Ad hoc interpreters in South African psychiatric services: service provider perspectives

Background: Language and communication lie at the heart of good quality mental health care and are a vital, yet complex, part of the diagnostic and treatment process. In South African mental health care, ad hoc interpreting arrangements are the status quo. However, these can cause both clinician and patient shame and distress. Objective: Though this issue has been researched from the point of view of informal interpreters, relatively little is known about psychiatrists’ experiences of working with ad hoc interpreters. This study is part of an attempt to bridge that gap. Methods: We made use of a cross-sectional qualitative interview design. We interviewed seven psychiatrists working at a psychiatric hospital in the Western Cape of South Africa. Data were analysed manually using thematic analysis. Results:Five main themes can be identified from the data: miscommunication and other difficulties associated with the language barrier; the language barrier between clinicians and patients and a need for language services; participants’ views on interpreting; the role of age, culture and gender; and the use of trained and untrained interpreters and using staff as interpreters. Conclusions: Psychiatrists experience numerous difficulties in conducting their work due to the language barrier. This has an impact on their ability to provide adequate mental health care to patients. There is a need for better language services to ensure that everyone that seeks mental health care can receive the same level of care. Currently, one’s ability to speak a certain language will have a significant impact on the quality of care received.