Working through interpreters

Saeed Farooq is Assistant Professor and Head of the Department of Psychiatry at the Postgraduate Medical Institute in Peshawar, Pakistan. His team provides general psychiatric care to a large multi-ethnic population in the North-West Province of Pakistan and adjoining Afghanistan. His interests include cross-cultural issues and psychiatric training in developing countries. Chris Fear is a consultant adult psychiatrist in the Gloucestershire Partnership NHS Trust (Wotton Lawn Hospital, Horton Road, Gloucester GL1 3WL, UK). His research interests include obsessive–compulsive disorder, delusions, schizophrenia and psychopharmacology as well as transcultural psychiatry.

Language is the essential psychiatric tool for eliciting both history and mental state. Both diagnosis and treatment are handicapped if there is no common language between doctor and patient and understanding is facilitated through a third party, who usually has no psychiatric training. Many factors can affect this process resulting in a convoluted interview and greater potential for misunderstandings and diagnostic errors. Linguistics and the use of interpreters are rarely mentioned in standard psychiatric texts. The different processes of translation and interpretation and their use in psychiatry are explored here. The variety of errors and pitfalls described in the literature are considered. The authors offer advice on the use of trained and untrained interpreters in order to minimise errors and make the most of the information available.

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