Exploring alcohol and other drug use among people from migrant and ethnic minority backgrounds in Australia
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2021
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Melbourne Authors
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Melbourne School of Population and Global Health
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PhD thesis
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Open Access
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© 2021 Caitlin Heather Douglass
Abstract
Evidence suggests the prevalence of alcohol and other drug (AOD) use is lower among migrant and ethnic minority groups than the wider Australian population. Although studies indicate these groups experience AOD-related harms and are under-represented in treatment, due to stigma and other barriers, our understanding of their perceptions and experiences of these issues is poor. This PhD research sought to improve understanding of the social-ecological factors that shape AOD use, enhance understanding of stigma associated with AOD use, and inform the development of interventions among migrant and ethnic minority communities in Australia. This research was based on interviews and a focus group with 21 young people from migrant and ethnic minority backgrounds, interviews with 15 service providers, and a systematic review of qualitative studies.
Findings generated from young participants and service providers suggest that multiple social-ecological factors interact to shape AOD-related perceptions and experiences among migrant and ethnic minority groups. Age, gender, religion, knowledge, stress and anxiety were identified as important individual factors. Within peer groups, AOD use was a normal part of identity and facilitated feelings of belonging. However, within families and communities, AOD use was stereotyped as failure to uphold responsibilities and bad parenting. Young participants preferred seeking information and solving AOD-related problems within their friendship groups, rather than seeking professional support. This finding was echoed by service providers, who described difficulties engaging with migrant and ethnic minority groups due to the stigma attached to AOD use. Service providers recognised the need for long-term engagement and outreach to build relationships with communities but claimed that short-term and precarious funding arrangements hindered this work.
The systematic review identified that stigma associated with AOD use is driven and facilitated by stereotypes, prejudice, laws and policies, socio-cultural norms, and precarious lived experiences including insecure employment, housing instability and social exclusion. Stigma attached to AOD use intersects with gender, citizenship, race and ethnicity, leading to poorer outcomes for people with multiple stigmatised identities. Treatment and harm reduction settings are considered risk environments for identification and negative labelling. Stigma manifests through exclusion, avoidance, gossip and discrimination in treatment and employment settings. Fear of stigmatisation encourages people from migrant and ethnic minority backgrounds to hide their AOD use and avoid seeking support to protect themselves and their families. Stigma has negative impacts including emotional distress, broken relationships, low self-esteem, isolation and loneliness.
The findings of this body of work suggest that AOD use among migrant and ethnic minority groups is shaped by individual factors, peer groups and the risk of stigma within families, communities and services. Youth-friendly and culturally responsive interventions are needed to address AOD use, including the negative outcomes and impacts of stigma, among migrant and ethnic minority groups. Interventions should capitalise on the existing protective practices of young people and respond to the complexities that arise from precarious lived experiences and multiple stigmatised characteristics. Partnerships between service providers, researchers and communities are required to develop and evaluate programmes that meet the needs of migrant and ethnic minority groups in Australia.
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Keywords
Alcohol, Drugs, Migrant, Stigma