Considerations for Mental Health Interpreting
Rachel VonDeylen
Houston Community College
SLNG 1321: Intro to Interpreting
Randy Thuesen
May 6th, 2022
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Considerations for Mental Health Interpreting
Considerations for Mental Health Interpreting
I have always had a fascination for mental health. Before I started college, I was
deciding between being an interpreter, doing theater, or becoming a psychologist. Freelance
interpreters get to interpret in so many settings, including theater and psychology. So, if I
become a freelance interpreter, I could do everything I want. That was my thought process
before choosing my major. Over the last year, I have learned so much about interpreting and
about myself. I learned that I love sign language with every bit of me and I want to interpret in
any place I can, and I learned that being an interpreter can be hard. It can bring so much stress
and trauma.
Sign language interpreters in mental health settings face many difficulties in
interpreting the everyday language used in these settings. This is particularly true when clients
have limited English proficiency, requiring interpreters to use expansion techniques to get
messages across successfully. Not only are interpreters vital in the mental health field, but their
task is far more difficult than most people realize, including mental health professionals and their
patients (Vernon, 2012).
One of the hard things about interpreting is vicarious trauma. Vicarious trauma is an
ongoing process of change. It results from witnessing or hearing about others' pain, suffering,
and need (Humphry, 2020). When you identify with people's pain, you bring their grief, fear, and
anger into your life. The symptoms from this can look like symptoms of PTSD (Humphry,
2020). Vicarious trauma is only one of the few things that come with mental health interpreting.
For an interpreter to go into this field of interpreting, they must take in all the considerations, be
understanding and knowledgeable of language dysfluency, and be aware of the difficulties and
stress that come with the job.
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Considerations for Mental Health Interpreting
Language Dysfluency and Mental Health Interpreters
Many deaf people in the mental health setting for which we interpret have language
dysfluency. This means that a person lacks proficiency in any language, in this case, it is usually
American sign language (Crump and Glickman, 2011). Sign language dysfluency has four main
causes: neurological problems, language deprivation, aphasias, and psychotic disorders (Crump
and Glickman, 2011).
It is common for deaf people to have poor skills in spoken language since they are
unable to hear it. The language dysfluency that I am referring to is evident in ASL. More than
half of the deaf patients served in the psychiatric unit were said to have severe language
dysfluency in signing (Crump and Glickman, 2011). Poor language skills are also the first thing
people see in "traditionally underserved" deaf people (Crump and Glickman, 2011).
Dysfluency has two types: specific errors and a general lack of fluency
(HealthBridges, 2022). Specific dysfluency is when a person is understandable but makes some
errors along the way (HealthBridges, 2022). Lack of fluency is when a person is very hard to
understand (HealthBridges, 2022). This one is very hard for interpreters to interpret and can
cause much stress. An interpreter's goal is to convey meaning from English to ASL or ASL to
English. When a client has severe language dysfluency, there may be no meaning in what they
are saying. This makes it difficult for the interpreter because of their goal: to convey meaning. If
the interpreter were to try and make sense and meaning out of what was said, that could change
many things (Crump and Glickman, 2011). For instance, the doctor or psychiatrist may need to
know the jumbled-up words the client is signing to make a diagnosis, but instead, the interpreter
made the jumbled-up words have meaning. An interpreter who is familiar with cultures and is
trained to interpret in mental health settings can recognize issues like this and can head off
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Considerations for Mental Health Interpreting
problems before they occur (Kroulek, 2019). Interpreters can provide information and opinions
related to the communication process and general information on issues of deaf culture. They
cannot provide information on the therapeutic process or the mental and emotional state of the
deaf person (Registry of Interpreters for the Deaf, 1997-1999). Communication between the
patient and clinician is crucial to quality care. Therefore, interpreters increase access to the care
needed in clinical and mental health settings and help patients understand the procedures.
Without access to mental health interpreting services, individuals limited in English or using sign
language may find it impossible to seek health. According to Frontiers in Public Health,
"Interpreting services can help bridge the gap, so people get treatment when they need it"
(Kroulek, 2019).
Mental health interpreting is a specialized profession, it is a type of medical
interpreting. A mental health interpreter should ideally have training in both general interpreting
and mental health settings. Mental health settings would include (but are not limited to),
hospitals, ERs, rehabilitation centers, and psychologists (Hlavac, 2017). Training is an important
attribute for interpreters to have if they want to work in mental health settings. Since 2018, the
National Accreditation Authority of Translators and Interpreters (NAATI) has been awarding
interpreters who are already in the mental health field or who want to be in the mental health
field with a higher credential: “certified interpreters – specialization: health interpreters”
(Hlavac, 2017). This means that the interpreter has taken a course in health interpreting
(including mental health) and they have completed the NAATI specialist test in health (Hlavac,
2017). Besides the NAATI certification, training courses are key to building and extending the
skills of a mental health interpreter (Hlavac, 2017). Knowing sign language well does not make
someone qualified to interpret. Unless the person is certified, you don’t know how accurate their
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Considerations for Mental Health Interpreting
translation will be. Inaccurate or incomplete communication may place the life and health of the
patient in jeopardy (Registry of Interpreters for the Deaf (1997-1999).
When deaf individuals are admitted to a psychiatric hospital, they take a mental
examination to determine if they have a disorder or indications of mental illness. Various
examination techniques are used in the attempt to evaluate and understand how that person
thinks. In these settings, dysfluency patients are no different than hearing patients. This testing
can be very stressful and/or traumatic. An interpreter being in the room with the patient would
help to decrease anxiety and language barriers (Anglemyer and Crespi, 2018). This is also giving
the patient access to quality care.
Analysis
The deaf and hard of hearing population is continually growing. Nearly ten million
people are hard of hearing and nearly one million are fully deaf (Mitchell, 2006). Three out of
every thousand people are prelingually deaf (Mitchell, 2006). This means that they were born
deaf or lost their hearing before learning a verbal language. Prelingually deaf people cannot
experience true auditory hallucinations (Davies, 2019). Instead, they experience visual or
physical hallucinations (AVH) like moving lips or facial expressions that they interpret as an
expression of the voice.
These hallucinations have been linked to the diagnosis of schizophrenia with more than
half of the individuals experiencing AVH (Davies, 2019). This diagnosis was based mostly on
the patient’s ability to verbalize the hallucinations, particularly auditory hallucinations to the
clinician.
Many laws and procedures have been put in place to protect and assist the underserved
and disabled, such as:
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Considerations for Mental Health Interpreting
Title VI of the Civil Rights Act mandates that interpreter services be provided for patients
with limited English proficiency who need this service.
The Americans with Disabilities Act (ADA) states that the mental health care provider is
responsible for providing auxiliary aids and services, including qualified interpreters. The
provider cannot legally charge a patient for interpreting services.
The American Academy of Family Physicians (AAFP) was made to promote and keep
the high-quality standards for family physicians who provide continuous health care to
the public. They also support improving health care access and providing funding for
patients with little English or who are deaf (AAFP, 2022).
Even with all these laws, deaf Americans with psychiatric needs are still very unserved.
Considerations of Mental Health Interpreting
It is hard for anyone to handle so much stress and anxiety. Vicarious trauma as I
mentioned before is the hardest for interpreters to go through. People forget that interpreters have
feelings too. They are not immune. Interpreters in the mental health setting should find a
colleague to talk to, a counselor, or even an online support group. Out of two hundred and
twenty-two people, eighty-three percent said they experienced trauma (Knodel, 2018).
Application
After really digging into mental health interpreting, I want to do it even more. I always
love a challenge, and this seems like a great way to use my gift of interpreting. This field should
not have to be underserved. They need more help than others because they could be in a life-or-
death situation, or they might be hallucinating making them unable to think clearly like most
people. I am fortunate to come from a family that does not have any mental illnesses so I cannot
say that I have experienced any of this before (in that way). Although I volunteered in a home for
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Considerations for Mental Health Interpreting
the disabled and connected with them, I got the chance to help them, and I loved it. For many
years, the deaf community and their advocates have fought for the recognition of American sign
language and communication with people that sign. Mental health workers need to be careful to
not draw conclusions based on someone’s way of communicating.
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Considerations for Mental Health Interpreting
References
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FcLnYbyZ_BxAa8
