Overcoming Language Barriers in Mental Healthcare and Other Community Settings: Interpreting Practices and Training Measures

Abstract

Linguistic diversity within societies is a global reality, yet mental healthcare and other community services often fail to adequately reflect this, leading to language discordance between service users and providers. This dissertation explores interpreting practices to overcome language barriers and training measures for community interpreters and service providers. Five research objectives were developed and investigated in five individual studies. In the first, a cross-sectional study was conducted among individuals identifying as interpreters and working in various community settings, such as (mental) healthcare, social care, education, or authorities in Germany. The findings provide an initial comprehensive and evidence-based overview of interpreters’ sociodemographic profiles, working conditions, (formal) training background, mental health status, and psychological distress regarding interpreting. The second study was conducted to explore informal interpreting practices by investigating security guards serving informally as interpreters in a psychiatric hospital in South Africa. Interviews with mental healthcare professionals and security guards showed that this compromises communication quality and poses emotional risks for the security guards, yet it can be assumed that such practices persist due to a lack of effective alternatives. In a third study, the impact of an interpreter’s presence on the communicative situation was investigated using the therapeutic alliance in a psychotherapeutic setting in Denmark as an example. Interpreters are an active part of the process, and their presence significantly changes the interaction. Conducting interpreter-mediated encounters effectively, including forming a good triadic therapeutic alliance, requires specialized training for both interpreters and service providers. The fourth study focused on the development and evaluation of a generic training program for community interpreters in Germany. The mixed-methods study found improvements in interpreters’ knowledge, competence, self-efficacy, and increased self-perceived professionalism. The importance of formalized training and certification for enhancing service quality and interpreters’ professional status was highlighted. In the fifth study, educational videos aiming at training service providers to work with interpreters across community settings were developed and evaluated. Interviews with service providers and experts in CI in Germany and Switzerland revealed that while the videos can increase providers’ knowledge and confidence, in-person practice is necessary for effective interpreter-mediated communication. Overall, this dissertation provides valuable knowledge about the individuals working (informally) as interpreters, the impact of the interpreters’ presence on communication, and how to train service providers and interpreters to collaborate effectively. Beyond changes at an individual level, socio-political reforms at the institutional and systemic levels are required to ensure effective and professional interpreting practices and thus promote equitable service access to and provision of mental healthcare and other community services in linguistically diverse populations.