Data & Evaluations
14 pages
English

Data & Evaluations

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14 pages
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Description

  • cours - matière potentielle : to college transition
  • cours - matière potentielle : program
CAPTURING DATA & DOCUMENTING OUTCOMES
  • intern fellows program parent outreach
  • students from the high school to college transition
  • disadvantaged students
  • higher education
  • college
  • education

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Nombre de lectures 17
Langue English

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129 - 142 tribe 25-06-2004 10:15 Pagina 129
Rachel Tribe & Jean Morrissey
Good practice issues in working with
interpreters in mental health
Rachel Tribe & Jean Morrissey
If access to appropriate mental health services is not vices, with negative consequences for psy-
to be limited to people’s ability to speak a dominant chological well-being and service provision.
or host language used by mental health providers, A range of studies have noted that language
an interpreter or bicultural worker will be required. concordance (when health worker and
This article makes suggestions for good practice in patient speak the same language or have
working with interpreters either in situations of access to qualified interpreters) leads to bet-
ongoing-armed conflict or with asylum seekers ter access to health care, quality of commu-
refugees and internally displaced people who have nication, patient satisfaction, fewer emer-
fled from areas of armed conflict. gency visits and improved compliance with
health regimes (Lee, Batal, Masselin &
Key words: Interpreters, language, culture, Kutner, 2002; Eyton, Bischoff, Rrustemi,
mental health, psychological well-being, Durieux, Loutan, Gilbert & Bovier 2002;
training, support Riddick, 1998; Stolk, Ziguras, Saunders,
Garlick, Stuart & Coffey, 1998; Perez-
Context Stable, Napoles-Springer & Miramontes,
More people are migrating across borders 1997; Manson, 1988; Morales,
or within countries either as displaced peo- Cunningham, Brown, Lin & Hays, 1999).
ple owing to armed conflict or for other rea- The inability to communicate can have par-
sons. UNHCR (2003) gives a figure of ticular resonance in situations of armed
20.6 million people ‘of concern’ at the conflict, when individuals, families and
beginning of 2003, compared with 19.8 mil- communities may be displaced or fragment-
lion in 2002. The 2003 figure roughly ed. The inability to speak the dominant or
equates to one out of every 300 people host language might exacerbate feelings
world-wide. Issues of good cross-cultural related to displacement and this may be
communication are thus becoming increas- counter to good psychological well-being
ingly important within health services, and and health. The resulting problems of
language is a central facet of this (Bischoff, access to mental health services and exclu-
Bovier, Isah, Francoise, Ariel & Louis, sion of individuals or communities may
2003). Without a common language, peo- mean that different cultural perspectives are
ple are unable to communicate their not represented or considered when these
requirements and health workers their ser- services are developed, and that services
129129 - 142 tribe 25-06-2004 10:15 Pagina 130
Good practice issues in working with interpreters in mental health
Intervention 2004, Volume 2, Number 2, Page 129 - 142
offered might be inappropriate or not or block communication should not be
meaningful to members of target groups. underestimated at either the individual or
An interpreter often provides an important community/national level, and can have
link between the two parties and their con- particular resonance in a situation of armed
tribution should be respected accordingly. conflict. Language has also been used at
It is also important to remember that most various times to restrict access to, for exam-
communities contain people who offer ple, due legal process. In South Africa
‘mental health’ services but who might label under apartheid, legal proceedings were
their work differently, and who may not be conducted in English or Afrikaans, effec-
identified as such by those using purely tively excluding more than half the popula-
western frames of reference. tion (Sacks, 2000). Alternatively a number
of regional communities are working hard
Working with interpreters in men- to retain their language from a dominant or
tal health: key issues historically-imposed language and through
The question of whether interpreters this protect their cultural identity, for exam-
should merely translate the spoken word or ple in Wales and Catalonia. Also, after the
play a role in interpreting cultural and con- break up of the former Federal Republic of
textual variables that may be relevant to the Yugoslavia, the various new countries
mental health issues in question is a com- changed the name of the same language
plex one, especially when someone has fled associated with their old country from
to another region or country because of Serbo-Croat to Serbian, Croatian and
armed conflict or when the mental health Bosnian respectively.
1worker is from a different cultural back- Issues of control and accountability
ground to the person seeking help. between the mental health worker, inter-
The modern disciplines of Psychology and preter and client can be exacerbated when
Psychiatry were generally developed in a language and culture are not shared (Patel,
‘western’ context, in America and Europe. 2003; Mudarikiri, 2003; Tribe, 2004). In
There has been a developing view that situations of armed conflict and displace-
some of the knowledge that they embody ment particular consideration is required to
and its applicability will be limited by this ensure that people have access to the best
particular context (Fernando, 1991; Young, possible service, and feel that they have
1995; Summerfield, 2002; Mezzich, been heard and respected and not further
Kirkmayer & Kleinman, 1999; Owusu- dis-empowered. The very experience of
Bempah & Howitt, 2000; Richards, 1997). being in a situation of armed conflict or dis-
For example, views on the body and the placement can itself be very frightening and
mind as separate or interwoven entities, threatening to individuals and communi-
notions of the self, views of the family struc- ties. Interpreters can provide an essential
ture, treatment options, notions of individu- voice to those who wish to access mental
alism and collectivism may differ materially health services. The people they might nor-
in different cultures, and an interpreter/ mally turn to may be unavailable or dis-
bicultural worker may need to ensure that placed themselves.
these differences are communicated to a Languages are not interchangeable. Words
2mental health worker . in one language might not exist in another
The power and politics of language to allow (Hoffman, 1998) or may reflect a culture or
130129 - 142 tribe 25-06-2004 10:15 Pagina 131
Rachel Tribe & Jean Morrissey
societal context (Stroll, 2002). Time frames munity level, and represents their inter-
and the pattern and placing of tenses do not ests beyond interpreting language for
correspond across some languages (Tribe, them (Drennan & Swartz, 1999; Baylav,
2004). Translating between languages can 2003; Razban, 2003).
in effect mean translating between two sep- 4. Cultural broker/bicultural worker,
arate world views. Various languages do where the interpreter interprets not
not always distinguish between present, only the spoken word but also relevant
perfect and pluperfect tenses and grammat- cultural and contextual variables (Tribe
ical constructions can differ in a number of 1998a; Drennan & Swartz, 1999).
ways. Language is multi-faceted, dynamic, Each of the above models of interpreting
and constantly changing to incorporate has their place and will be appropriate in
new words or societal changes. The exact particular circumstances. For example the
relationship between language and meaning linguistic or word for word approach will be
is contested. Many theorists argue that lan- most appropriate in a medico-legal setting
guage not only transmits meaning but also when purely factual information is required
constructs and shapes it at the individual and any psychological meaning or emotion-
and societal level (Anderson & Goolishian, al resonance is seen as marginal or largely
1992; Burr, 1995). Generally then, lan- irrelevant. This model assumes that to
guage bears a close relation to particular some degree languages are inter-changeable
ways of construing meaning that may not codes, which relate to a universal set of
be shared across cultures (Mudarikiri, meanings, it minimises the differences
2003), and may both reflect and shape how between languages and the ways they con-
3the world is interpreted. struct meanings .
The psychotherapeutic or constructionist
Models of Interpretation mode is most useful when working within a
Four basic models of interpreting are pre- context of psychotherapy or counselling
sented below, although other writers offer where the meaning/feeling of the emotions
slightly different accounts. and words is paramount and the interpreter
1. The linguistic mode, where the inter- is primarily concerned with ensuring that
preter tries to interpret (as far as is pos- the meaning of the client’s words and emo-
sible) word-for-word and adopts a neu- tions are conveyed rather than purely con-
4tral and distanced position (Cushing, centrating on the linguistic forms . This
2003; Tribe, 1999). model gives the interpreter more flexibility
2. The psychotherapeutic or construction- to manoeuvre in ensuring that the client’s
ist mode, where the meaning/feeling of meaning is accurately conveyed but also
the words is most important, and the requires a higher level of responsibility,
interpreter is primarily concerned w

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