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The need for measurable standards in mental health interpreting: a neglected area

  • Jan Cambridge (a1), Swaran P. Singh (a2) and Mark Johnson (a3)
Summary

This editorial offers an overview of mental health service provision across different languages and cultures in the UK. It is increasingly recognised that mental health service users with limited English proficiency are rendered doubly vulnerable by the combination of their illness and their language difficulties. Only recently has the importance of safe, coherent, nationally available interpreting, translation and language support (ITALS) been recognised by healthcare providers. We review the challenges within the interpreted interaction, some reasons for the scarcity of qualified and accredited ITALS suppliers, and some solutions to the ITALS problem.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Jan Cambridge (jancambridge@uwclub.net)
Footnotes
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See commentary, pp. 124–125, this issue.

Declaration of interest

J.C.'s current PhD study concerns interpreting in mental health services. S.P.S. and M.J. are her supervisors.

Footnotes
References
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1 McGurk, H, McDonald, J. Hearing lips and seeing voices. Nature 1976; 264: 746–8.
2 Woodhouse, L, Hickson, L, Dodd, B. Review of visual speech perception by hearing and hearing-impaired people: clinical implications. Int J Language Commun Disord 2009; 44: 253–70.
3 Cambridge, J. Information loss in bilingual medical interviews through an untrained interpreter. Translator 1999; 5: 202–19.
4 Divi, C, Koss, RG, Schmaltz, SP, Loeb, JM. Language proficiency and adverse events in US hospitals: a pilot study. Int J Qual Health Care 2007; 19: 60–7.
5 Flores, G. The impact of medical interpreter services on the quality of health care: a systematic review. Med Care Res Rev 2005; 62: 255–99.
6 National Centre for Languages (CiLT). Standards, Qualifications and Frameworks. CiLT, 2005 (http://www.cilt.org.uk/home/standards_and_qualifications.aspx).
7 Aspinall, PJ. Language ability: a neglected dimension in the profiling of populations and health service users. Health Educ J 2007; 66: 17.
8 Archer, D. Unspoken diversity: cultural differences in gestures. Qual Sociol 1997; 20: 79105.
9 Gile, D. Conference interpreting as a cognitive management problem. In The Interpreting Studies Reader (eds Pöchhacker, F, Shlesinger, M): 162–76. Routledge, 1997.
10 Collados Aís Á. Quality assessment in simultaneous interpreting: the importance of non-verbal communication. In The Interpreting Studies Reader (eds Pöchhacker, F, Shlesinger, M): 326–36. Routledge, 1997.
11 Moser-Mercer, B. Process models in simultaneous interpretation. In The Interpreting Studies Reader (eds Pöchhacker, F, Shlesinger, M): 148–61. Routledge, 1997.
12 Elderkin-Thompson, V, Cohen Silver, R, Waitzkin, H. When nurses double as interpreters: a study of Spanish-speaking patients in a US primary care setting. Soc Sci Med 2001; 52: 1343–58.
13 Khoei, EM, Richters, J. Concepts of sexuality and health among Iranian women in Australia. Aust Fam Physician 2008; 37: 190–2.
14 Greenhalgh, T, Robb, N, Scambler, G. Communicative and strategic action in interpreted consultations in primary health care: a Habermasian perspective. Soc Sci Med 2006; 63: 1170–87.
15 Anon. The 1986 Administrative Procedure Act (including subsequent amendments). Cited in Swedish Country report to EU Fundamental Rights Agency 1986. Available at http://www.sweden.gov.se/sb/d/574/a/64892.
16 Mikkelson, H. The professionalization of community interpreting. In Global Vision: Proceedings of the 37th Annual Conference of the American Translators Association (ed. Jér⊚me-O'Keefe, MM): 7789. American Translators Association, 1996.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
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The need for measurable standards in mental health interpreting: a neglected area

  • Jan Cambridge (a1), Swaran P. Singh (a2) and Mark Johnson (a3)
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Re:The psychiatrist and the interpreter

Jan Cambridge, Interpreter. Interpreter trainer.
13 June 2012

I am glad to see such a positive response to the Editorial on interpreting practice. Psychiatry and Speech and Language Therapy are two of the most challenging areas of practice for interpreters.

Australia has an honourable tradition in the field of language support for its diverse population, as I exprienced in New South Wales a few years ago.

Andrew Firestone's description of using a triangular seating arrangement but having changed to sitting the interpreter next to him is interesting. I have found that if I sit next to either the clinician or the patient problems in the doctor-patient relationship can still occur. If closer to the patient, it is more likely that they will address quesions directly to me, trying to draw me in 'on their side', such as 'are you married?', or 'do you have childen?' If closer to the clinician, my impartiality can seem to the patient to be compromised.

In the UK almost all interpreters in the public sector are indpendent freelance workers. Being seen by the service user as directly employed by a State institution, whichever it is, can cause them to distrust our interpretation, especially if they have arrived from a totalitarian state. Seating the interpreter at the apex of an isosceles triangle, in which the clinician and patient are closest together and directly facing one another, allows eye contact to be maintained between them, and keeps the interpreter out of direct line of sight. Interpreters who are taking notes will be busy with their notebooks and not available for eye contact. They still need to be able to see the speakers' faces, ofcourse.

It would be interesting to know if interpreters and clinicians maintain direct speech during clinic sessions, such as "how are you feeling?" rather than "ask her how she feels". This is another way of keeping the interpreter out of a direct relationship with either party during the interview. It is very important that the interpreter introducesthemselves and briefly explains how they work, at the beginning of the session. This, and everything else that is said, should be done in both languages. If the patient is reminded at the outset that 'I will interpreteverthing I hear' and 'I will speak to you as the doctor does, with I and you; they are his words', ownership of what is said remains with the primary interlocutors, not the interpreter.

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Conflict of interest: None declared

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The psychiatrist and the interpreter

andrew firestone, consultant psychiatrist
08 June 2012

It was good to see the article of Cambridge et al and the response of MacSuibhne , in the April 2012 issue of The Psychiatrist. It is true there is little literature on psychiatrists' use of interpreters - which differs from general medical use.

Skilled medical interpreters may habitually assist busy hospital doctors by summarizing patients' meanings. The psychiatrist must begin by explaining that every word said by either party is to be translated "as this is a psychiatric interview, and exactly how things are said is important information, as well as what is said".

Here in Melbourne - a migrants' city, with excellent interpreter training at University level - interpreters have been taught to form a triangle in the room with the two parties involved. However over many years I have found that this will delay development of my relationship with the patient, as only fluctuant eye contact is the result. I prefer toseat the interpreter right next to me, so the patient gives both of us eyecontact at once.

In family interviews however, if only one member is being translated into English, and the interpreter is busy too with translating from everyone else's English for that person - the interpreter sits next to the person and can softly translate simultaneously from English. Welltrained interpreters love to practise their skills in this way!

After the interview the experienced interpreter is often asked to remain behind for a minute, to share the impression the patient's languageuse made on them. Some interpreters enjoy providing cultural information too, and will usefully correct our misconceptions during a session, once they know and trust us.

It is important to keep in mind that interpreters have frequently suffered similar traumatic experiences to the patient. After a heavy session, the interpreter should be given an opportunity to debrief.

On one point all are in agreement. Use of a family member to translate is a minefield. The Telephone Translating Service was developed precisely to overcome this practice.

Australia offers doctors telephone interpreters free of charge, and in fact this often creates less interference (using a speaker phone) than an interpreter in the room. We specify if a male or female interpreter is required. The interpreter may be in a different city. "Translate every word please, this is a psychiatric interview" is said at the outset.

Patients and relatives will often gesture, in these circumstances, toindicate that their dialect is being poorly understood or to relate their lack of confidence in the translation - useful information! On the other hand, the 'phone interpreter seldom provides cultural understanding as the room interpreter can do.

For the experienced psychiatrist, the increased difficulty of interpreted work can be a pleasant challenge. However it must be acknowledged that cultural expectations at variance with each other can cause frustrations.

The psychiatrist (2012), 36, 121-124, doi: 10.1192/pb/bp.110.031211

The Psychiatrist (2012), 36, 124-125, doi: 10.1192/pb.bp.111.038117

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Conflict of interest: None declared

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