Interpreters in Transcultural Psychiatry

Skammeritz, Signe; Sari, Nevra; Jiménez-Solomon, Oscar; Carlsson, Jessica

doi:10.1176/appi.ps.201800107

Cited by 11 publications

(6 citation statements)

References 9 publications

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“…On the other hand, possible bias associated with the use of interpreters needs recognition. The quality of the translations was vital for the obtained data, and any inaccuracies or misapprehensions may possibly have resulted in errors in our interpretations [ 66 , 67 ]. We acknowledge that the interactions between the Afghan refugees and professional psychologists moderating the FGIs may have involved transactions between EMs in its’ own right, in that the participants deliberately downplayed more “exotic” cultural perceptions in favor of a more “western” explanatory framework.…”

Section: Discussionmentioning

confidence: 99%

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

et al. 2022

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Background The current situation in Afghanistan makes it likely that we are facing a new wave of Afghan refugees, warranting more knowledge about how to deal with mental health problems among them. This study aims to gain more knowledge on Explanatory Models (EM) of depression and post-traumatic stress disorders (PTSD) among Afghan refugees resettled in Norway. Methods We conducted six gender-separated, semi-structured focusgroup interviews based on vignettes with Afghan refugees (total N = 27). The vignettes described a fictional character with symptoms of either depression or PTSD symptoms in line with DSM-5 and ICD-10 criteria. Results The findings showed that EM varied with gender, age, generation, and migration stories. Participants suggested different potential causes, risk factors, and ways of managing symptoms of depression and PTSD depending on the context (e.g., in Norway vs. Afghanistan). In describing the causes of the depression/PTSD in the vignettes, females tended to emphasize domestic problems and gender issues while males focused more on acculturation challenges. The younger males discussed mostly traumatic experiences before and during flight as possible causes. Conclusion The practice of condensing a single set of EMs within a group may not only be analytically challenging in a time-pressed clinical setting but also misleading. Rather, we advocate asking empathic questions and roughly mapping individual refugee patients’ perceptions on causes and treatment as a better starting point for building trusting relationships and inviting patients to share and put into practice their expertise about their own lives.

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Section: Discussionmentioning

confidence: 99%

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

et al. 2022

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“…It is extremely rare to encounter any interpreter with mental health training at all. Most experts in this field have built up their experience over years of specialist practice (Skammeritz et al, 2019) and some voluntary registers such as that of NRCPD, for example, will enable an interpreter to specify their expertise. However, there is not a recognized qualification in mental health interpreting in the UK.…”

Section: Discussionmentioning

confidence: 99%

Mental health professionals' (AMHPs) perspectives on interpreter-mediated mental health act assessments

Young,

Vicary,

Tipton

et al. 2023

Journal of Social Work

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Summary This article concerns interpreter-mediated Mental Health Act (MHA) (1983) assessments where either a signed or spoken language interpreter is required. It reports data from 132 Approved Mental Health Professionals (AMHPs) in England who have direct experience of such circumstances addressing expertise, training, readiness, and potential influences on the outcome when interpreters are involved. Quantitative data were collected by means of an online survey analyzed descriptively with additional open-ended qualitative responses analyzed thematically. Findings More interpreter-mediated MHA assessments were reported as occurring in hospital than in community settings. Although AMHPs were confident in their expertise, nearly two-thirds felt they were less effective when an interpreter was involved. The vast majority had received only minimal training on how to work with an interpreter. Recording of language and interpreter use in the assessment was revealed as inconsistent. Most AMHPs thought incorrectly that interpreters were subject to mandatory registration with assured minimum standards of qualification and expertise. Practical problems associated with the timeliness of access to interpreters and complexities of using telephone interpreters instead of face to face were raised. AMHPs expressed a wish for more training and guidance including expectations of the interpreter role. Applications Consistent standards of formal recording of interpreter use as part of annual monitoring of the MHA are required to understand any potential inequities of outcome resulting from language mediation. Joint training with interpreters is desirable with more specific guidance and resources for working AMHPs and interpreters to promote best practice.

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“…Although the literature recommends systematically working with qualified interpreters during psychiatric assessments of individuals with limited language proficiency (Skammeritz et al, 2019), and discourages the use of ad hoc interpreters, the use of trained interpreters was never documented in this study. When the use of interpreters was reported, it mostly consisted of patients' relatives and healthcare professionals.…”

Section: Underutilization Of Interpreters and Normalization Of Limite...mentioning

confidence: 94%

“…When patients express themselves in their own language, they articulate their experiences in a more nuanced manner, which ultimately improves the accuracy of their psychiatric assessment and diagnosis (Kirmayer et al, 2008). The literature recommends systematically working with qualified interpreters during psychiatric assessments of individuals with limited mainstream language proficiency (Skammeritz et al, 2019) and discourages the use of ad hoc interpreters who may fail to recognize nuanced patterns of speech with clinical relevance, such as disordered thought processes (Elkington & Talbot, 2016). Indeed, informal interpreters are at higher risk of committing translation mistakes with clinical consequences (Flores et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…In the context of globalization and increasing immigrant diversity, the Canadian population has come to speak more languages in recent decades (Statistics Canada, 2017), which has made healthcare more complex. A substantial body of literature has established that language barriers between clinicians and patients increase the risk of misdiagnoses and medication errors, and negatively impact healthcare access, adherence to treatment, and patient satisfaction (Bowen, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Documenting language barriers in a general hospital psychiatry setting

Arpin-Gemme

Gelgoot

Miklavcic

et al. 2023

Transcult Psychiatry

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Previous research has demonstrated that without the use of professional interpreters, language barriers interfere with patient care. The literature recommends documenting the presence of language barriers in medical charts. To our knowledge, this mixed methods study is the first to examine language documentation practices in a Canadian inpatient psychiatry setting. The research team interviewed 122 patients admitted to a tertiary care psychiatry ward in Montreal, Canada between 2016−2017 to assess their ability to communicate in the healthcare establishment's languages (English/French). Nineteen participants identified as having a language barrier were selected for a qualitative analysis of the retrospective audit of their medical charts. The presence of a language barrier was reflected in 68% of these charts. When a language barrier was documented, professional interpreters were never used. Our qualitative analysis, informed by literature on medical discourse, aimed to provide clinical, administrative, and organizational recommendations to optimize the utilization of interpreting services in psychiatric wards. Documentation of language data was inconsistently collected, often vague, and shed light on the clinical challenges involved in differentiating language barriers from psychopathology. Normalization of limited care for language diverse patients was reflected in the clinical notes. Findings show that a change of organizational culture is imperative to provide optimal care to language diverse patients. We recommend clinician education and standardization of documentation practices, along with institutional policies supporting the systematic use of professional interpreters in mental healthcare settings, to maximize human rights and patient safety, and to bring medical practices to an acceptable standard of care.

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Interpreters in Transcultural Psychiatry

Cited by 11 publications

References 9 publications

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

Explanatory models of post-traumatic stress disorder (PTSD) and depression among Afghan refugees in Norway

Mental health professionals' (AMHPs) perspectives on interpreter-mediated mental health act assessments

Documenting language barriers in a general hospital psychiatry setting

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