A man sits on a white couch with his head in his hands. A mental health provider sits facing him holding a clipboard.

Keep These Things in Mind When Interpreting for Mental Health Interactions

A man sits on a white couch with his head in his hands. A mental health provider sits facing him holding a clipboard.
Source: Alex Green from Pexels

Accessing mental health services was already challenging for a large number of the nation’s population before the pandemic, but COVID-19’s uncertainty and social isolation has impacted the mental health of many and highlights the need for more effective access to mental healthcare.

Research reported by Nirmita Panchal and colleagues states that “during the pandemic, about 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder.” However, up to 24% of adults with a mental illness reported an unmet need for treatment in a recent study by Mental Health America in 2021.

Because May is Mental Health Awareness Month, we wanted to acknowledge this growing health crisis, and contemplate the ways in which interpreters can provide high-quality language service for limited English proficient (LEP) patients during mental health interactions.

In the past year, telemedicine has been instrumental for some healthcare facilities looking to keep patients safe from COVID-19. As a result, remote interpreters may see more situations when we are called upon to assist in a call related to mental health. These situations can be delicate in nature and should be handled with extra diligence.

If you receive a call like this, keep these pointers in mind as you navigate the interaction. They will help you maintain a high level of service and give the LEP patient the care they deserve.

Maintain role boundaries

An LEP patient in need of mental health services can be going through a very challenging time. As humans, our first instinct may be to sympathize with the patient, offer kind words, or even reassure them that everything will be OK.


The interpreter code of ethics clearly outlines the role boundary that interpreters should observe during all calls. This means that interpreters are only there to assist with language expertise so that a trained and licensed healthcare professional can communicate with the patient effectively and understand the patient’s needs.

Know when to be an advocate

Although there are clear neutrality boundaries interpreters must observe, the National Council on Interpreting in Health Care (NCIHC) clearly defines instances when it is OK to advocate for a patient.

In a published paper, NCIHC guides interpreters through the decision-making process of advocacy. From this piece, interpreters gain clarity and are able to understand the specific situations when they can advocate for an LEP patient (when a patient is in imminent physical or emotional danger).

This valuable resource can help interpreters provide a better health outcome for a patient involved in a mental health crisis. Another valuable resource by NCIHC is the chart of decision questions. This chart can help determine if a situation warrants advocacy intervention.

Stay faithful to the message

This goes beyond accuracy. Being faithful to the message includes tone matching and matching speech patterns and pauses in the LEP patient’s communication style. Providers rely not only on the information presented, but on the way it’s being presented through the patient’s nonverbal cues. Do not edit the information presented by a patient when you feel it may be repetitive or redundant. Always communicate this information.

Lastly, be prepared to switch to simultaneous interpretation when the patient is upset and unable to pause for the interpreter. This should only be used in extreme situations where controlling the flow of the conversation is not a possibility.

Practice self-assessment

Mental health calls can be emotionally draining for all parties involved. Remember to take care of yourself. Check in with yourself often during your workday — especially after a challenging call involving a mental health situation. If the subject matter is triggering for you, make sure you understand the limits of your abilities to interpret effectively and recognize when you need to take a break.   

The importance of mental health is compounded during the stress-filled times we’ve been collectively experiencing across the globe. Now, more than ever, through ongoing practice and educational opportunities available online, interpreters can better help elevate the voices for those LEP individuals in need. 

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