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Communication is vital in psychiatry, but it can be impaired when speakers do not share a language or lack language proficiency. The aim of this study is twofold: firstly, we examine how the interpreter’s presence has an impact on communication between psychiatrist and patient in a psychiatric consult; secondly, we explore the possibility to compare two different types of language mediation (in this case, a professional interpreter and Dutch as a foreign language to the patient) through the triangulation of data and analytic methods. In this respect, two psychiatric consultations were video-recorded. Additionally, a retrospective interview was conducted with the psychiatrist. The discursive data were analysed using conversation analysis focusing on turn design, question-answer sequences, and topic development, combined with quantitative elements (e.g. turn count) and the results from a thematic analysis of the interview transcription. The analysis revealed advantages and disadvantages in working with an interpreter and showed some discrepancies between the psychiatrist’s perceptions or expectations and what we found in the discursive data. We conclude that the combination of research methods provides valuable insights into psychiatric consultations with and without an interpreter

Language barriers in psychiatry can be problematic, since communication is an essential part of psychiatry: it is used during anamnesis, diagnosis and treatment. There are several options to bridge language gaps. Doctors can adjust their language to the language level of the patients, they can try to find a common foreign language (lingua franca), a friend or family member can accompany the patient and act as informal interpreter, or a professional interpreter can be engaged. The above types of language mediation are discussed in this PhD study, but the main focus is on professional interpreters and the use of a lingua franca. This study explores the effect of language mediation on communication in a psychiatric consultation. In this way, two research gaps and shortcomings that were revealed in the literature review are addressed: firstly, how different types of language mediation influence communication and secondly, the effect of a lingua franca. To achieve this aim, an exploratory case study design was chosen. The primary data set contains audio and video recordings of psychiatric consultations. A total of 11 consultations were selected, transcribed and thoroughly analyzed, both qualitatively and quantitatively. The analysis focused on turns and turn duration, question- and answer sequences and thematic development. The analysis showed that the type of language mediation certainly influences communication. In general, both professional interpreters and the use of a lingua franca are good ways of bridging the language gap, but in the lingua franca consultations, the language proficiency of both interlocutors is decisive, while in the interpreter-mediated consultations the many shifts in translation are an obstacle. This PhD thesis provides an overview of the advantages and disadvantages of each type of language mediation. This may allow mental healthcare workers to make a more informed decision and to be more aware of the possibilities and consequences of the language mediation chosen. Some recommendations for psychiatrists who work with interpreters, for interpreter services and for doctor training are also formulated. The main strength of the study is that real-life data was used and a realistic picture is sketched of the problems that occur in language-mediated psychiatric consultations. The main limitation is closely related to the very fact that real-life data is used: every consultation is different, and it is difficult to control the research parameters. This makes a generalization of the results impossible, but some clear trends were revealed, which offer various possibilities for further research.

In Flanders (Belgium) social interpreters and intercultural mediators help bridge the communication gap between foreign language speaking patients and healthcare workers. This paper reports on a comparative survey among social interpreters and intercultural mediators with a focus on how they perceive their role and tasks as interpreters in a healthcare setting. We examine if this is related to different codes of conduct and task descriptions. The survey showed that intercultural mediators feel that they can take on various roles, and have a whole range of responsibilities and duties, much more than social interpreters. In practice, social interpreters find it difficult to stick to their code of conduct. Another survey among healthcare workers working inside a hospital revealed that, in general, their expectations of an interpreter correspond more to the profile of an intercultural mediator than to the profile of a social interpreter.

The present article deals with community interpreting and intercultural mediation in the field of healthcare in the Netherlands and Flanders. First, an institutional background is provided in which legislation and policies in both areas are contrastively described. Secondly, we take a look at terminology. The profession has different labels not only in the Netherlands and Flanders, but also in the rest of the world differences can be found. Finally, we compare theory and practice. That is to say, there are codes of practice for community interpreters, but these are not always sufficient when it comes to dealing with culture differences. Interpreters find it sometimes difficult to draw the line between interpreting and mediating, especially in a healthcare setting.