Setting

This audit is relevant in all subspecialties and in all psychiatric settings.

Background

Communicating with patients who do not speak English as a first language is a common challenge and yet it is impossible to provide high-quality mental health services without excellent communication between mental health staff and patients. It is worth noting that the Royal College of Psychiatrists does not currently have guidelines on working through interpreters.

Standards

Standards were obtained from the Victorian Transcultural Psychiatry Unit (VTPU). These are generally acceptable standards which were published in 2006 in Australia. They give guidance on booking interpreters and the use of interpreters before and during the interview, and requesting feedback after the interview:

ᐅ Appointments should be for 1.5 hours and time should be used to maximum effect.

ᐅ The patient and the interpreter should be matched as closely as possible regarding language and dialect, education, ethnic origin, religion and gender preferences.

ᐅ During the consultation, chairs should be arranged such that the interpreter is next to the health worker, opposite patient (this may have to be adapted according to the size of the group).

ᐅ The health worker should keep control of the meeting and speak directly to the patient.

ᐅ The health worker should use short sentences and expect everything said in the room to be interpreted.

ᐅ A ‘code word’ can be used to stop the meeting if the patient wishes to.

ᐅ The worker should give the interpreter feedback after the meeting and ask for feedback in return.

The target is that these standards are met for all patients seen through interpreters.

Method

Data collection

A list of trust employees was obtained from human resources. A questionnaire, developed to reflect the above standards (and that included demographic information), was distributed to staff (this could include any staff group with patient contact or only doctors) either in person or through the internal mail system.

Data analysis

The percentage of staff who reported meeting the above standards was calculated.

Resources required

People

This audit should be undertaken by two people, owing to the amount of information that needs to be collected and analysed.

Time

It is estimated that for 50 completed questionnaires it would take around 8 weeks to collect and 3 hours to analyse all the data.