The consequences of language barriers are some of the most fundamental challenges refugees and asylum seekers face, undermining both the accessibility of mental health services and the quality of the services received. This scoping review provides the first synthesis of research on interpreters working in mental health settings with refugees, one of the most prominent yet understudied strategies to improving language access and the cultural appropriateness of services for this unique population. Comprehensive searches were conducted in PsycINFO, Medline, Web of Science, Social Services Abstracts CAIRN, and Erudit for relevant journal articles and book chapters published up to April 2019. A total of 84 peer-reviewed studies met the inclusion criteria. Publications represented a range of disciplines including social work, linguistics, psychology, anthropology, public health, medicine, psychiatry, and nursing. Six thematic areas were identified: (1) Lack of adequate interpretation as barrier to care; (2) Emotional impact of interpreting on the interpreter; (3) Training and supervision; (4) Impact of the interpreter on the process of psychotherapy/mental health intervention; (5) The impact of the interpreter on the intervention outcome; and (6) The role of the interpreter. The results indicate that despite undeniable challenges, including concerns around confidentiality and bias, when clinicians and refugee clients do not share proficiency in a common language, interpreters have a positive impact on refugee clients’ quality of care and clinical outcomes. The implications of these findings for host countries providing mental health services for refugees globally are considered and recommendations offered.

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As the number of refugees worldwide reaches unprecedented levels, social workers’ ability to provide effective and appropriate mental healthcare to this population is as critical as ever. This article provides a review of contemporary debates revolving around the cultural adaptation (CA) of mental health interventions—when it is warranted, what approach should be taken and what components of an intervention should be adapted. CA is presented as a promising and pragmatic approach to service delivery, one that can assist clinical social workers in designing and implementing interventions that reflect refugees’ local needs and knowledge without neglecting important advances in research evidence and clinical expertise. However, it is not without its challenges. By drawing on literature related to the integration of cultural and contextual factors in mental health interventions and services, the article addresses critical issues in the CA approach and asks: is it possible to strike a balance between fidelity to evidence-based interventions and culturally compatible care?

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