Documenting language barriers in a general hospital psychiatry setting

Previous research has demonstrated that without the use of professional interpreters, language barriers interfere with patient care. The literature recommends documenting the presence of language barriers in medical charts. To our knowledge, this mixed methods study is the first to examine language documentation practices in a Canadian inpatient psychiatry setting. The research team interviewed 122 patients admitted to a tertiary care psychiatry ward in Montreal, Canada between 2016−2017 to assess their ability to communicate in the healthcare establishment's languages (English/French). Nineteen participants identified as having a language barrier were selected for a qualitative analysis of the retrospective audit of their medical charts. The presence of a language barrier was reflected in 68% of these charts. When a language barrier was documented, professional interpreters were never used. Our qualitative analysis, informed by literature on medical discourse, aimed to provide clinical, administrative, and organizational recommendations to optimize the utilization of interpreting services in psychiatric wards. Documentation of language data was inconsistently collected, often vague, and shed light on the clinical challenges involved in differentiating language barriers from psychopathology. Normalization of limited care for language diverse patients was reflected in the clinical notes. Findings show that a change of organizational culture is imperative to provide optimal care to language diverse patients. We recommend clinician education and standardization of documentation practices, along with institutional policies supporting the systematic use of professional interpreters in mental healthcare settings, to maximize human rights and patient safety, and to bring medical practices to an acceptable standard of care

Audit · Documentation · Health care · Interpreter · Language barrier · Limited English proficiency · Medical education · Political science · Qualitative research · Sociology · Standardization · Emergency and Acute Care Studies · Interpreting and Communication in Healthcare · Medicine · Migration, Health and Trauma · Nursing · Psychology

• Respecting Diversity, Equity, and Inclusion

  Open Access•L J Kirmayer, Dörte Bemme et al.•Transcultural Psychiatry•2026

  Incluir item

• Race, Ethnicity, and Language Data

  Cheryl Ulmer•Race, ethnicity, and language data•2009

  Incluir item

• Errors in Medical Interpretation and Their Potential Clinical Consequences in Pediatric Encounters

  Glenn Flores, M Barton Laws et al.•PEDIATRICS•2003

  Incluir item

• Errors of Medical Interpretation and Their Potential Clinical Consequences

  Open Access•Glenn Flores, Milagros Abreu et al.•Annals of Emergency Medicine•2012

  Incluir item

• Discourse and social change

  Norman Fairclough•Discourse and social change•1993

  Incluir item

• Speech Genres and Other Late Essays

  M M Bakhtin, Vern W Mcgee et al.•Speech Genres and Other Late Essays•2010

  Incluir item

• Challenges in Language Services

  Open Access•Marsha Regenstein, Holly Mead et al.•Journal of Immigrant and Minority…•2008

  Incluir item

• Assessing the Need for a Medical Interpreter

  Open Access•Karen Okrainec, Mark A Miller et al.•Journal of Immigrant and Minority…•2013

  Incluir item

• Facilitators and barriers of sociodemographic data collection in Canadian health care settings

  Open Access•Hazel Williams-Roberts, Cory Neudorf et al.•International Journal for Equity…•2018

  Incluir item

• Introduction

  Monika Class•Literature and medicine•2014

  Incluir item

• Health care and health knowledge

  Open Access•Sydney H Croog•Social Science & Medicine Part D…•1979

  Incluir item

• English Proficiency and Language Preference

  Open Access•Gilbert Gee, Gilbert C Gee et al.•American Journal of Public Health•2010

  Incluir item

• The role of interpreters in mental health care

  Open Access•Emily J Elkington, Kirsten M Talbot•South African Journal of Psychology•2016

  Incluir item

• Using thematic analysis in psychology

  Open Access•Braun, Virginia Braun et al.•Qualitative Research in Psychology•2006

  Incluir item

• Narrative strategies in medical discourse

  Open Access•Elizabeth M Coker•Social Science & Medicine•2003

  Incluir item

• Qualitative Data Analysis for Health Services Research

  Open Access•Elizabeth H Bradley, Leslie A Curry et al.•Health Services Research•2007

  Incluir item

• The role of progress notes in the professional socialization of medical residents

  Open Access•Pamela Hobbs•Journal of Pragmatics•2004

  Incluir item

• Medical Discourse

  James M Wilce•Annual Review of Anthropology•2009

  Incluir item