The role of interpreters in mental health care

Abstract

Increasing globalization and immigration has seen an increase in linguistic and cultural diversity worldwide. This has necessitated the use of interpreters in public service settings. Of particular interest to the authors, and the focus of this article, is the impact of linguistic diversity on access to health care and, more specifically, to mental healthcare services. It is widely documented that language discordance impedes access to, and quality of, health care and that formally trained interpreter-assisted consults vastly improve client satisfaction and clinical outcomes. This article examines the current situation in South Africa regarding the use of interpreters in this setting. The ethical and practical implications for psychotherapy and psychodiagnostics are considered. Current policy and legislation relevant to language services and health care is reviewed. Possible ways forward to ensure equal access to healthcare services are discussed.Language serves many functions in society. It is the most important medium of communication and arguably one of the most important means of interaction. Through a dialectical process, language shapes and is shaped by culture. However, internationally, there are examples of language being used in a divisive manner. The apartheid government used language as an instrument in the politicization of the country which aided the segregation of the South African nation. Therefore, among other ethnographic variables, language was used as yet another marker of difference to justify segregation and oppression in South Africa. The origins of South Africa's language issue lie in the country's settler-colonial history. English and Afrikaans, the languages of the settlers and colonists, were imposed upon indigenous South Africans and other oppressed groups. The White minority had access to the best public services which were exclusively provided in English and Afrikaans.

Speech-Language Pathologists’ Use of Language Interpreters With Linguistically Diverse Clients: A Nationwide Survey Study

“…Although previous investigations have examined the association between SLPs’ clinical self-efficacy and years of experience (Harris, 2004; Kimble, 2013), no prior study, to the best of our knowledge, has explored the influence of years of work experience on the decision to utilize or not utilize an interpreter. It is important to note, however, that previous research in other health care fields indicate that only few resident clinicians in nursing (Tuttle, 2009) and recent graduates in mental health (Elkington & Talbot, 2016) access interpreters when compared with experienced clinicians. One possible reason for this difference between newer clinicians and seasoned practitioners could be the limited awareness regarding use of language interpreters among newly qualified SLPs (Elkington & Talbot, 2016).…”

“…It is important to note, however, that previous research in other health care fields indicate that only few resident clinicians in nursing (Tuttle, 2009) and recent graduates in mental health (Elkington & Talbot, 2016) access interpreters when compared with experienced clinicians. One possible reason for this difference between newer clinicians and seasoned practitioners could be the limited awareness regarding use of language interpreters among newly qualified SLPs (Elkington & Talbot, 2016). It is likely that experienced SLPs have had several opportunities for working with CLD clients.…”

“…Investigations in the past have not specifically looked at SLPs’ years of experience as a factor that affects their choice of utilizing language interpreters. However, in the fields of nursing and mental health, recent graduates and clinicians with few years of experience reported limited awareness regarding importance of language interpreters and limited understanding of how to best utilize their services (e.g., Elkington & Talbot, 2016; Tuttle, 2009). In the absence of similar investigations in the field of speech-language pathology, one can only assume that several newly qualified SLPs and recent graduates are less cognizant of the role of language interpreters in-service delivery for linguistically diverse clients.…”

Service gaps related to culturally appropriate mental health care for African immigrants

“…() however, noted that it was not unusual for a family member or a friend to interpret, or a bilingual health professional to be involved, although misinterpretation as a result of unfamiliar vocabulary or medical terminology was recognised. It has been reported that in some instance parents have used their children, who have adopted the English language, as translators and interpreters, however this practice poses the risk of role reversal which may result in undermining normal lines of communication within families (Elkington & Talbot ; Wood & Newbold ). Adequate interpretation is necessary for the provision of culturally appropriate care.…”

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

“…The advent of democracy in South Africa has brought many benefits, but for the vast majority of people that access public health care there has been no substantial change [3]. Very few mental health care professionals speak an indigenous African language, with Afrikaans and English remaining the dominant languages, and little systematic attention to ethnic differences [6,[34][35][36].…”