Qualified interpreters vs. ad hoc interpreters
The individuals who are called upon to interpret typically fall into two main categories:
Qualified interpreters, who are trained and tested.
Ad hoc interpreters, who are untrained, untested, self-assessed bilinguals such as friends or family members, and staff members.
Since interpreting is a complex task and requires specific skills and training, it is always preferable to use a qualified professional interpreter in a mental health setting. They are bound by a standard of practice to interpret accurately, faithfully and transparently, and to adhere to the professional code of ethics to remain neutral and protect privacy and confidentiality. In general, it is best practice, from both a client safety and client-centred care perspective, to work with a qualified interpreter for medically-related discussions with clients with limited English proficiency. Another best practice guideline is to use qualified interpreters for high-risk medical scenarios, including emergency care, informed consent, surgical care, medication reconciliation and discharge (Betancourt et al., 2012).
There is no single modality for working with qualified interpreting in professional settings. Instead, most organizations have adopted a multi-modality approach (e.g., in-person, telephonic and/or video conferencing) to ensure that clients can express themselves in the language of their choice, and to ensure full bilateral communication between clients and the providers.
A current reality in some systems is that access to a qualified professional interpreter may be limited due to lack of funding. As a result, health service providers may turn to ad hoc interpreters. Service providers should be aware of the types of quality problems that may occur when working with an ad hoc interpreter to evaluate and treat clients (Bauer & Alegria, 2010).
An untrained interpreter's lack of understanding of mental health terminology and concepts may interfere with a provider's assessment process. In delicate situations, the interpreter may prevent or, on the other hand, facilitate the expression of certain elements of the client's history.
For example:
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Health service provider:
What kind of mood have you been in lately?
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Untrained interpreter:
How have you been feeling?
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Client:
I have a headache all the time.
In 2007, the Health Interpretation Network (HIN), representing a cross section of public and private sector organizations, published the National Standards for Interpretation Services (Healthcare Interpretation Network, 2007). This document outlines the core competencies and ethical principles for interpreters.
No interpreter is perfect and errors can occur. In their study, Nápoles et al. (2015) found an average of 27 errors per visit. Most errors had potential clinical consequences, and those committed by ad hoc interpreters were significantly more likely to have potential consequences than those committed by qualified professional interpreters.
Strengths and weaknesses of professional interpreters
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- Specifically trained for interpreting
- Protect confidentiality and privacy
- Less likely to make linguistic and paralinguistic elements errors or misinterpret emotions
Strengths
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- For on-site interpreting, lead time to book the interpreter
- Client may be uncomfortable with a third party
- If over the phone, additional time may be required for clarifications that may be necessary to convey message accurately
Weaknesses