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THE RISKS OF USING FAMILY AND FRIENDS

The risk of using un-accredited interpreters such as family and friends include:

  • Inaccuracy of details being discussed.
  • No knowledge of specific mental health terminology.
  • Lack of knowledge on how to interpret correctly.
  • Confidentiality standards may not be met.
  • It can often undermine the authority of relationships especially if younger children are used to interpret for older adults.
  • Children will not have the social skills to deal with issues discussed during a session and can have a negative impact upon the child’s mental state.
  • They may find it hard to remain impartial and will often give their own opinions.
  • There is a risk of information being withheld or even being distorted due to the emotional or sensitive nature of the issues and the effects it may have upon the family. See the example below:

A patient’s daughter spoke good English and was used to interpret for her mother during medical visits. For months all the doctors assumed she did an excellent job interpreting until one day when a physician, who understood some of the language, did a consultation. At the physician’s request an interpreter was called to assist. At this point it was determined that the daughter had not told the patient she had terminal liver cancer. When asked what the daughter thought about both the patient and oncologist not knowing all of the information, she stated, “It has never been a problem, because when I interpreted, I only told my mother what I wanted her to know, and only told the doctor what I wanted him to know.”[1]

[1] University of Minnesota, Working with interpreters, 2009, pg 11.

By using an accredited interpreter you are not only meeting the patient’s needs but also ensuring you have covered your own duty of care obligations. Mental health services must consider the potential legal consequences of adverse outcomes when using un-accredited people to ‘interpret’ if an accredited interpreter is available.[2]

Untrained interpreters often do not have the background in medical terminology or appropriate interpretation practices and therefore cannot adequately communicate questions, diagnosis, symptoms and health concepts between the patient and provider.[3]

If your patient does refuse the use of an accredited interpreter this should be clearly documented on the Patients Progress Notes or in their Medical Records or other relevant documentation.[4] This should then be discussed with clinical management as an assessment of the patients future treatment will need to be made if they refuse to use an accredited interpreter.

You should note that where a patient speaks a rare or exotic language it may not always be possible for this requirement to be fulfilled; therefore making the use of family or friends may be necessary, however in this situation family or friends should only be used to arrange an appointment where an accredited interpreter can be present.

As a general rule, only when there is an immediate risk and where this can be fully justified by yourself as the practitioner should an un-accredited interpreter/family member or friend be used. If telephone interpreting is not accessible, again this should be documented on the Patients Progress Notes that an accredited interpreter was not accessible at the time of the emergency.

 

[2] Queensland Health Interpreter Service, Working with interpreters, Guidelines, Queensland Health Publishing Service, 2007, pg 6.

[3] Aranguri, C. et al, Patterns of communication through interpreters: A detailed sociolinguistic analysis. JGIM, 21, 2006, pgs 623-629.

[4] Queensland Health Interpreter Service, Working with interpreters, Guidelines, Queensland Health Publishing Service, 2007, pg 12.

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