What can we talk about, in which language, in what way and with whom? Sami patients' experiences of language choice and cultural norms in mental health treatment

Abstract

BackgroundThe Sami in Norway have a legal right to receive health services adapted to Sami language and culture. This calls for a study of the significance of language choice and cultural norms in Sami patients’ encounters with mental health services.ObjectivesTo explore the significance of language and cultural norms in communication about mental health topics experienced by Sami patients receiving mental health treatment to enhance our understanding of linguistic and cultural adaptation of health services.MethodsData were collected through individual interviews with 4 Sami patients receiving mental health treatment in Northern Norway. A systematic text reduction and a thematic analysis were employed.FindingsTwo themes were identified:(I) Language choice is influenced by language competence, with whom one talks and what one talks about.Bilingualism was a resource and natural part of the participants’ lives, but there were limited possibilities to speak Sami in encounters with health services. A professional working relationship was placed on an equal footing with the possibility to speak Sami.(II) Cultural norms influence what one talks about, in what way and to whom.However, norms could be bypassed, by talking about norm-regulated topics in Norwegian with health providers.ConclusionSami patients’ language choice in different communication situations is influenced by a complexity of social and cultural factors. Sami patients have varying opinions about and preferences for what they can talk about, in which language, in what way and with whom. Bilingualism and knowledge about both Sami and Norwegian culture provide latitude and enhanced possibilities for both patients and the health services. The challenge for the health services is to allow for and safeguard such individual variations within the cultural framework of the patients.

“You never know who are Sami or speak Sami” Clinicians’ experiences with language-appropriate care to Sami-speaking patients in outpatient mental health clinics in Northern Norway

“…As for the Sami, the level of fluency in Sami language necessary to be accepted as Sami-speaking has not been defined (21,28). In addition, findings in a previous study (12), as well as in the present study, indicate that Sami-speaking patients switch between languages depending on with whom they talk, and when talking about emotional issues. Bilingualism and the use of language switch in different situations may conceal language needs (42).…”

“…This study concurs with findings in a previous study showing how Sami-speaking patients switch between Sami and Norwegian in therapy (12). This raises questions about the significance of language switch in therapy.…”

“…However, language assessment is complex; language proficiency and level of fluency are not easily defined and may vary whether it is clinician- or patient-assessed. Furthermore, patients’ language use and preferences may vary with relation to interlocutor or topic of conversation (7,12). The purpose of this study is to explore how clinicians deal with language-appropriate care with Sami-speaking patients in specialist mental health services.…”

‘Contradictions in having care providers with a South Sami background who speak South Sami’: older South Sami People in Sweden's expectations of home nursing care

“…Dagsvold et al. interviewed four bilingual care receivers with North Sami background in outpatient mental health in Norway, about their preferred language when receiving care, and they found that language choice was influenced by the language competence of both the care receiver and care provider. Dagsvold et al.…”

“…Dagsvold et al. found that language choice influenced whom the care receiver talked to and what the care receiver talked about, and they highlighted that switching between Sami and Norwegian was a natural part of everyday life, and one participant said that it did not make any difference whether speaking Sami or Norwegian because of their ability to express themselves and to think clearly in both languages. Similar thoughts were not expressed by participants in our study, but some highlighted that whether care providers speak Swedish or South Sami was seen as secondary.…”