught to listen to our elders, parents and teachers. So we followed along, absorbing the unspoken message that our instincts were somehow out of place. And this was true - we were in Australia and in college. In this sense, we were Sarah's peers - adults now. Except she was still our teacher.

As I moved through university and into the workplace, the words became familiar.

These words were offered kindly, but they landed heavily. I had been raised to listen first, to observe, to speak only when I had something meaningful to contribute. Not just anything but something substantial, something worth taking up space for. Speaking without purpose felt indulgent. Interrupting felt disrespectful. Taking up space felt presumptuous.

But in Australia, these instincts were read as shyness, passivity, or lack of confidence. Slowly, I internalised the idea that my natural way of being thoughtful, measured, observant were flawed. A deficit. Evidence that I was somehow behind and needed to change if I were to be accepted. If I were to be seen as belonging.

It did not help as I stepped out into the world of work. A shame I had carried was not passing my family therapy exam the first try and applying for more than 50 roles, not being able to land one until nearly a year post-graduation. I had the same qualification, and had earned internship experiences at one of Australia's leading public healthcare providers, the largest in Victoria.

But I did poorly at interviews. Having to push to talk about myself, what I had accomplished felt painful. It felt boastful to talk about what I felt was just necessary as part of my job, redundant because it was already crafted into my resume and my letters and uncomfortable because I felt like I had to explain myself akin to being in the principal's office.

It took years to understand that what I carried was not inadequacy, but a different emotional language. A different cultural logic. A different understanding of respect and contribution. But at the time, all I felt was the quiet erosion of self‑esteem, the sense of always being slightly out of step with the world around me.

When Race Becomes Visible

I grew up in a small coastal city in Malaysia, a country where race is not just a descriptor but a system. Since the 1960s, race‑based policies have shaped access to education, housing, and opportunity. As a Malaysian Chinese person, I learned early that I would have to work harder, achieve more, and prove myself in ways that were never explicitly stated but always understood. My grandparents were not unfamiliar to this. After all, they left China to survive and landed in Borneo at the time.

In the last few decades post-WWII, the Chinese population in Malaysia declined from around 40% to roughly 15% — a shift driven by lower birth rates and significant emigration. Many left in search of opportunities or simply a place where their belonging wasn’t conditional.

I come from Malaysian Borneo, where regional politics add another layer of complexity. Growing up there meant holding a sense of being both inside and outside the national story — part of the country, yet peripheral to its centre.

So when I moved to Australia, I carried with me a familiar vigilance: the instinct to work twice as hard, the awareness that race shapes opportunity even when people insist it doesn’t. Australia was meant to be a fresh start. And in many ways, it was. But I quickly learned that I would once again be navigating the subtle terrain of fitting in.

A compliment about how “good” my English is. A stranger trying to guess where I’m really from. Someone confidently assuming I was American - a continent I had never visited.

Even my name carries this story. Most clients don’t know that “Helen” isn’t my legal name. It stuck because at 18 months old, I answered to it. It was the name of my Dutch friend in playgroup. A tiny act of assimilation before I even had language.

These moments didn’t wound me in obvious ways. They shaped me quietly, teaching me to adapt, to blend, to anticipate how others might see me. They taught me that race is not always loud; sometimes it is a soft pressure, a subtle recalibration of self, a constant negotiation of how much space you are allowed to take.

Many Asian Australian clients recognise this instantly; the feeling of being both visible and invisible, of being misread, of adjusting yourself to fit into rooms that were not designed with you in mind.

When “Culture‑Blind” Care Becomes Cultural Hegemony

Australian mental health care is built on evidence‑based models - CBT, Schema Therapy, attachment theory, family systems. These frameworks are valuable, but they were developed within Western, individualistic contexts. They carry assumptions about what healthy development looks like, how emotions should be expressed, and what constitutes a functional family.

None of this is wrong. But it does mean that Western norms often sit quietly at the centre of our clinical thinking.

I felt this paradox sharply when I began my career. As an Asian therapist, most of my early clients were Anglo‑Australian. I was expected to understand different cultural references, communication styles, family dynamics. And I did. I had spent years learning how to navigate Western emotional norms.

But the reverse was not always true.

There were moments when my own cultural instincts to listen first, to observe, to speak only when I had something meaningful to add, were interpreted as hesitation. Moments when my quietness was misread as lack of confidence rather than attunement. Moments when I realised that even in a profession built on empathy, the dominant cultural lens remained largely unexamined.

This is what cultural hegemony looks like in practice. It is not intentional exclusion, but the quiet assumption that one emotional worldview is the default.

For many Asian Australian clients, this can mean:

• emotional restraint is misread as inhibition

• interdependence is mistaken for enmeshment

• indirect communication is labelled as passivity and avoidance

• duty‑based love is misunderstood as overcontrol

• internal conflict is pathologised rather than contextualised

  
  

When we overlook cultural context, we could risk misinterpreting culturally coherent behaviours as dysfunction. But when we pause and ask, What is the cultural logic beneath this?", the picture changes. We begin to see emotional restraint as relational integrity. Interdependence as identity. Acculturative family distancing as a painful but predictable outcome of navigating two emotional worlds.

This is where culturally attuned care begins.

Why Race and Culture Matter For Clients and For Us

Race and culture matter in Australian mental health because they shape the emotional landscapes of the people we serve. But they also matter because they shape us, the clinicians who are increasingly coming from culturally diverse backgrounds ourselves.

Many of us grew up navigating multiple cultural systems long before we learned the language of psychology. We bring with us different emotional grammars, different ways of listening, different understandings of respect and relationship and different experiences of belonging and exclusion.

These are not liabilities. They are forms of wisdom if the profession makes room for them.

When we acknowledge race and culture in mental health, we are not only advocating for our clients. We are creating space for clinicians like us to practise without shrinking, contorting, or translating ourselves into a limited version of “professionalism” that was never designed with us in mind.

We are building a field where cultural nuance is recognised as clinical insight, lived experience is valued as expertise, diverse ways of relating are understood, not corrected and therapists from minority backgrounds do not have to leave parts of themselves outside the therapy room.

Australia’s mental health landscape is shifting. Not only because our clients come from many cultural worlds, but because we, the clinicians, increasingly do too. When we honour that truth, we move toward a profession that reflects the complexity of the communities we serve.

And perhaps this is the real invitation: to keep widening our lens, to stay curious about the emotional worlds our clients inhabit, and to let their stories reshape our understanding of what care can be. When we do that, we don’t just become better clinicians. By integrating, not assimilating, we become better companions in the work of being human.

See you soon,

Helen

To read about Core Emotional Needs in the Asian Australian Context, here's the link.

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"A journey of a thousand miles, begins with a single step"

"千里之行，始于足下“

Lao Tzu; 老子