Intended for healthcare professionals

Education And Debate

How To Do It: Work with an interpreter

BMJ 1995; 311 doi: (Published 26 August 1995) Cite this as: BMJ 1995;311:555
  1. Michael Phelan, clinical lecturer in psychiatrya,
  2. Sue Parkman, research worker, Psychiatric Research in Service Measurement (PRiSM)a
  1. aInstitute of Psychiatry, London SE5 8AF
  1. Correspondence to: Dr M Phelan, Charing Cross Hospital, London W6 8RF.
  • Accepted 24 May 1995

The Audit Commission recently highlighted the need for health services to plan language services to help the problems of poor communication facing non-English speaking patients. Doctors and other health workers need to know how to work effectively when interviewing patients with an interpreter. This article describes the different options for helping non-English speaking patients; explains how interviews should be conducted with a trained interpreter, including those using sign language; and outlines the extent of interpreting services currently available in the United Kingdom, complete with a list of addresses of organisations offering interpreting services.

Patients whose first language is not English may face difficulties in being understood and in understanding diagnoses. To help such patients the health service needs to provide language services,1 which are largely of four types.

Bilingual health workers--These workers remove the need for a third party to be involved and are the ideal option for most patients. Bilingual health workers are, however, few and will never be universally available.

Trained interpreters--The use of a professional interpreter is the next best option. These professionals maintain a strict code of confidentiality and are skilled in interpreting the sense and intent of what is said while preserving the content of the interview. Although the provision of trained interpreters for health services appears to be increasing, their availability and use is still patchy, and doctors will often find themselves depending on informal help from friends or relatives of the patient or from untrained volunteers.

Friends or relatives--The perceived advantages of using people known to the patient are that they are readily available, that they may be knowledgeable about the patient's problems, and that their presence may be a reassurance to the patient. However, the risk is that someone close to the patient will not stop their own views of the …

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