Requesting an interpreter
An interpreter should be called upon if the client requests one, and/or in cases where a language barrier between the client and the health care provider interferes with effective communication. Language barriers include complete lack of proficiency in English of French and limited English or French proficiency, which is when the client self-assesses as speaking and understanding English or French less than very well (Institute of Medicine, 2009). If there are language barriers, it may be difficult to gather information and obtain a clear assessment of the client.
A language barrier occurs when people are unable to effectively communicate because they do not share a common language.
Some clients may refuse or prefer not to use interpreters, often because of concerns about confidentiality or for the stigma associated with mental illness within their cultural community. If this occurs and the health care provider considers it important to use a trained interpreter for better care, the health care provider should try to reassure the client and explain that professional interpreters are bound by a code of ethics and are required to respect privacy and confidentiality, and that the service is provided free of charge.
Remote interpreting
Remote interpreting, by either telephone or videoconferencing, has been increasingly employed in health care over the past few years when on-site interpretation could not be provided, in emergency situations or in remote locations. The COVID-19 pandemic jumpstarted remote interpreting and the use of remote interpreting increased exponentially.
Remote interpreting can be readily accessed and effectively used. Telephone interpreting can be arranged in advance or accessed on-demand, regardless of the location of the client or service provider. The service is easy-to-use and there are little to no time constraints to set up. Videoconferencing is similarly easy-to-use and readily accessible; it also offers a visual component that allows the client, the health care provider and the interpreter to all see one another. There is also an option to “mute” any visual feeds as appropriate for the encounter.
Providing care “in language” vs. interpreting
There are two main ways in which language support can be provided for a client with limited English or French proficiency:
Service is provided “in language,” meaning the provider is qualified to deliver care in the language shared with client.
An interpreter is used during the encounter.
Providing service “in language” does not involve interpreting as the client and health service provider are able to communicate directly with each other. Before providing care “in language,” both the provider and organization should be assured of the provider's ability to competently deliver care in the client's language. For example, an organization may arrange for third-party language proficiency assessments for settlement and social service providers health care professionals.