Considerations for Mental/Behavioral Health Providers
For limited-English-proficient (LEP) clients, the use of trained interpreters should be part of services provided. It's important to understand the role interpreters play in mental/behavioral health care settings.
Conduit of communication
- This is the most basic and the default role of an interpreter. The interpreter conveys in one language literally what has been said by the other, without additions, omissions, editing, or polishing.
- The interpreter explains or creates “word pictures” of terms that have no linguistic equivalent (or whose linguistic equivalent will not be understood by the provider or the LEP client) and checks for understanding. This role is adopted when the interpreter believes it is necessary to help all participants understand.
- The interpreter provides a necessary cultural framework for understanding the message being interpreted from the patient’s cultural perspective and not from the interpreter’s. This role is adopted when cultural differences are leading to a misunderstanding by either the provider or client.
Easing confidentiality concerns
For many LEP patients, especially those from small, lesser encountered language communities, providing options for type of interpreter (phone vs. in-person) may ease confidentiality concerns. Because of stigma associated with mental/behavioral health in many communities, using interpreters who are well-known community members may not be the best option.
It’s about preparation.
Whether you are using in-person or telephone interpreting, a best practice for working with an interpreter involves some form of a triadic interview. Aspects of the Triadic Interview Method include:
- Provider—maintains control of the interview/encounter; focuses and speaks directly to the patient/client. Avoid saying “Tell him,” “Ask her,” etc.
- LEP client—interacts directly with the provider, speaking directly to him or her.
- Interpreter—speaks in the first person and draws as little attention as possible.
The focus of the interaction should always be between the provider and the patient. The interpreter is there to ensure that everything is communicated efficiently and effectively. This triadic relationship leads to good communication and helps create trust and ensure confidentiality and a balance of power in the encounter.
Plan for an LEP patient by doing a pre- and post-session with interpreter.
Items for a provider to consider for a pre-session:
- Tell interpreter about any special techniques used
- Disclose any pertinent information about the patient’s diagnosis/encounter
- Any items that could affect communication such as impaired or difficult-to-understand speech
Items for a provider to consider for a post-session:
- Trauma/sensitive items or subjects (vulgar, angry, or inappropriate speech, etc.)
- Note the interpreter used for the session
Helpful resources about interpretation