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From: Health of minority ethnic communities in the UK [mailto:[log in to unmask]] On Behalf Of Sanyal, Neil
Sent: 02 November 2017 10:55
To: [log in to unmask]
Subject: Re: Hospital interpreter services
Sorry I am late to this discussion but I wanted to relate an interpreting experience I had about 13 years ago which somewhat balances out the debate, although I am not advocating telephone interpreting as the norm of course.
A CMHT Consultant Psychiatrist and I were dealing with an asylum seeker from the Middle East (I’m not being any more specific than that for confidentiality purposes) who lived in a local hostel and to facilitate our ongoing assessment and support for this young man we used a face to face interpreter from the same community as the patient for several sessions. Several minutes of Arabic sentences spoken by the patient were interpreted back with about 30 seconds of speech by the interpreter. The Consultant and I were continually frustrated by this as we believed the patient was suffering from troubling psychotic delusions that might be a risk to himself or others or his health but could not ascertain enough information with which to formulate a proper plan of support and appropriate treatment. Then the patient was admitted to an acute inpatient unit under section 2 MHA 1983 (not assessed by either of us on the day of detention) and during his admission the nursing and medical staff did not use an interpreter. The patient appealed to a Mental Health Review Tribunal (MHRT) and was discharged because the Treating Inpatient Consultant Psychiatrist, on the basis of no interpreted discussions at all, believed the patient was not psychotic. I attended the MHRT and witnessed this situation for myself and was very frustrated by what I saw unfolding. Fortunately, the patient after discharge continued to see the community Consultant and I and we saw him soon afterwards. This time the Consultant rang Language Line and for an hour used the telephone interpreting service. It became very apparent that the patient was troubled by a massive paranoid psychotic delusional system in which he believed the Prime Minister of the day was spying on him in the toilet for example. The Community Consultant and I were interested to note that we got a far more comprehensive picture of the patient’s mental state when the person interpreting was not in the room with us than we had had with a face to face interpreter. The treatment plan that resulted – change of medication amongst other aspects – definitely reduced the risks for him, improved his quality of life and prevented another admission to hospital.
I will not comment on my opinion of why the community situation unfolded as it did - just to say that telephone interpreting can be effective in some cases but I still believe it should not be the norm. As for the inpatient staff and their lack of use of an interpreter – I hope this kind of malpractice is now consigned to history.
Neil
Neil Sanyal
Social Worker/AMHP
Adult Mental Health New Forest Substance Misuese Social Care Team
Lymington Area OfficeLymington
Hampshire
SO41 9YB
Tel: 01590 625120
From: Naseer Ahmad [mailto:[log in to unmask]]
Sent: 02 November 2017 10:13
To: [log in to unmask]
Subject: Re: Hospital interpreter services
May I thank everyone who emailed me both directly and through the list.
I will write a reply to my trust quoting all the relevant sources given. I think a combined approach is best as there always needs to be a compromise - but ultimately it has to be a clinical decision which service to use rather than a management one.
Sometimes, we need a person to be present eg consenting for surgery, breaking bad news etc but for some routine outpatient stuff, a telephone service (with usually lesser qualified staff) is sufficient.
Thank you everyone
Nas
On 2 Nov 2017, at 9:13 am, Beverley Costa <[log in to unmask]> wrote:What a great list!
We also researched patients' experiences of interpreters in an NHS setting. Let me know if you would like me to send you the paper:
Costa, B. & Briggs, S. (2014) Service-users’ experiences of interpreters in psychological therapy: a pilot study International Journal of Migration, Health and Social Care, 10:4 , 231-244 DOI 10.1108/IJMHSC-12-2013-0044.
Dr Beverley Costa DPsych, UKCP reg.Psychotherapist
Chief Executive Officer and Clinical Director
Mothertongue
22-24 Cross Street
Reading RG1 1SN
0118 957 6393
www.mothertongue.org.uk
From: Health of minority ethnic communities in the UK <[log in to unmask]> on behalf of Tom Allport <[log in to unmask]>
Sent: 02 November 2017 08:44
To: [log in to unmask]
Subject: Re: Hospital interpreter services
I put the search terms 'interpreters face telephone comparison' into google scholar and immediately got some useful papers e.g.
Garcia, E.A.., Roy, L.C., Okada, P.J., Perkins, S.D. and Wiebe, R.A., 2004. A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department. Pediatric emergency care, 20(6), pp.373-378.
Locatis, C., Williamson, D., Gould-Kabler, C., Zone-Smith, L., Detzler, I., Roberson, J.., Maisiak, R. and Ackerman, M., 2010. Comparing in-person, video, and telephonic medical interpretation. Journal of general internal medicine, 25(4), pp.345-350.
I also searched with 'interpreters trust telephone' and got interesting papers e..g.
Hsieh, E., Ju, H. and Kong, H., 2010. Dimensions of trust: The tensions and challenges in provider—interpreter trust. Qualitative Health Research, 20(2), pp.170-181.
Edwards, R., Alexander, C. and Temple, B., 2006. Interpreting trust: Abstract and personal trust for people who need interpreters to access services. Sociological Research Online, 11(1).
This one has a review with some references to relevant papers:
Gray, B., Hilder, J. and Stubbe, M., 2012. How to use interpreters in general practice: the development of a New Zealand toolkit. Journal of Primary Health Care, 4(1), pp.52-61.
Some may not directly address the telephone issue but I think help to present the critical role of trust for
I couldn't get the full text for:
Edwards, R., Temple, B. and Alexander, C., 2005. Users’ experiences of interpreters: the critical role of trust. Interpreting, 7(1), pp.77-95.
but think it might make very interesting reading.
Good luck
Tom
Dr Tom Allport
Consultant Paediatrician and Senior Lecturer
From: Health of minority ethnic communities in the UK <[log in to unmask]> on behalf of Naseer Ahmad <[log in to unmask]>
Sent: 01 November 2017 11:14:38
To: [log in to unmask]
Subject: Hospital interpreter services
Dear all,
May I ask for some views and evidence please.
Our trust is moving from an in person translator/interpreter service to a telephone based one.
My view is that this is retrograde for all the usual reasons and especially bad for central manchester. However, what are the sources that I can quote to argue that this is bad for patients?
Thank you all in advance.
Best wishes
Naseer
Naseer Ahmad BSc MBChB FRCS MD
Consultant Vascular Surgeon
Honorary Senior Lecturer
Manchester Vascular Centre
Manchester University Foundation Trust
Manchester Royal Infirmary
Oxford Road
Manchester
M13 9WL
0161 276 8524 (sec)
0161 276 4737 (direct)
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