Culture and language influence the way that we all interpret, explain and communicate mental illness.

The following assessment guidelines and tools aim to assist health professionals to consider culture and language when assessing culturally and linguistically diverse (CALD) patients.


Cultural Awareness Tool (CAT) (pdf 640.7KB)

Developed by Multicultural Mental Health Australia the Cultural Awareness Tool aims to assist health care providers to understand the influence of cultural diversity in mental health.
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Transcultural Assessment Checklist (pdf 245.5KB)

The Transcultural Assessment Checklist aims to increase clinician awareness of CALD issues and facilitate the collection of culturally relevant information during CALD client assessment.
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Transcultural Assessment Module (pdf 355KB)

The Transcultural Assessment Module is a form for recording cultural information obtained during assessment with CALD clients.
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Transcultural Referral Guide (pdf 273.5KB)

The Transcultural Referral Guide aims to increase clinicians' awareness and use of culturally or linguistically relevant services for CALD clients.
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Diagnostic and Statistical Manual of Mental Disorders (DSM–5)


The Outline for Cultural Formulation in the DSM–5 provides a framework for assessing information about cultural features of an individual’s mental health problem and how it relates to their social and cultural context and history. The Outline for Cultural Formulation can be found in Section III: Emerging Measures and Modules of the DSM–5.

The Outline for Cultural Formulation requires a systematic assessment of:

  • Cultural identity of the individual
  • Cultural conceptualisations of distress
  • Psychosocial stressors and cultural features of vulnerability and resilience
  • Cultural features of the relationship between the individual and clinician
  • Overall cultural assessment

The Glossary of Cultural Concepts of Distress can be found in the Appendix of the DSM–5. Cultural concepts of distress refers to ways that cultural groups experience, understand, and communicate suffering, behavioural problems, or troubling thoughts and emotions.

The following DSM–5 Cultural Formulation Tools are available to download free of charge from the American Psychiatric Association website:

Note: The DSM-5 is available for purchase through the American Psychiatric Association. Click here to visit the American Psychiatric Association DSM-5 Website.

Find the DSM-5 in languages other than English (pdf 163.11KB). 

If you work within NSW Health you can access the full text of the DSM-5 through the Clinical Information Access Portal (CIAP).

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Additional tools

CLEAR Toolkit
The CLEAR toolkit is a clinical decision aid developed to help physicians, nurses and other allied health workers (e.g. midwives, community health workers, etc.) assess different aspects of patient vulnerability in a contextually appropriate and caring way and easily identify key referral resources in their local area. The CLEAR toolkit is accompanied by a trainers manual and is available in more than ten languages. 

Cognitive Assessment and people from CALD backgrounds (pdf 476KB)
Department of Health & Human Services Victoria, 2011
This Tip Sheet describes a range of cognitive assessment tools for people from culturally and linguistically diverse backgrounds.

Conversation Matters - Supporting Communities to Talk about Suicide
Hunter Institute of Mental Health, 2013
These resources highlight some of the factors that health professionals should consider when talking to CALD individuals, families and communities about suicide.

Cultural Awareness Tool (pdf 666.2KB)
Multicultural Mental Health Australia, 2002
This tool is provides practitioners with general guidance on how to manage clients with mental illness in a culturally aware manner.

Culturally Adapted Screening Tools
Beyond Blue
Culturally adapted screening tools have been developed as part of a study funded by beyondblue and conducted by the National Ageing Research Institute (NARI) that investigated the usefulness of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) in detecting late life depression and anxiety in community dwelling older Chinese migrants.

Montreal Cognitive Assessment 
The Montreal Cognitive Assessment is a cognitive screening test designed to assist health professionals to detect mild cognitive impairment.

Orientation to Cultural Responsiveness
Victorian Transcultural Mental Health, 2015
This introductory resource aims to help practitioners to explore creating culturally responsive mental health services.

Rowland Universal Dementia Assessment Scale (RUDAS) 
Alzheimer's Australia, 2004
RUDAS is cognitive screening instrument designed to minimise the effects of cultural learning and language diversity on the assessment of baseline cognitive performance.

WONCA Culturally Sensitive Depression Guideline (pdf 92.1KB)
World Organization of Family Doctors, 2004
These guidelines have been developed to assist clinicians with the diagnosis and treatment of adults with depressive disorder in primary care.

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Further Reading

The following journal articles and monographs discuss various aspects of cross cultural mental health assessment.

Where available we have provided links to the full text or abstract of articles. If items are not freely available online please contact your local library or hospital or university library (where applicable) to obtain the full text.

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