Ad hoc interpreters in South African psychiatric services: service provider perspectives

Abstract

Background: Language and communication lie at the heart of good quality mental health care and are a vital, yet complex, part of the diagnostic and treatment process. In South African mental health care, ad hoc interpreting arrangements are the status quo. However, these can cause both clinician and patient shame and distress. Objective: Though this issue has been researched from the point of view of informal interpreters, relatively little is known about psychiatrists' experiences of working with ad hoc interpreters. This study is part of an attempt to bridge that gap. Methods: We made use of a cross-sectional qualitative interview design. We interviewed seven psychiatrists working at a psychiatric hospital in the Western Cape of South Africa. Data were analysed manually using thematic analysis. Results:Five main themes can be identified from the data: miscommunication and other difficulties associated with the language barrier; the language barrier between clinicians and patients and a need for language services; participants' views on interpreting; the role of age, culture and gender; and the use of trained and untrained interpreters and using staff as interpreters. Conclusions: Psychiatrists experience numerous difficulties in conducting their work due to the language barrier. This has an impact on their ability to provide adequate mental health care to patients. There is a need for better language services to ensure that everyone that seeks mental health care can receive the same level of care. Currently, one's ability to speak a certain language will have a significant impact on the quality of care received.

Do not lose your patient in translation: Using interpreters effectively in primary care

“…14,16 It is common practice in the South African healthcare sector to use untrained bi-or multilingual staff and ad hoc interpreters. 20 Despite not being the first choice, ad hoc interpreters (e.g. family or friends) have some benefits and may often be the only option available in the facility (Table 1).…”

“…Ad hoc interpreters in local studies were found to have inadequate language proficiency and were prone to frequent errors during interpretation. 5,19,20 Most published data on this topic comes from the Western Cape Province and isiXhosa-speaking patients. 5 Thus, a research gap exists regarding other provinces and languages in South Africa.…”

South African clinical psychology practice: The challenge of local contextual change.

“…The struggle itself is both broader and more complex. Added to this are the layers of taken-for-granted workplace relationships (themselves, as always, relationships of both enablement and exclusion, always in an unequal power matrix) which may constrain change and which always have to be understood in the context of the local vulnerabilities of all actors in a work environment (Hagan et al, 2020). Given all of these considerations, we do not claim that our insights lead to immediately implementable lessons for change, but we suggest that having discussions such as those we are engaged in, on a large scale, may play some role in the slow business of social change.…”

“…The struggle itself is both broader and more complex. Added to this are the layers of taken-for-granted workplace relationships (themselves, as always, relationships of both enablement and exclusion, always in an unequal power matrix) which may constrain change and which always have to be understood in the context of the local vulnerabilities of all actors in a work environment (Hagan et al, 2020).…”

Können digitale Kommunikationshilfen den Informationsaustausch in der allgemeinmedizinischen Sprechstunde verbessern?

“…Damit widerspricht diese Studie vielen anderen Arbeiten und Expertenmeinungen, die nicht zuletzt auch wegen der variierenden medizinischen Standards in den Herkunftsländern, der Anstrengungen auf der Flucht und der Hygienezustände in vielen Gemeinschaftsunterkünften eine höhere Prävalenz bestimmter Infektionskrankheiten unter den Geflüchteten vermuten (Hampel et al 2016). Dies lässt sich auch exemplarisch an einer Studie zur Seroprävalenz für Hepatitis B bei Geflüchteten zeigen: Hier lag die Prävalenz für das HBsAg, einem wichtigen serologischen Marker einer durchgemachten Hepatitis-B-Virusinfektion, bei 2,3% und damit deutlich höher als in der deutschen Allgemeinbevölkerung (Hampel et al 2016) (Hagan et al 2020).…”