Health Care

Interpreting

Anna Kenny, Professional

Development Coordinator

Session Outline
About Health Care Interpreter Service
NSW Health Policy on Interpreter Use
Health Care Interpreter Qualifications
Role of Health Care Interpreter
Health Care Interpreting Assignments

About HCIS
SWAHS HCIS provides language
services to health care providers & clients
in public health facilities & some nongovernment organisations
Services available 24 hours a day seven
days a week
Available in over 120 languages,
including AUSLAN

Services Available
On-site interpreting
Telephone interpreting
Interpreting via videoconference
Translation of health related documents

NSW Health Policy

To use professional health care interpreters

Not relatives, friends or unaccredited bilingual

staff
http://www.health.nsw.gov.au/policies/pd/2006/PD2006_053.html

Why Not Use Relatives, Friends

or Unaccredited Bilingual Staff
Emotional involvement
Uncertainty about community language
quality
Non-professional interpreting
Not bound by Code of Ethics
- Confidentiality

Professional Health Care

Interpreters are
NAATI accredited in languages in which
testing is available
Highly trained
Specialised in medical terminology
Bound by the AUSIT Code of Ethics

Role of Health Care Interpreter

Provide professional & confidential
interpreting services which facilitate
communication
Responsible for clear communication
Close to Interpreter as Manager of Communication Model

Role of Health Care Interpreters

Accuracy
Interpret everything- including
unpleasant remarks & swearwords
Ask for clarification
Explain metaphors, concepts that dont
exist in the target language
Clarify misunderstandings
Maintain register

Role of Health Care Interpreters

Maintain confidentiality (exception: suspected
child abuse)
Maintain impartiality (*small communities)
Sight translations
Provide cultural information relevant to clinical
& social needs of the client
Overcome barriers to communication embedded
in cultural, class, religious & other social
differences

How to Provide Cultural Information

Preferably before or after the interview
If it is necessary to interrupt the session, ask the
patients permission to provide cultural information
All parties must be informed about what is being
said
Do not stereotype
Encourage the health provider to explore the
cultural issue with the patient

Interpreting Within Culture

A Guatemalan Mayan example

When a Guatemalan Mayan woman explains that she is

listening to her ancestors who are giving her advice on how
to solve her problems, the provider suggests that she is
hearing voices. The interpreter must be knowledgeable
about the culture of Guatemalan Mayans to explain to the
provider that she may have to explore this more closely
before concluding that the Guatemalan woman is hearing
voices. In Guatemalan Mayan culture, it is common practice
to ask wise ancestors for advice; it is not necessarily a sign
of psychosis
Buwalda, 2004./ Greg Turner, TMHC, Queensland Health

Role Boundaries
Health providers and patients are responsible for
the ultimate resolution of the encounter
Patients often have unrealistic expectations
regarding the services interpreters provide
Some health professionals are unaware of the
role of the interpreter

Health Care Interpreters Do Not

Assume the role of other health professionals
Give advice or opinion
Advocate on behalf of the patient
Interpret for own relatives or friends
Fill out forms on behalf of a client
Repeat information that a client disclosed in the
waiting area to a service provider upon clients
request

Types of Assignments
Hospital inpatient & outpatient appointments
Community Health & Early Childhood Centres
Paediatric setting
Survivors of torture & trauma
Family conferences
Home visits

Specialist Settings
Mental Health
Neuropsychological Assessment
Speech Pathology

How Do We Operate
Scheduled appointments

Traveling time

Waiting time

The Interpreting Assignment

Introduce yourself
Avoid waiting with the patient if possible
Briefing with heath care provider
Debriefing after the assignment

Interpreting Skills and Techniques

Seating arrangement
Use 1st person
Eye contact
Communication pace management
Simultaneous vs. consecutive interpreting

Interpreting in Mental Health

Interpreters must understand the purposes of
psychiatric interviewing & therapy sessions, &
the role communication plays in them
Psychiatric interviews are often characterised
with distortions to normal communication
patterns, which are vital for diagnosis and
treatment

Interpreting in Mental Health

Interpreting for patients who are confused
Sometimes there is no message
Discourse may be incoherent, fragmented,
jumping from issue to issue
Disconnected discourse is difficult to
remember clearly and reproduce

Mental Health Speech Sample

Patient: Yoga (Pause) Falling everything
falling no stopping (Pause) Being held Yoga
teacher holding me (Pause) In pieces They
wrote to me The Yoga class (Pause) Six
months since hadnt been since Im falling
again I cant stop the falling. (Casement, 1985:
149)

Mental Health- Role of Interpreter

Give exact renditions of vocal effects &
content
Interpret simultaneously if appropriate
Describe communicative features of terms &
aspects of speech that cannot be rendered into
English
Do not make interpretations of what the
patient means

Neuropsychological Assessment
Standardised assessment- compare skills with
general population
Strict instructions for administering and scoring
Assessment to investigate changes in thinking &
memory that identifies strengths & difficulties

Neuropsychological Assessment Role of Interpreter

Awareness of format & purpose of assessment tools
Interpret everything the client says
Avoid giving any helpful clues to the client
Provide information about aspects of clients
speech that cannot be rendered into the target
language

Interpreting in Speech Pathology

Speech therapy deals with deviations from
natural language use: stuttering, slurring,
unorthodox pronunciation patterns and
confusion in syntax
Diagnosis is based upon a range of verbal,
vocal and paralinguistic behaviours that extends
far beyond any normal understanding of a
message to be passed from one party to another
Liaison Interpreting, Gentile, Ozolins, Vasilikakos, (1996, p125)

Interpreting in Speech Pathology

Most interpreting is done to convey what
the person/speaker means- what they are
saying
Speech pathologists need to know how
things are being said- the focus of the task has
shifted
L.Clark & L.Hand, Critical Link Conference, 2007

Speech Pathology- Speech Sample

Non-fluent Aphasia
Oh, is itterrible, terribleis itI cant imagine is it
terribleis it my tongue and is brainis itis it
terrible because is, ah, is it hospital and is no
nothingto you cup of tea and no good and is, er, is
breakfastI dont know what is it breakfastand I
cant is terriblefraidfraid meis terribleis,
erI cant phoneand communicate , eris, er, is,
er, family, is, er, bobblingis it, is itreading is
lots of actionbut for me it bang (snaps fingers) and
is terrible and is family, is erterribleterrible.
From Lenore Scali, Speech Pathologist

Interpreting in Speech Pathology

Awareness of format & purpose of
assessment tools
Render into the target language what can be
rendered (Gentile, 1996, p.126)
Simultaneous interpreting when appropriate
Describe error patterns in speech and
language to the speech pathologist (L.Clark &
L.Hand, 2007)

Additional Information
For more information on SWAHS HCIS,visit us on
Internet:
www.wsahs.nsw.gov.au/services/hcis/index.htm
Phone 9840 3456
Fax 9840 3789
Email: hcis@wsahs.nsw.gov.au