दुभाषिया की मध्यस्थता मानसिक स्वास्थ्य अधिनियम आकलन (INForMHAA)

परियोजना प्रगति अद्यतन संख्या।2 – Jemina Napier

यह वी/ब्लॉगपोस्ट बीएसएल, अंग्रेजी, स्पेनिश, फ्रेंच और हिंदी में उपलब्ध है

BSL: https://youtu.be/Q4bjGhdApfw

यह वी/ब्लॉगपोस्ट,  INforMHAA प्रोजेक्ट टीम की ओर से इस परियोजना पर अब तक की गई शोध का विवरण है।

पहले वी/ब्लॉगपोस्ट ने परियोजना के लक्ष्यों और प्रमुख कारणों की जानकारी प्रदान की है।  इसमें हमारे सलाहकार समूह, रोगी और सार्वजनिक (पीपीआईई) समूह की भागीदारी के बारे में भी जानकारी दी गई थी।

इस शोध परियोजना के लिए मुख्य प्रश्न यह है कि : मानसिक स्वास्थ्य अधिनियम के अनुसार किए गए आकलन (assessment) पर दुभाषिए की मध्यस्थता का क्या प्रभाव पड़ता है और ऐसे मध्यस्थता वाले आकलनों को कैसे सुधारा जा सकता है?

निम्नलिखित उप-प्रश्नों के साथ:

  1. मानसिक स्वास्थ्य अधिनियम (एमएचए) के आकलन में दुभाषिया (सांकेतिक भाषा / बोली जाने वाली भाषा ) की भागीदारी, किस हद तक अनुमोदित मानसिक स्वास्थ्य पेशेवर (एएमएचपी AMHP) के अभ्यास को बाधित या सक्षम करती है?
  2. AMHP अभ्यास के भीतर दुभाषियों के बजाय भाषा संगत (language concordant) सेवाओं (जैसे भाषा/सांस्कृतिक अधिवक्ता) का उपयोग करना कब अधिक उपयुक्त हो सकता है और कैसे?
  3. AMHPs और पेशेवर दुभाषियों के लिए एक प्रभावी प्रशिक्षण मॉडल क्या है?

परियोजना की शुरुआत में हमें क्या पता था?

  • असमानताओं के आंकड़ों में, जातीयता और सांस्कृतिक विरासत के कारण परिवर्तन कैसे किए जाते हैं, इसका वर्णन किया गया है। हालांकि इसमें विभिन्न भाषा उपयोग के बारे में कोई जानकारी शामिल नहीं है।
  • सी क्यू सी (CQC) और एन एच एस (NHS) डिजिटल डेटा में, असेसमेंट किए गए लोगों के भाषा और दुभाषिया कि जानकारी प्रकाशित नहीं करते हैं ।
  • एम एच ए (MHA) सुधार दस्तावेज, भाषा की मध्यस्थता वाले एम एच ए(MHA) आकलन पर जरूरी ध्यान नहीं देते हैं।
  • अभ्यास संहिता के अनुसार, ‘साक्षात्कार उचित तरीके से’ आयोजित किया जाना चाहिए, जिसमें दुभाषियों और सांस्कृतिक अधिवक्ताओं का उचित उल्लेख होना चाहिए।
  • इंग्लैंड और वेल्स भाषाई रूप से अत्यधिक विविध देश हैं ।
  • दुभाषिया मध्यस्थता वाले एम एच ए (MHA) आकलन या उनके अंतरराष्ट्रीय समकक्षों के बारे में साक्ष्यो की कोई पिछली व्यापक समीक्षा नहीं है ।
  • ए एम एच पी(AMHP), दुभाषियों या धारा 12 डॉक्टरों के लिए कोई अच्छा अभ्यास मार्गदर्शन दस्तावेज प्रकाशित नहीं है ।
  • सेवा उपयोगकर्ताओं और देखभाल करने वालों पर दुभाषिया की मध्यस्थता वाले एम एच ए असेसमेंट का प्रभाव के बारे में कोई जानकारी नहीं हैं।
  • एम एच ए (MHA) की एन एच एस (NHS) डिजिटल वार्षिक रिपोर्टिंग अपने न्यूनतम डेटा सेट में दुभाषिया के उपयोग या असेसमेंट की भाषा के बारे में जानकारी प्रदान नहीं करती है। यह  सीक्यूसी प्रकाशन मानकों में भी उपलब्ध नहीं है।

यह दूसरा v/blogpost अब तक किए गए विश्लेषण की समीक्षा है कि हमें और क्या जानने की जरूरत है और दुभाषिया की मध्यस्थता वाले एम एच ए (MHA)  आकलन में सर्वोत्तम कार्यप्रणाली कैसे सुनिश्चित किया जाए।

आज तक हमने जो किया है:

  • मानसिक स्वास्थ्य अधिनियम के आकलन में प्रासंगिक और धूसर(Grey) साहित्य सकी, कोविडेन्स सहायत स्कोपिंग रिव्यु  का प्रोटोकॉल प्रकटन किया है। कुल मिलाकर 40 अध्ययन मिले जो पूर्ण समीक्षा का आधार बनेगा। इनमें से कोई भी हमारे अध्ययन के प्रश्नों से संबंधित नहीं है।
  • एम एच ए (MHA) आकलन पर काम करने के उनके अनुभवों के बारे में 132 एएमएचपी (AMHP) और 24 दुभाषियों के साथ सर्वे किया गया। दुभाषिए के उत्तरदाताओं में से अधिकांश बीएसएल (BSL) दुभाषिए थे, इसलिए हम दुभाषियों का सर्वे को फिर से खोलने की योजना बना रहे हैं ताकि बोली जाने वाली भाषा के दुभाषियों से अधिक प्रतिक्रियाएं प्राप्त करने का प्रयास किया जा सके।
  • 17 एएमएचपी (AMHP) और 6 दुभाषि (+4 लंबित), जिन्होंने सर्वे का जवाब दिया और इंटरव्यू के लिए सहमत थे, उनके के साथ अनुवर्ती इंटरव्यू आयोजित किया है। ताकि हम उनके अनुभवों के बारे में, उनके निर्णय लेने में सहायता करने वाले महत्वपूर्ण विचारों के बारे में, AMHP और दुभाषिया के बीच सहकारी पेशेवर अभ्यास के बारे में गहराई से जांच करे।

अब हम क्या जानते हैं?

  • उपलब्ध साहित्य में से किसी ने भी विशेष रूप से व्याख्या करने के बारे में और एमएचए (MHA) आकलन के ‘पल’ के दौरान  मानसिक स्वास्थ्य असेसमेंट को संबोधित नहीं किया है; और ना ही  ए एम एच पी (AMHP) और दुभाषियों की आवश्यकताओं को संबोधित किया है।
  • दुभाषिया की मध्यस्थता वाले एम एच ए आकलन हालांकि दुर्लभ हैं, लेकिन नियमित हैं। सर्वे में भाग लेने वाले 132 AMHP में से अधिकांश ने औसतन एक वर्ष में 5 दुभाषिया-मध्यस्थ असेसमेंट किए हैं ।
  • ए एम एच पी (AMHP) रिपोर्ट फॉर्म यह स्पष्ट नहीं करते हैं कि क्या वे आकलन की भाषा के बारे में प्रश्न पूछते हैं और यदि हां तो किस रूप में प्रश्न पूछा जाता है।
  • जब AMHP से पूछा गया कि क्या उन्होंने दुभाषिए के साथ अपना काम दर्ज किया है, तो 115 AMHP में से 100 ने ‘कभी-कभी’ कहा। और केवल 50% से अधिक ने कहा कि उन्होंने दुभाषिया के भाषा संयोजन को दर्ज किया है।
  • यदि कोई ‘समस्या’ प्रतीत होती है, तो इसे AMHP द्वारा लगातार नोट किया जाता है ।
  • 121 AMHP में से केवल 9 ही अपने योग्यता पाठ्यक्रम के दौरान दुभाषिया के साथ काम करने के किसी भी प्रशिक्षण के बारे में बताया हैं।
  • दुभाषियों के साथ काम करने के प्रशिक्षण में  केवल 28% AMHP ने अपने अप्रूवल के बाद भाग लिया था।
  • लगभग 60% ने कहा कि उनके प्रशिक्षण ने उन्हें दुभाषियों के साथ काम करने के लिए पर्याप्त रूप से तैयार नहीं किया, चाहे वह AMHP के रूप में हो या किसी अन्य भूमिका/व्यवस्था में।
  • मूल्यांकन (assessment) किए गए व्यक्ति द्वारा उपयोग की जाने वाली भाषा को समझने मे कठिनाइयों के कारण, दुभाषियों को अपने नियमित दुभाषिया अभ्यास में विशेष सुधार करने की आवश्यकता हो सकती है, उदाहरण के लिए, ‘जब भाषा पूरी तरह से समझ में नहीं आती’ तो भाषा सुधारने के बजाय एक मेटा-वर्णनात्मक (meta-descriptive) दृष्टिकोण अपनाना उपयुक्त होगा। इसके लिए AMHP की ओर से दुभाषियों पर एक मजबूत विश्वास की आवश्यकता है।
  • दुभाषियों को सहयोग और मार्गदर्शन की आवश्यकता होती है ताकि इन संवेदनशील स्वभाव वाले अनुभवों से उनकी व्यक्तिगत सेहत और पेशेवर प्रदर्शन पर नकारात्मक असर न हो।
  • दुभाषियों को न केवल भाषाई पहलू, बल्कि एम एच ए आकलन के क़ानूनी पहलू के बारे में भी व्यापक समझ होनी चाहिए, जो पार्टियों के बीच अच्छी गुणवत्ता संचार और सफलता सुनिश्चित करने में सहायक होंगे। कुछ अवधारणाओं, जैसे ‘सेक्शन 12’ ‘निकटतम रिश्तेदार’ ‘आपत्ति’ में एक मजबूत कानूनी घटक होता है, जो सामान्य भाषाई अर्थ से भिन्न होता है, जो विशेषज्ञ प्रशिक्षण के महत्व पर प्रकाश डालता है।
  • इस संदर्भ में ‘अंतर-पेशेवर गतिशीलता’ पर विचार करने की ज़रूरत हैं।

हमारे अनुसंधान द्वारा अब तक उजागर किए गए कुछ प्रमुख मुद्दे:

  • AMHP और दुभाषिए संभवतः MHA असेसमेंट के दौरान पहली बार मिले होंगे।
  • AMHP के पास सेवा उपयोगकर्ता की भाषा और असेसमेंट के बारे में बहुत कम या आमतौर पर कोई जानकारी नहीं होती है। यह मूल्यांकन किए जा रहे व्यक्ति की मानसिक स्थिति और समझने के स्तर के बारे में समग्र रूप से जानकारी लेने की उनकी (AMHP) क्षमता को प्रभावित करता है।
  • एएमएचपी (AMHP) को आमतौर पर यह पता नहीं होता है कि उनके साथ काम करने वाले दुभाषियो को एमएचए आकलन में कोई पूर्व अनुभव है या नहीं। और दुभाषिया की बुकिंग करते समय इसे एक आवश्यकता के रूप में निर्देशित करना एएमचपी के लिए कठिन है।
  • अधिकांश दुभाषियों ने कभी भी एम एच ए आकलन में भाग नहीं लिया है। कुछ लोगो को सामाजिक कार्यकर्ताओं की दमनकारी स्वभाव और एम एच ए के बारे में पहले से मौजूद चिंताएं हैं जो मूल्यांकन (assessment) में उनकी भूमिका में दखल दे सकती हैं।
  • इस बात की बहुत कम संभावना है कि दुभाषियों और एएमएचपी ने कभी भी एक साथ या विशेष रूप से एमएचए अस्सेस्मेंट में अंतर-पेशेवर काम करने के प्रशिक्षण में भाग लिया हो।
  • AMHP और दुभाषिए  को कानूनी प्रक्रियाओं के अनुरूप सर्वोत्तम अभ्यास करने के लिए एक दूसरे पर निर्भर होना पड़ता है

हमने और क्या किया है?

  • हमने एक दुभाषिए परियोजना वेबसाइट विकसित की है, जो कि बीएसएल और अंग्रेजी में है, और जो टीम के किए गए कार्यों का विवरण सहित परियोजना और उसके सभी पहलुओं का विस्तृत जानकारी देता है।
  • हमने अपने सलाहकार समूह के साथ त्रैमासिक बैठकें की हैं, जो सभी चरणों में अनुसंधान डिजाइन और डेटा संग्रह में लगे हुए हैं और सर्वे उपकरणों, सिमुलेशन परिदृश्यों और प्रतिभागियों की भर्ती में महत्वपूर्ण रहे हैं।  हमें यह बताते हुए बहुत दुख हो रहा है कि हमारे सलाहकार समूह के सदस्यों में से एक, मार्टिन स्टीवंस, जो एनआईएचआर नीति अनुसंधान इकाई के एक वरिष्ठ शोध साथी थे, उनका अप्रत्याशित रूप से निधन हो गया। हम उनके परिवार और सहकर्मियों के प्रति अपनी संवेदना व्यक्त करना चाहते हैं, और उनकी भागीदारी के दौरान INforMHAA परियोजना में उनके बहुमूल्य योगदान की सराहना करते हैं।
  • हमारे पीपीआई समूह ने अपना प्रशिक्षण शुरू कर दिया है, जो बीएसएल और अंग्रेजी में दुभाषि स्व-शिक्षण ऑनलाइन मॉड्यूल के माध्यम से उपलब्ध है। अब तक, उन्होंने छह नियोजित सत्रों में से तीन पूरे कर लिए हैं: सत्र 1 में INForMHAA टीम, समूह कार्य, विविधता और समावेश को समझना; और सत्र 2 कवर किया गया PPIE क्या है? – PPIE को समझना, अनुसंधान में यह कैसे काम करता है, इससे परिचित होना, NIHR PPIE मानकों से अवगत होना और यह जानना कि आप PPIE में कैसे शामिल हो सकते हैं। और सत्र 3 में ‘अनुसंधान क्या है?’ – हम शोध क्यों करते हैं, गुणात्मक, मात्रात्मक और मिश्रित-विधि दृष्टिकोण और डेटा संग्रह विधियों से अवगत होना । सत्र 4 में ‘नैतिकता और सहमति’ शामिल होगी।
  • हमने दुभाषिया-मध्यस्थता वाले एमएचए(MHA) मूल्यांकन परिदृश्यों का सिमुलेटेड फिल्मांकन पूरा कर लिया है। हमने एएमएचपी और दुभाषियों से मिली जानकारी के आधार पर चार परिदृश्य बनाए है. यह जानकारी एमएचए आकलन में पहचाने गए विशिष्ट मुद्दों के सर्वे और साक्षात्कार के माध्यम से और सलाहकार समूह के परामर्श के माध्यम से एकत्र की गई थी। परिदृश्यों में चार अलग-अलग भाषा संयोजन शामिल हैं: ये भाषाएं कुर्द, डच, ब्रिटिश सांकेतिक भाषा और हिंदी है। हमने मार्च 2022 में मैनचेस्टर विश्वविद्यालय के TIPP नाटक समूह के समर्थन से फिल्मांकन पूरा किया।
  • हमने कई प्रस्तुतियां भी दी हैं और कुछ प्रकाशन भी तैयार किए हैं।

हम आगे क्या कर रहे हैं?

  • सिमुलेशन/अनुकृति परिदृश्य वीडियो अब परियोजना के अगले चरण के लिए संपादित किए जा रहे हैं। इसमें शामिल होगा: (i)GoReact एनोटेशन सॉफ्टवेयर का उपयोग करके बातचीत में महत्वपूर्ण अंकों का विश्लेषण और (ii) सिमुलेशन अवलोकन में हम दुभाषियों और AMHP को ज़ूम वेबिनार के बहुभाषी इंटरप्रेटिंग फ़ंक्शन का उपयोग करने और इन सिमुलेशन को ऑनलाइन देखने के लिए कहेंगे। उसके आलावा मेंटीमीटर ऑडियंस सर्वे के द्वारा इस बात पर चर्चा करने के लिए कहेंगे की वे सर्वोत्तम अभ्यास के रूप में क्या देखते हैं, खास मुद्दे क्या है और चीजों को कैसे सुधारा जा सकता ।
  • हम सर्वे और साक्षात्कार डेटा के आधार पर प्रकाशनों पर काम कर रहे हैं, और इस परियोजना में हमारे द्वारा उपयोग की  जाने वाली नवीन पद्धतियों पर एक लेख लिखने की भी योजना है।
  • सभी डेटा विभिन्न नियोजित परिणामों (outcomes) में फीड होंगे, जिसमें नए प्रशिक्षण संसाधनों का सह-उत्पादन, पेशेवर अभ्यास दिशानिर्देश, एएमएचपी और दुभाषियों के लिए जानकारी, और दुभाषिया-मध्यस्थता वाले एमएचए आकलन आयोजित करने के लिए प्रस्तावित नए परिवर्तन के सिद्धांत प्रतिमान (Theory of change model) शामिल हैं।

Projet INforMHAA: évaluations de la santé mentale menées en vertu de la loi sur la santé mentale par l’intermédiaire d’interprètes

Rapport d’activités – Jemina Napier

Ce v/blogpost est en disponible en BSL, anglais, espagnol, français et hindi

BSL: https://youtu.be/Q4bjGhdApfw

Dans cet article, l’équipe INforMHAA vous fournit une mise à jour des progrès accomplis jusqu’à présent.

Notre premier post a présenté une vue d’ensemble du projet : les objectifs, les phases principales du cycle de vie du projet, et l’intervention du comité consultatif et du groupe de participation des patient·es et du public.

La principale question de recherche du projet est :

Quel est l’impact de l’interprétariat sur les évaluations aux termes de la Loi de 1983 (Angleterre/Pays de Galles) sur la santé mentale, et comment ces évaluations peuvent-elles être améliorées ?

Questions complémentaires :

Dans quelle mesure et comment la participation d’un·e interprète de langue des signes / de langue parlée dans les évaluations MHA (c’est à dire les évaluations aux termes de la Loi de 1983 (Angleterre/Pays de Galles) sur la santé mentale) limite ou facilite-t-elle les bonnes pratiques des professionnel·les agréés de la santé mentale (Approved Mental Health Professionals ou AMHP) ?

Dans quelles situations, lors d’une évaluation MHA, serait-il plus approprié d’employer des services adéquates du point de vue linguistique (par exemple les professionnel·les qui parlent plus d’une langue ou un·e conseiller·ère culturel) au lieu d’un·e interprète et comment ?

Qu’est-ce qui fait l’efficacité d’un modèle de formation pour les AMHP et les interprètes ?

Que savions-nous au début du projet ?

  • Il n’est fait aucune mention des services linguistiques pouvant être nécessaire à ces évaluations, bien qu’il existe une inégalité entre groupes ethniques et de patrimoine culturel différent en matière de résultats.
  • La Commission relative à la qualité des soins (Care Quality Commission (CQC) en anglais) et NHS Digital ne publient pas d’informations sur la langue de ceux et celles qui font l’objet d’une évaluation, ni sur le recours à un·e interprète lors des évaluations.
  • L’absence de référence à l’interprétariat dans les évaluations MHA dans le cadre des documents portant sur la réforme de la loi sur la santé mentale.
  • Le code de bonnes pratiques qui s’adresse aux AMHP prévoit que les évaluations soient effectuées “de manière appropriée” et fait mention des interprètes et conseiller·ères culturels.
  • L’Angleterre et le Pays de Galles sont des pays à la diversité linguistique élevée.
  • Il n’existe pas d’évaluation globale des preuves relatives aux évaluations MHA médiatisées par les interprètes ni de leurs équivalents internationaux.
  • Il n’existe pas de guide de bonnes pratiques publié pour les AMHP, les interprètes ou les médecins “Section 12” (il s’agit des médecins spécialisés qui ont la capacité de formuler des recommandations quant aux hospitalisations sous contrainte et en conformité avec la Loi de 1983 (Angleterre/Pays de Galles) sur la santé mentale).
  • On ignore l’impact sur les utilisateurs et utilisatrices des services et sur leurs soignant·es d’une évaluation (aux termes de la Loi de 1983 (Angleterre/Pays de Galles) sur la santé mentale) médiatisée par un·e interprète.
  • La langue de l’évaluation et le recours à un·e interprète ne figurent pas dans l’ensemble minimal de données du rapport annuel (rédigé par NHS digital) sur les évaluations MHA, ni dans les normes publiées par la CQC. 

Ce deuxième post fournit une mise à jour sur ce que nous avons accompli jusqu’à présent afin d’explorer les connaissances supplémentaires dont nous pourrions avoir besoin et les moyens possibles pour garantir l’utilisation des bonnes pratiques dans les évaluations MHA médiatisées par un·e interprète.

Jusqu’à présent :

  • Nous avons publié le protocole à suivre pour une évaluation assistée par Covidence de la portée des travaux empiriques pertinents et de la littérature grise sur l’interprétariat dans les évaluations MHA. Nous avons identifié 40 études qui formeront la base de l’évaluation complète. Aucune d’entre elles n’est en rapport direct avec les questions de notre étude.
  • Nous avons mené des enquêtes auprès de 132 AHMP et 24 interprètes sur leurs expériences de travail dans les évaluations MHA. La majorité des interprètes qui ont répondu étaient des interprètes de langue des signes britannique, nous prévoyons donc d’ouvrir à nouveau l’enquête aux interprètes pour essayer d’obtenir plus de réponses des interprètes de langue parlée.
  • Nous avons réalisé des entretiens de suivi avec 17 AMHP et 6 interprètes (+ 4 en attente) qui ont répondu à l’enquête et qui ont accepté d’être interviewés afin que nous puissions approfondir notre étude de leurs expériences et trouver des exemples de points critiques de prise de décision et de pratique professionnelle coopérative pour les AMHP et les interprètes.

Que savons-nous maintenant?

  • Aucune littérature n’aborde spécifiquement l’interprétariat et l’évaluation de santé mentale par rapport au “moment même” de l’évaluation MHA, ni les exigences des AMHP ou des interprètes pour répondre à ces situations. 
  • Les évaluations MHA médiatisées par un·e interprète, bien que peu fréquentes, sont une constante. Sur les 132 AMHPs de l’enquête, la plupart effectuent en moyenne 5 évaluations médiatisées par un·e interprète par an.
  • Il existe un manque de cohérence dans les formulaires de rapport de l’AMHP concernant l’inclusion d’une question sur la langue utilisée lors des évaluations et le format de cette question.
  • Interrogé·es sur le fait de savoir s’ils ou elles enregistrent le recours à un·e interprète, 100 sur 115 AMHPs ont répondu “parfois” et un peu plus de 50% disent enregistrer la combinaison linguistique de l’interprète.
  • S’il semblait y avoir un “problème”, les AMHP le notaient systématiquement.
  • Seulement 9 sur 121 des AMHP peuvent se rappeler d’une formation au travail avec un·e interprète dans le cadre de leur formation initiale.
  • Depuis l’obtention de leur diplôme d’AMHP, seulement 28% ont participé à une formation au travail avec un·e interprète.
  • Près de 60% ont déclaré que leur formation ne les avait pas préparé·es de manière adéquate à travailler avec des interprètes, que ce soit en tant qu’AMHP ou dans tout autre rôle/contexte.
  • En raison des difficultés occasionnelles de production linguistique de la personne évaluée, les interprètes doivent parfois faire certains ajustements à leur pratique habituelle, par exemple, en adoptant une approche méta-descriptive de leurs interprétations « lorsque le langage n’a pas de sens » au lieu de mettre de l’ordre dans le langage. Ceci nécessite une confiance absolue de la part de l’AMHP envers l’interprète.
  • Les interprètes ont besoin de soutien et d’une supervision afin que le caractère délicat de ces rencontres n’ait pas d’impact négatif sur leur bien-être personnel et les performances professionnelles qui s’en suivent.
  • La compréhension au sens plus large par les interprètes de l’aspect législatif des évaluations MHA, et non pas seulement de ses aspects linguistiques, est un facteur de réussite évident pour assurer une communication de bonne qualité entre les interlocuteurs. Les concepts comme “Section 12” (la qualification autorisant légalement un médecin à admettre un ou une patient·e sans son consentement), “nearest relative” (personne chargée de la protection d’une personne majeur) ou “objection” (objection à ce qu’une personne soit admise ou placée sous tutelle) ont une forte composante juridique qui diffère de la signification linguistique générale, ce qui souligne l’importance de la formation spécialisée.
  • L’importance de prendre en compte “la dynamique interprofessionnelle” dans ce contexte.

Quelques questions clés mise en évidence par notre investigation jusqu’à présent :

  • Les AMHP et les interprètes ne se sont probablement pas déjà rencontré·es au moment de commencer une évaluation MHA.
  • Les AMHP n’ont que peu ou pas d’accès à la langue de l’utilisateur·trice du service et de l’évaluation, ce qui affecte leur capacité à recueillir les informations holistiques sur l’état mental et le niveau de compréhension de la personne évaluée.
  • Les AMHP n’ont généralement aucune idée de l’expérience de l’interprète en matière d’évaluations MHA et il est difficile d’en faire une exigence lors de la réservation des services d l’interprète.
  • La plupart des interprètes n’ont jamais pris part à une évaluation MHA. Certain·es ont des préjugés concernant la nature oppressive des travailleurs sociaux et des évaluations MHA qui peuvent affecter leur performance au cours de l’évaluation.
  • Il est fortement improbable que les interprètes et AMHP aient déjà jamais participé à une formation les amenant à travailler ensemble dans un contexte professionnel ou plus particulièrement dans le cadre d’une évaluation MHA.
  • Les AMHP et les interprètes dépendent les un·es des autres pour garantir la mise en œuvre des bonnes pratiques et le respect des pratiques juridiques.

Qu’avons-nous fait d’autre?

  • Nous avons tenu des réunions trimestrielles avec notre groupe consultatif, qui a participé à la conception de la recherche et à la collecte des données à toutes les étapes, et qui a joué un rôle essentiel dans la conception des instruments d’enquête, des scénarios de simulation, et du recrutement des participant·es. Nous avons le regret d’annoncer le décès inattendu de l’un des membres de notre groupe consultatif, Martin Stevens, qui a été chargé de recherche principal pour l’unité de recherche sur les politiques de NIHR (l’Institut national pour la recherche médicale). Nous tenons à présenter nos condoléances à sa famille et à ses collègues, et à reconnaître sa précieuse contribution durant sa participation au projet INforMHAA.
  • Notre groupe PPIE a commencé sa formation, qui est disponible via des modules bilingues (en langue des signes britannique et en anglais) d’autoapprentissage en ligne. Jusqu’à présent il a complété trois des six séances prévues : la session 1 portait sur l’équipe d’INforMHAA, la compréhension du travail du groupe, la diversité et l’inclusion ; la session 2 portait sur “qu’est-ce que le PPIE ?”, comprendre le PPIE, se familiariser avec son fonctionnement dans la recherche, connaître les normes PPIE et savoir comment s’impliquer dans le PPIE NIHR. La session 3 portait sur “qu’est-ce que la recherche ?”, pourquoi faisons-nous de la recherche, les approches qualitatives, quantitatives et mixtes, et les méthodes de collecte de données. La session 4 portera sur l’éthique et le consentement.
  • Nous avons terminé le tournage des scénarios simulés d’évaluation MHA médiatisés par un·e interprète. Nous avons créé quatre scénarios basés d’une part sur les rapports des AMHP et des interprètes, obtenus au cours d’enquêtes et d’entretiens, sur les problèmes typiques qu’ils ont rencontrés lors des évaluations MHA, et d’autre part sur les échanges avec le groupe consultatif. Les scénarios présentaient quatre combinaisons linguistiques différentes : kurde, néerlandais, hindi et langue des signes britannique. Nous avons terminé le tournage en Mars 2022 avec le soutien du groupe de théâtre TIPP de l’Université de Manchester.

Quelles sont les étapes suivantes ?

  • Nous sommes en train d’éditer les vidéos pour la prochaine phase du projet pendant laquelle nous allons (1) analyser les points critiques dans les interactions par le biais du logiciel d’annotation GoReact et (2) mettre en place des sessions d’observation des scénarios simulés pour les AMHP et les interprètes – où on leur demandera d’observer les scénarios simulés en ligne en utilisant la fonction multilingue d’interprétation en webinaire Zoom ainsi que la fonction sondage dans le logiciel Mentimeter pour discuter de ce qu’ils et elles identifient comme étant les bonnes pratiques et les enjeux, et comment améliorer l’évaluation MHA médiatisée par un·e interprète.
  • Nous travaillons à la rédaction d’articles portant sur l’analyse des données de l’enquête et des entretiens. Nous avons aussi l’intention de rédiger un article sur les méthodologies innovatrices que nous avons utilisées dans ce projet.
  • Toutes les données serviront de base aux divers résultats du projet, qui incluent la co-production de nouvelles ressources de formation et de lignes directrices aux bonnes pratiques, des informations pour les AMHP et les interprètes, et un nouveau modèle de la théorie de changement pour les évaluations MHA médiatisées par un·e interprète.

Proyecto INForMHAA: evaluaciones de salud mental llevadas a cabo de conformidad con la Ley de Salud Mental mediadas por intérpretes

Informe de actividad – Jemina Napier

Esta v/blogpost está disponible en BSL, inglés, español, francés e hindi

BSL: https://youtu.be/Q4bjGhdApfw

En esta entrada del (video-)blog, las integrantes del grupo de investigación INForMHAA compartimos algunos de los últimos avances de nuestro trabajo.

En la primera entrada del (video-)blog del proyecto INForMHAA, ofrecimos una descripción general del proyecto y de sus objetivos, así como de las etapas en las que consistiría e información sobre cuál sería la contribución del comité asesor (Advisory Board) y del Grupo de Participación de Pacientes y del Público General (Patient & Public Engagement Group, PPIE) que brindan apoyo al proyecto.

Como recordatorio, las evaluaciones de salud mental llevadas a cabo conforme a la Ley de Salud Mental (LSM) en Inglaterra y Gales (1983) tienen como objetivo determinar si es necesario el internamiento psiquiátrico de una persona tanto de forma voluntaria como involuntaria por razón de trastorno psíquico. Cuando la persona evaluada habla un idioma diferente al empleado por los profesionales del sistema de salud, es necesario emplear los servicios de mediación lingüística de un intérprete profesional.

Las preguntas principales que guían el planteamiento y el desarrollo del proyecto INForMHAA son las siguientes: ¿Qué influencia ejerce la figura del intérprete al mediar en evaluaciones de salud mental llevadas a cabo de conformidad con la LSM? Y ¿cómo pueden mejorarse las dinámicas en este tipo de encuentros, por ejemplo, de carácter lingüístico o interaccional?

Aparte de indagar sobre estas dos cuestiones principales, el proyecto INForMHAA también busca dar respuesta a las siguientes preguntas:

1) ¿Hasta qué punto y de qué manera se ve facilitada o limitada la implementación de una conducta profesional óptima por parte de los Profesionales de Salud Mental Autorizados (AMHPs, por sus siglas en inglés) en las evaluaciones de salud mental llevadas a cabo de conformidad con la LSM, cuando estas cuentan con la participación de intérpretes de lenguas habladas o de signos?

2) ¿Bajo qué circunstancias y de qué forma sería más conveniente para los AMHPs emplear servicios de concordancia lingüística (por ejemplo, mediadores lingüísticos y culturales) en lugar de intérpretes?

3) ¿Cómo podríamos diseñar un modelo de formación que ayude a mejorar la preparación de los AMHPs y los intérpretes para trabajar de forma eficaz en este tipo de encuentros?

¿De qué información disponíamos cuando comenzó el proyecto?

  • Cuando nació el proyecto INForMHAA, ya había constancia de que hay grupos de población que están en desventaja por su origen étnico y/o herencia cultural, cuando se enfrentan a un examen que determinará la necesidad del internamiento psiquiátrico del paciente.
  • Los organismos oficiales que publican estadísticas demográficas tales como la Comisión de Calidad de Servicios destinados a los Cuidados (Care Quality Commission) y el Servicio Digital del Sistema Nacional de Salud británico (NHS Digital) no proporcionan información sobre los idiomas empleados por las personas que se enfrentan a este tipo de exámenes de salud mental.
  • En ninguno de los documentos oficiales relacionados con la reciente reforma de la LSM se hace referencia a los servicios de mediación lingüística que se puedan llevar a cabo en este tipo de evaluaciones de salud mental, aun cuando sí que se reconocen las desigualdades en los resultados de estos exámenes por motivos de diferencia étnica.
  • El código de buenas prácticas profesionales de los AMHPs determina que ellos deben garantizar que este tipo de exámenes se lleven a cabo de una manera «adecuada» (incluyendo la garantía de una comunicación eficaz) sin hacer mención al papel que puedan desempeñar los intérpretes o mediadores culturales en encuentros en los que exista una diferencia lingüística.
  • Existen tasas muy altas de diversidad lingüística entre la ciudadanía de los territorios de Inglaterra y Gales.
  • Hasta ahora, no se ha llevado a cabo un estudio coherente y metódico que determine el alcance de la información disponible sobre la mediación lingüística en este tipo de encuentros, tanto en los territorios de Inglaterra y Gales como en otros países que tengan un equivalente jurídico a la LSM.
  • No existen publicaciones oficiales que incluyan recomendaciones de práctica profesional dirigidas a los AMHPs, intérpretes o médicos habilitados para participar en este tipo de evaluaciones (de acuerdo con la sección 12 de la LSM) cuando estas cuentan con la participación de intérpretes.
  • No se tiene constancia de la repercusión que pueden tener este tipo de encuentros para los pacientes y sus familias.
  • Los organismos oficiales como La Comisión de Calidad de Servicios de Cuidados (Care Quality Commission) y el Servicio Digital del Sistema Nacional de Salud británico (NHS Digital) no prescriben la obligatoriedad de un registro formal del idioma empleado por los pacientes en este tipo de evaluaciones de salud mental, por lo que no hay datos disponibles en este área.

Tomando toda esta información como punto de partida, las investigadoras del proyecto INForMHAA queremos compartir en esta segunda entrada del blog algunas tareas que hemos llevado a cabo para entender mejor cómo funcionan este tipo de exámenes de salud mental y qué medidas se pueden adoptar para mejorarlas, si esto fuese necesario. Queremos destacar las siguientes tareas:

  • Hemos publicado el protocolo de nuestra revisión sistemática exploratoria (Scoping Review), llevada a cabo con ayuda del programa informático Covidence, una herramienta de revisión y extracción de datos para los autores de revisiones bibliográficas. En nuestra búsqueda de estudios empíricos y de literatura gris sobre evaluaciones de salud mental llevadas a cabo de conformidad con la LSM mediadas por intérpretes, hemos seleccionado 40 fuentes que mencionan este tipo de exámenes, aunque de forma tangencial y que no abordan de forma directa e íntegra las preguntas que han impulsado el desarrollo del proyecto INForMHAA.
  • Hemos distribuido dos encuestas en línea, una destinada a AMHPs (hemos recibido 132 respuestas) y otra dirigida a intérpretes con experiencia directa en este tipo de contextos (habiendo recibido 24 respuestas). La mayoría de los intérpretes que completaron la encuesta son intérpretes de lengua de signos, por lo que estamos planteando la posibilidad de volver a habilitar la encuesta para obtener más respuestas de intérpretes de lenguas habladas y así compensar esta diferencia.
  • Hemos llevado a cabo entrevistas de seguimiento a 17 AMHPs y 8 intérpretes (con dos más programadas próximamente), que respondieron a las encuestas y proporcionaron sus datos de contacto para explorar algunos de los temas recogidos en la encuesta con más profundidad. En estas entrevistas, prestamos especial atención a las opiniones de los participantes así como sus experiencias, y les animamos a aportar ejemplos de algunos puntos clave relacionados con la toma de decisiones y las prácticas de colaboración inter-profesional llevadas a cabo de forma conjunta entre los AMHPs y los intérpretes.

¿Qué información nueva tenemos ahora?

  • Ahora tenemos constancia de que en la literatura científica disponible hasta el momento no se ha abordado de forma específica el desarrollo de las evaluaciones de salud mental llevadas a cabo de conformidad con la LSM mediadas por intérpretes, ni los requisitos que necesitan tener en cuenta los profesionales para garantizar que estos encuentros se realizan de forma adecuada.
  • Las evaluaciones de salud mental llevadas a cabo de conformidad con la LSM mediadas por intérpretes, aunque se realizan de forma poco frecuente, sí que se llevan a cabo de forma regular o constante a lo largo del tiempo. La mayoría de los 132 AMHPs que contestaron a la encuesta respondieron que llevan a cabo este tipo de exámenes contando con la participación de intérpretes al menos cinco veces al año.
  • Los modelos de informes de los AMHPs para estos exámenes no incluyen una sección que permita registrar el idioma empleado por el paciente, por tanto, no se tienen datos sobre ello.
  • De los 132 AMHPs que contestaron a la encuesta, 115 AMHPs afirmaron que trabajan con intérpretes «a veces» y poco más del 50% de los encuestados afirmaron registrar el idioma empleado por el paciente.
  • Los AMHPs reconocen que existen algunos problemas recurrentes que pueden surgir en este tipo de evaluaciones.
  • Tan solo 9 de los AMHPs encuestados afirmaron haber tenido algún tipo de formación sobre cómo trabajar con intérpretes y tan solo un 28% de los encuestados afirmaron haber contado con formación para trabajar de forma eficaz en este contexto.
  • Casi el 60% de los AMHPs encuestados afirmaron que la formación recibida no les prepara para trabajar con intérpretes de forma eficaz, ni en su papel como AMHP ni en ningún otro papel en un sentido más amplio en su trabajo como trabajadores sociales.
  • Cuando los intérpretes trabajan en este tipo de exámenes de salud mental, deben adoptar medidas extraordinarias para tratar con el tipo de lenguaje adoptado por el paciente que puede verse gravemente afectado por el trastorno psíquico que sufra. Algunas medidas mencionadas por los interpretes encuestados incluyen adoptar un enfoque meta-comunicativo por el cual los intérpretes describen en lugar de interpretar o traducir directamente el uso del lenguaje por parte del paciente, cuando este «no tiene sentido» o no es coherente. Esta medida permite ofrecer una representación más fiel del original, en lugar de ordenar la versión original, ya que esto puede causar que el AMHP no perciba la distorsión presente en la producción lingüística del paciente, teniendo como posible consecuencia un diagnóstico inadecuado (infra-diagnóstico) de la severidad del trastorno psíquico. Emplear este tipo de medidas requiere que se establezca un vínculo de confianza profesional muy sólido entre el AMHP y el intérprete.
  • Los intérpretes necesitan apoyo y supervisión para que su participación en este tipo de contextos no les afecte de forma negativa, debido a la gran carga emocional que conllevan este tipo de encuentros. Contar con el apoyo y supervisión adecuados permite que no esté en peligro el bienestar personal de los intérpretes y que, por tanto, no se vea comprometido su rendimiento profesional.
  • Los intérpretes pueden trabajar de forma más eficaz en estos contextos si tienen un conocimiento no solo lingüístico y de traducción sino también un entendimiento amplio del contexto de estos exámenes, incluyendo aspectos legislativos básicos relacionados con la LSM. Al tener un conocimiento general de en qué consisten este tipo de encuentros y cómo están ubicados dentro del marco jurídico, los intérpretes son más capaces de garantizar una comunicación adecuada a nivel global. Esto es porque hay términos que pueden no tener un equivalente lingüístico o jurídico en diferentes idiomas; por ejemplo, qué implica la sección 12 de la LSM, el papel del tutor legal del paciente o qué significa oponerse legalmente al internamiento psiquiátrico. Todos estos términos tienen un significado altamente vinculado a su carácter legal, lo que pone de manifiesto la necesidad de que los intérpretes tengan formación especializada.
  • Es de vital importancia que se consideren las dinámicas de carácter inter-profesional entre el AMHP y los intérpretes en este tipo de evaluaciones.

Nuestra investigación ha puesto de manifiesto los siguientes aspectos a destacar:

  • En la mayoría de los casos, el AMHP y el intérprete no se conocen ni han trabajado nunca juntos, antes de llevar a cabo una evaluación de LSM de forma conjunta.
  • Los AMHPs no tienen acceso directo a las características del lenguaje de un paciente que hable otra lengua, y esto limita su capacidad para que puedan tener una idea precisa del estado mental en que se encuentren los pacientes así como la capacidad de estos para entender y procesar información.
  • Los AMHPs normalmente no tienen constancia de la experiencia previa de los intérpretes en este tipo de contextos ya que esto no se tiene en cuenta a la hora de contratarles para un encargo a través de agencias.
  • La mayoría de los intérpretes no tienen experiencia en este tipo de contextos. Algunos intérpretes pueden percibir que el rol de los trabajadores sociales que lleven a cabo estas evaluaciones puede ser opresivo y esto puede interferir con el desarrollo de sus funciones como intérpretes durante la evaluación.
  • Es muy probable que los intérpretes y los AMHPs no tengan formación especializada donde se les hayan proporcionado pautas para trabajar de forma eficaz, particularmente en este tipo de contextos.
  • Existe una relación de dependencia profesional entre el AMHP y el intérprete para garantizar que la evaluación se desarrolla de forma adecuada y de conformidad con la ley.

¿Qué otras tareas hemos llevado a cabo?

  • Hemos desarrollado y publicado la página web del proyecto en lengua de signos y en inglés, que proporciona una visión general del proyecto y aspectos específicos como la declaración de posicionamiento de las integrantes del proyecto.
  • Tenemos reuniones trimestrales con los miembros de nuestro comité asesor (Advisory group), que han participado en el diseño de investigación y en tareas relacionadas con la recogida de datos. Los integrantes de nuestro comité asesor han sido clave a la hora de diseñar nuestras herramientas de recogida de datos tales como las encuestas, los escenarios destinados a las simulaciones grabadas y también a la hora de encontrar participantes para el proyecto. Aprovechamos la mención al comité asesor para comunicar que nos entristece enormemente informar sobre la defunción repentina e inesperada de uno de los miembros del comité asesor: Martin Stevens, investigador honorario en la sección de investigación en materia de políticas del Instituto Nacional de Investigación Sanitaria británico (NIHR, por sus siglas en ingles). Las integrantes del proyecto queremos expresar nuestro más sincero pésame a la familia y allegados del señor Stevens, y queremos reconocer el gran valor de su contribución para el proyecto INforMHAA durante su participación.
  • Nuestro grupo de Participación de Pacientes y del Público General (Patient & Public Engagement Group, PPIE) ha comenzado su periodo de formación. Este curso consiste en un modelo de autoaprendizaje dividido en una serie de módulos en inglés y lengua de signos. Hasta ahora, hemos completado tres de las seis sesiones planeadas en su inicio. La sesión 1 aborda aspectos generales sobre el equipo de INForMHAA, la naturaleza del trabajo grupal, diversidad e inclusión social. La sesión 2 tiene como objetivo entender en qué consiste el trabajo del grupo PPIE, qué contribución puede aportar un grupo de PPIE a un trabajo de investigación, los estándares que marca el NIHR para los grupos de PPIE así como las diferentes formas en que los miembros pueden contribuir en esta tarea. La sesión 3 aborda conceptos relacionados con la investigación, tales como en qué consiste la investigación cualitativa, cuantitativa, y los enfoques con métodos mixtos, así como una variedad de métodos para recabar datos. La sesión 4 incluye información sobre ética y consentimiento informado.
  • Hemos terminado de grabar cuatro escenarios inspirados en casos reales obtenidos a través de información que hemos recogido a través de las encuestas y en las entrevistas, en las cuales los participantes compartieron situaciones que se pueden encontrar en evaluaciones de salud mental llevadas a cabo de conformidad con la LSM mediadas por intérpretes. Los miembros del comité asesor también aportaron información útil para diseñar los escenarios.  En los escenarios se muestran varias combinaciones de idiomas: Inglés junto con Kurdo, Neerlandés, Lengua de signos británica y Hindi. Terminamos de grabar los escenarios en Marzo de 2022 con el apoyo del grupo TIPP, un grupo de teatro de la Universidad de Manchester.
  • También hemos dado varias ponencias y produjo algunas publicaciones iniciales.

¿Y ahora qué?

  • Estamos editando los videos de las simulaciones grabadas, ya que este material se va a usar como parte de nuestra recogida de datos durante la siguiente etapa del proyecto. Esta tarea conllevará (i) analizar puntos clave de las interacciones utilizando el software de anotación GoReact y (ii) organizar y llevar a cabo las observaciones de las simulaciones en las que pediremos a un conjunto de intérpretes y AMHPs que observen con atención estas situaciones utilizando la función de interpretación en Zoom y la herramienta de encuestas Mentimeter para que los participantes puedan comentar qué aspectos pueden definir buenas prácticas y qué aspectos de la interacción podrían mejorarse.
  • Estamos trabajando para publicar los resultados de las encuestas y de las entrevistas. También estamos planeando escribir un artículo sobre metodologías innovadoras para investigar que hemos empleado en este proyecto.
  • Todos los datos recogidos hasta ahora van a informar el diseño de las aplicaciones prácticas del proyecto tales como la producción de recursos de formación, recomendaciones para la implementación de buena conducta profesional, información para AMHPs e intérpretes y nuestra propuesta de un modelo de «Teoría para el Cambio» para llevar a cabo evaluaciones de salud mental llevadas a cabo en conformidad con la LSM mediadas por intérpretes de forma eficaz.

Interpreters for Mental Health Act Assessments (INForMHAA)

Project progress update no. 2 – Jemina Napier

This v/blogpost is available in BSL, English, Spanish, French and Hindi

BSL: https://youtu.be/Q4bjGhdApfw

This v/blogpost is an update from the INforMHAA project team on our progress on the project to date.

The first v/blogpost gave an overview of the project and our goals, the planned key phases of the project, and the involvement of our Advisory Group and Patient & Public Engagement (PPIE) Group.

As a reminder, mental health assessments carried out under the Mental Health Act in England and Wales (1983) are intended to determine whether a person’s voluntary or involuntary psychiatric commitment is necessary for reasons of psychic disorder. When the person evaluated speaks a language other than the one used by health system professionals, it is necessary to use the linguistic mediation services of a professional interpreter.

The overall research question for the project is: How does interpreter mediation impact on Mental Health Act Assessments and how can interpreter-mediated Mental Health Act Assessments be improved?

With the following sub-questions:

  1. To what extent and how does the involvement of a spoken/signed language interpreter in Mental Health Act (MHA) assessments constrain or enable best Approved Mental Health Professional (AMHP) practice?
  2. When might it be more appropriate to use language concordant services (e.g. language/cultural advocates) rather than interpreters within AMHP practice and how?
  3. What constitutes an effective training model for AMHPs and professional interpreters?

What did we know at the start of the project?

  • Evidence of disparities in disposal by ethnicity and cultural heritage did not encompass language use
  • CQC and NHS Digital do not publish data on language use of those assessed nor whether interpreter was used
  • No attention given to language mediated MHA assessments in MHA reform documentations
  • Code of practice requires ‘interview in suitable manner’ with some mention of interpreters and cultural advocates
  • England and Wales are highly linguistically diverse countries
  • There is no previous comprehensive review of evidence about interpreter mediated MHA assessments or their international equivalents
  • There is no published good practice guidance for AMHPs, interpreters or Section 12 doctors
  • The impact on service users and carers of interpreter mediated MHA assessment is unknown
  • Language of the assessment and whether an interpreter was used is not in the minimal data set for NHS digital annual reporting of MHA nor in CQC publications of standards

This second v/blogpost gives an update of what we have done so far in order to interrogate what more we need to know and how to ensure best practice in interpreter-mediated MHA assessments.

To date we have:

  • Published the protocol for a  Covidence-assisted scoping review of relevant empirical work and grey literature on interpreting in Mental Health Act assessments and identified  40 studies which will form the basis of the full review. None are of direct relevance to the questions of our study.
  • Conducted surveys with 132 AMHPs and 48 Interpreters about their experiences of working in MHA assessments.
  • Conducted follow-up interviews with 17 AMHPs and 6 interpreters (+ 4 pending) who responded to the survey and agreed to be interviewed to delve deeper into their experiences and source examples of critical points of decision-making and co-operative professional practice for AMHPs and interpreters.

What do we know now?

  • No literature has specifically addressed interpreting and mental health assessment during the ‘in the moment’ of MHA assessments nor the requirements of AMHPs and interpreters to meet those situations
  • Interpreter-mediated MHA assessments although infrequent are a constant. Of the 132 AMHPs in the survey most averaged 5 interpreter-mediated assessments a year
  • AMHP report forms are not consistent in whether they ask questions about the language of the assessments and in what form them ask the question
  • Asked about whether they recorded when they worked with an interpreter 100/115 AMHPs said ‘sometimes’ and just over 50% said they recorded the language combination of the interpreter
  • If there seemed to be a ‘problem’ this was consistently noted by AMHPs
  • Only 9/121 AMHPs could recall any training about working with interpreter as part of their qualifying course
  • Since approval only 28% had participated in any training on working with interpreters
  • Nearly 60% said their training had not adequately prepared them to work with interpreters whether as an AMHP or in any other role/setting.
  • Due to the occasional difficulties of language output by person assessed, interpreters might need to implement special adjustments to their regular interpreting practice, for example, adopting a meta-descriptive approach to their interpreting renditions ‘when language does not make sense’ instead of ‘tidying up’ language. This requires a strong sense of trust in the interpreter on the part of the AMHP.
  • Interpreters need support and supervision so that the sensitive nature of these encounters does not negatively impact in their personal wellbeing and resulting professional performance.
  • Interpreters’ wider understanding of the legislative aspect of MHA assessments, not just linguistic aspects, is a clear success factor to ensure good quality communication between the parties. Concepts like ‘section 12’ ‘nearest relative’ ‘objection’ have a strong legal component that differs from general linguistic meaning, which highlights the importance of specialist training.
  • Importance of considering ‘inter-professional dynamics’ in this context.

A few key issues highlighted by our research so far:

  • AMHPs and interpreters have probably never met before when they first enter an MHA assessment
  • AMHPs have little or usually no access to the language of the service user and assessment and this affects their ability to pick up holistically information about the mental state and level of understanding of the person being assessed
  • AMHPs usually have no idea whether the interpreter has any background experience in MHA assessments and it is hard to specify this as a requirement when booking an interpreter
  • Most interpreters have never taken part in an MHA assessment.  Some have pre-existing concerns about the oppressive nature of social workers and of the MHA which can interfere with their role in the assessment
  • Highly unlikely that interpreters and AMHPs have ever taken part in training in inter-professional working together or specifically in an MHA assessment
  • AMHPs and interpreters are dependent on each other to ensure that best practice and conformation to legal practice are carried out

What else have we done?

  • We have developed a bilingual project website in BSL and English, which gives a detailed overview of the project and all its aspects, including a team positionality statement.
  • We have held quarterly meetings with our Advisory Group, who have engaged with the research design and data collection at all stages and have been critical in shaping the survey instruments, the simulation scenarios and recruiting participants. We are very sad to report that one of our advisory group members, Martin Stevens who was a senior research fellow for the NIHR policy research unit, passed away unexpectedly. We would like to extend our condolences to his family and colleagues, and acknowledge his valuable contribution to the INforMHAA project during his involvement.
  • Our PPIE Group have begun their training, which is available through bilingual self-learning online modules  in BSL and English. So far, they have completed three out of six planned sessions: Session 1 covered the INForMHAA team, understanding group work, diversity and inclusion; and Session 2 covered What is PPIE? – understanding PPIE, being familiar with how it works in research, being aware of NIHR PPIE standards and knowing how you can get involved in PPIE. And Session 3 covered ‘What is Research?’ – why we research, qualitative, quantitative and mixed-methods approaches and data collection methods. Session 4 will cover ‘Ethics and Consent’.
  • We have completed filming of the simulated interpreter-mediated MHA assessment scenarios. We created four scenarios based on reporting from AMHPs and interpreters in the surveys and interviews of typical issues that they had come across in MHA assessments, and through consultation with the Advisory Group. The scenarios featured four different language combinations: Kurdish, Dutch, British Sign Language and Hindi. We completed filming in March 2022 with the support of the TIPP drama group from the University of Manchester.
  • We have also given several presentations and produced some initial publications.

What is next?

  • The simulation scenario videos are now being edited together for the next stage of the project. This will involve: (i) analysis of the critical points in the interactions using GoReact annotation software and (ii) simulation observations where we will ask interpreters and AMHPs to observe these simulations online using the multilingual interpreting function in Zoom webinar and the Mentimeter audience survey tool to discuss what they see as best practice, what they see are the issues and how things can be improved.
  • We are working on publications from the survey and interview data, and also plan to write an article on the innovative methodologies we have used in this project.
  • All of the data will feed into various planned outcomes, including the co-production of new training resources and professional best practice guidelines, information for AMHPs and interpreters, and a proposed new Theory of Change model for conducting interpreter-mediated MHA assessments.

JUSTISIGNS 2 project

Supporting deaf female victims of domestic, sexual and gender-based violence

By Jemina Napier & Lucy Clark

See link to this blogpost in British Sign Language (BSL):

Following on from our last v/blogpost, in this v/blogpost Jemina Napier and Lucy Clark from the SIGNS@HWU team in the Centre of Translation & Interpreting Studies in Scotland (CTISS) at Heriot-Watt University provide an update on what they have been doing as part of the Justisigns 2 project.

The wider project focuses on how to support victims and survivors from deaf and migrant communities with their experiences of domestic, sexual and gender-based violence (DSGBV), with a view to understanding best practices for key professionals (i.e., police, health and social) and interpreters working together to ensure access to support. The Heriot-Watt University team are focusing on support for deaf women specifically.

Below is a translation of the blogpost presented in BSL.

JEMINA:          We’re back! It’s been some time since our last blogpost, which we did in 2021 when Lucy first started work on the project. So we’re here to give you an update of what we’ve been doing with the Justisigns 2 project.

Firstly, we administered two surveys – one to service providers who provide support to women that have reported incidents of DSGBV, and one to interpreters (of all languages) about their experiences of working in this context. We have analysed those results, and they will be published later. The results are interesting because it seems that both service providers and interpreters feel they need more training about how to work together. So, the service providers want to know how best to work with interpreters, for example, how to identify if they’re qualified and if they’ve had any specialist training around DSGBV situations; and the interpreters said that they felt they didn’t understand the terminology, the jargon…

LUCY:               Yes, that is right, how to sign things or how to explain certain things and that perhaps one word could have different definitions in the DSGBV context.

JEMINA:          So, the interpreters said that they also would like training. Fortunately, one of the goals of the Justisigns 2 project is develop training resources for interpreters and support service providers, and we’re working on that at the moment. I will hand back to Lucy to tell you about other things we’ve done.

LUCY:               We held an event back in March 2022 for International Women’s Day. It was so nice, a very successful event that was well attended by many older deaf women. This was interesting as it helped us to think about what the younger generation think about DSGBV issues too. We provided small workshops, for example, training on safety and well-being, how to look after your health, for people have experienced abuse how to report it and how to engage in self-care has part of your recovery. We also had presentations from the police, who gave information about how to report incidences of DSGBV and everyone seemed to really get a lot out of it. It was a very relaxed environment which made it conducive to talking about this specific sensitive issue, and serveral people asked us for more events. We delivered a webinar. Unfortunately I was sick and couldn’t attend, so over to Jemina to tell you how that went.

JEMINA:          The webinar was aimed at interpreters to share the survey results and the training needs identified through the survey. I think there were about 70 interpreters that attended from all over the UK and internationally. A lot of the discussion was about how much interpreters would really like to get access to specialist training on this topic.

We will also be doing some other presentations coming up for Police Scotland and for the Policing Domestic Abuse Research Network about the survey results and be the deaf perspective on this topic.

Last year (in 2021), we also had a roundtable with deaf Independent Domestic Violence Advisors (IDVAs) and interpreters to talk about their roles, what is important to include in training, what they need in their respective roles and how best to work together, which was very useful. From all of these different events, we identified that we need to develop some kind of glossary in BSL. So, Lucy went about researching key terms…

LUCY:               Yes, it was important to identify key terminology as we realised that perhaps people might think it means one thing but there could be other meanings and especially in relation to the DSGBV context. We used our networks to get support to identify important terminology and did some research into what these terms mean. By developing a BSL glossary of these terms, it will support many deaf people that might not be familiar with these terms.

JEMINA:          Also, this glossary will be helpful for interpreters if they find themselves working in this situation, then they will be able to do some research and preparation using the BSL glossary.

At the end of last year (2021), we held an initial workshop on Zoom between deaf and hearing interpreters and support service professionals who have experience of working in DSGBV contexts to begin to discuss these glossary terms. But we agreed that it would be more productive to proceed with a face-to-face workshop. So, we are hosting approximately 15 people in Edinburgh in May 2022, including representatives from Police Scotland, to discuss about these terms, whether there are established signs or the best ways to sign them. And then we will re-film and make the BSL glossary freely available through our website for both deaf people and for interpreters.

LUCY:               It is really nice to see the involvement from Police Scotland because obviously the police are often the first point of contact so we can work with them to identify gaps in knowledge, for example, if deaf people want to report incidences, so we can try and make sure that the process is as smooth as possible: for interpreters so they know how to interpret the jargon, that the police understand about deaf culture and that deaf women know how to ask for help from the police. It feels good to know our project will make this difference.

We have also interviewed several deaf women and we are in the process of summarising and identifying the key themes that have emerged from those interviews. The interviews did not focus on DSGBV incidents themselves, but on what happened once they had reported an incident of violence, for example: Did they get the right kind of support? Could they find an interpreter? Were they directed to the right services? How did they communicate? And so on. We really wanted to tap into those experiences, and from that data we will be able to create some recommendations for the police and other support services about the best way to support deaf women in these contexts and to understand from the beginning to the end of the process, what information needs to be given.

JEMINA:          In addition to creating a summary and writing up the data, we are also planning to make a mini-documentary to illustrate the experiences of deaf women. We will bring in actors so that we can keep our interviewees anonymous and protect their identities. But we think it’s important that the deaf community are able to see this information in BSL and hopefully, this documentary could also make an impact on hearing organisations about the experiences of deaf women.

So, we’ve been busy!

LUCY:               We have been really enjoying the work. If any of you have any questions or if any of you want to know more, please do contact us (Email: L.Clark@hw.ac.uk/ Twittter: @JUSTISIGNS2) so it can feed into our research on this topic.

JEMINA:          And we will be back with another update later on in the project. Thank you.

Transcribed by https://otter.ai

INterpreter-mediated Mental Health Act Assessments (INForMHAA)

Project update

Celia Hulme & Jemina Napier

Click here for the blog post in BSL

Introduction

I am Jemina Napier, from Heriot-Watt University, and I am Celia Hulme, from the University of Manchester, and here we provide an overview of a project that we are both involved in as part of a research team.

The aim of the project is to explore mental health and interpreting but very specifically how AMHPs (Approved Mental Health Professionals) work alongside spoken language interpreters or sign language interpreters, particularly if an individual needs assessing under the Mental Health Act (in England). The person may be unable to access English written or spoken, for whatever reason, so the interpreter and the professional need to work together. Very little research has been done in this area, so it’s a very important and novel project.

The INForMHAA project has been funded by the National Institute for Health Research (NIHR), under the School of Social Care Research and it is funded for 18-months. It is an interdisciplinary project bringing together professionals from various backgrounds. 

We have a team of six people on the core research team, all from different backgrounds bringing different expertise and experiences. Firstly, we have Alys Young, Principal Investigator on the project. She is at the University of Manchester, a Professor of Social Work and brings a social work perspective, and also a Deaf Studies perspective. Then, we have, Jemina Napier, Co-investigator on the project, who is from Heriot-Watt University, a Professor and Chair of Intercultural Communication and the Director of Research for the School of Social Sciences, bringing perspective as a sign language interpreter and someone that trains interpreters and also uses BSL. Next, we have Dr Rebecca Tipton, another Co-investigator on the project. She is also from the University of Manchester and she lectures in Translation and Interpreting Studies, and speaks French. Next, we have Dr Sarah Vicary, who is also a Co-investigator on the project. She is from the Open University and is the Associate Head of School of Nations. She is also a registered qualified social worker and has been for 30 years, and she brings a social work perspective. We also have Dr Natalia Rodriguez Vicente from the University of Essex. She lectures in Modern Languages, Interpreting and Translation, and she is also a Spanish speaker and works as a postdoctoral research associate on the project. And Celia Hulme who is from the University of Manchester and is a final year PhD student in health research and I am involved in the INForMHAA project as a research assistant bringing a deaf perspective, but also a PPIE perspective. Jackie Wan Brown has recently joined the project as an intern as part of her NIHR funded pre-doctoral programme.

Project Advisory Group

With respect to the Project Advisory Group, it’s really important as a research team to have an advisory group as we have knowledge about the research process but we also need people to advise whether they are AMHPs, social workers and also interpreters; they are experts in their field. We set up an advisory group so that throughout the process of doing the research, we make sure that their personal and professional experiences are included. We also want to include key stakeholders, interpreters, both for spoken and sign languages, but also people that work as AMHPs and even teach AMHPs and go through that process.

The aim of the advisory group is to meet once every three months. So, we get together on a regular basis to talk about the research, we update them as to what we’ve been doing and how things are going. We ask them to contribute any ideas, resources that we could use such as academic literature, policies, and legislation. Also, anything that they would like to recommend that they know about, for example key contacts if we are trying to recruit people, so we also use their network alongside ours. When we produce our preliminary results, we will ask them for feedback in the results and methods. We will work alongside them to promote the research through their networks and contacts; hopefully recruit people and make sure that this research has a real strong impact. It is a really important group to have involved in the project. Hopefully at the end of the research when it’s all been completed, they will help with dissemination as well through their networks. It is an ongoing process, not only for a limited time. We are hoping that they will support in the long term as well.

Patient and Public involvement and Engagement (PPIE) group

The PPIE group is for people that are not on the Advisory Group. These are a different group; they may be service users themselves or have direct experience of being assessed under the Mental Health Act. Their inclusion in the project is of real importance so

that is why we have a PPIE group. Our aim is to recruit eight members, all from different backgrounds, because the project is focused on Interpreter-Mediated Mental Health Act Assessments, we need to get people who have direct experience of working with interpreters and being assessed by an AHMP. So, we need to reflect their background.

We are trying to make sure we have diverse representation, so, we may have different language speakers on the panel, but also people with different skills and experiences.

When we recruit individuals, we don’t get going straight away, we will train the panel members to enable them to be effective panel members.  We give them information as to

what PPIE means, the research process, and then we will get them involved in the research project. They are involved in different tasks such as project design, where we will ask their opinions. They can get involved in data collection also in dissemination of the research, be potential authors, attend conferences, present findings from the study to difference audiences and pass on information on our behalf. So, they are going to be very busy in the project.

Scoping review

The scoping review is an important part of the project. What we need to do is try to understand what research has been done in this area and how our research can fill a gap in knowledge. It’ really important for us to identify this gap. People talk about literature reviews, that is one way of doing it, but our project is different because its social care research. We will be doing something different and it is referred to as a scoping review. So, this helps us identify what’s been published, and what research has been done in the area, but not only academic research. It could be things that have been published such as policies, legislation, any information pertaining particularly to the Mental Health Act assessments.  We have a strict inclusion and exclusion criteria that we must follow. For example, we are interested in research to do with mental health and interpreting but would not be interested in health interpreting generally. We try to narrow it down and understand particular research about mental health. We try to identify the gaps to make sure our project aims are covering a gap and giving new knowledge. It is a long process, and we are currently in the process of filtering the research, checking, agreeing what we will and will not include. We are going through that process at the moment and that’s just one of our methods. 

Mixed-methods research

There are two phases to the project, and each phase is different. This is a mixed-methods study, so we are not only using one method but several. One method, is the scoping review, which is taking place in Phase 1. But we also want to find out the experience of the AHMPs and the interpreters, and we are getting that information through a survey questionnaire, also in Phase 1. There are two surveys because the questions are different for interpreters and AHMPs. In the survey, there is an option for them to agree to be involved in an interview so they can talk in more detail about their experiences.

Phase two involves what we call ‘simulated practice’ and what we envision will happen is

people will observe a Mental Health Act assessment taking place, so there will be

an AHMP with an interpreter, in BSL or a spoken language, doing an assessment with other

individuals (from the advisory and/or PPIE groups) observing this happening.  We will then discuss what has worked well and if there were any issues that we need to think about. This will help us develop training materials. Because of the COVID-19 pandemic, we decided that everything has to take place online.

We are lucky that Zoom has different options and a special function that we can turn on that allows you to provide different language interpretations, so different spoken languages can be used simultaneously. Our aim is to adopt a multilingual approach.  So that means AHMPs could speak English, and the individual being assessed could use BSL or a different spoken language and people can listen to different language options or watch BSL interpreters. And then after the simulation is finished we will gather their thoughts and opinions on the process and what that felt like. We want to ask them different questions using a poll. We have trialled several different options to see what works well so that people to contribute their views. We’re still in midst of that. We are currently piloting what works well. Then, we will work out the situation and what that is going to look like. We will start developing that soon, so it’s very exciting.

Data analysis

In terms of the analysis, we will use various different methods. For example, for the survey, we will be using descriptive analysis and may use statistical analysis. For the interviews, we will use something called the phenomenological approach which allows us to examine the individuals and their experiences. For the simulated practice, we will using different approaches. We will be analysing the interaction between the interpreter, the assessor, the service user, or the carer. We will be using software tools GoReact and ELAN. So, we will use both to analyse the information.

So, that’s the overall project.

Knowledge Exchange and Information Exchange (KEIE)

We also have a responsibility to share our findings. We have to make sure that research is accessible and has an impact and will benefit those people concerned. For example, service users, AMHPs and interpreters, so we do this through KEIE. We will publish papers but the main foundation and principle behind our project is accessibility, making sure information is accessible. So, we will disseminate information in English, in sign language like we’re doing today with this vlog. But also, we want to try to make it available in different spoken languages. We will have a website where these different language options are available and everything will be available in sign language. We will post regular updates as we go along that will be on the website, so that people can engage and see the information we are putting out there. We will also host workshops, deliver presentations at academic conferences and for professional organisations and communities, making sure that people are aware of what is going on with the project. For example, we delivered a workshop to NIHR SSCR, who funded the project and we talked about accessibility, what that means and how we designed our project with accessibility in mind using a multilingual approach and how we have embedded the principle of accessibility in the whole research design that will hopefully continue long after the lifespan of the project.

Website & Resources

A website is currently being developed for the project. There will be information and guidance available on the website at the end of the project. We hope to create some training materials, guidelines for interpreters working with AMHPs and guidelines for AMHPs working with interpreters plus, these resources will be free and available online, so anybody interested in the topic can download these materials, whether they teach AMHPs or are interpreters, they will have access to these materials as well.

Bridging the Gap 5: Academics and community engagement

by Annelies Kusters, Jordan Fenlon and Jemina Napier

 

In the weekend of 25-26 November 2017, the fifth Bridging the Gap (BtG) conference was hosted at Heriot-Watt University. The aim of this conference series is to work towards bridging two gaps: first, the gap between academics (involved in Deaf Studies and sign language research) and deaf community members; and second, the gap between deaf and hearing academics within these fields. While the second gap triggered the organisation of the first BtG conference in 2014, the fifth iteration of the conference mostly focused on the gap between community members and academics. It was the first time that BtG lasted two days rather than one, and it attracted 120 participants: community members and academics hailing from all over the UK, the largest audience so far. The conference was heavily discussed on social media, particularly on Twitter (see #BTG5). The core organising committee consisted of Jemina Napier, Jordan Fenlon and Annelies Kusters, and others who have worked with us to plan the conference included Steve Emery, Dai O’Brien, Heather Mole and Emmy Kauling, and a number of student volunteers.

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Annelies, Jemina and Jordan.

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The conference started off with an introduction by Nicola Nunn, who organised the first BtG conference in Preston. She introduced the BtG series, emphasising that she was very happy to see that the conference was not an one-off and is now an established one in the British deaf conference landscape.

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After Nicola, Jemina Napier took the stage to give the audience an impression of the kind of research and community work we are doing here at Heriot-Watt, where the BSL section has recently exponentially grown.

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After opening the conference in this way, Hillary Third (Equality Unit, Scottish Government) and Frankie McLean (Deaf Action) gave a keynote presentation focusing on the implementation of the BSL (Scotland) Act. Hillary and Frankie explained that the aim of the Act is to make “Scotland the best place in the world for BSL users to live, work and visit”. The BSL National Plan for 2017-2023 contains 10 long-term goals and 70 actions in the next 3 years (covering early years and education training and work; health; culture and the arts; transport; justice and democracy) and a further set of actions will be published in 2020.

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The Plan was constituted after extensive consultation: the National Advisory Group (NAG) has been successful in engaging large numbers of Scottish deaf people in the BSL Act. Not only was the NAG a great input for the Scottish Government, it also served as an instrument of empowerment. Several feeder NAGs such as a parent and youth NAG had input into the general NAG. An inspiring video was shown of 2 deaf teenagers who were involved in the youth NAG, talking about the valuable experience of being involved, since they “are the future”. The Act is a great example of working with and for a deaf community in order to create better life conditions for deaf people. This opening session was livestreamed (https://www.facebook.com/HWUBSL/).

When we were planning BtG5, we already knew during our first meeting that we didn’t want to organise a “typical” conference consisting of presentations to disseminate research findings. Indeed we thought that if we really wanted to work towards bridging a gap, we would need an interactive format, designed in order for people to be able to express a range of thoughts on the “gap” under discussion. So the three sessions that followed the keynote presentation were interactive.

The first interactive session was based on the TV programme Dragon’s Den, where entrepreneurs could pitch an idea for a panel of venture capitalists who would decide if they would fund the particular project or not. Jordan Fenlon facilitated this session at BTG5, asking: “what would you do if you had £2 million for a research project?”

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The aim of this panel was for academics to learn about what kind of research deaf people find important and for the audience to get insight in the kind of thinking that’s involved in crafting a research proposal. Panelists for example pointed out the need to use buzzwords such as Thomas Lichy’s use of the word “hate crime”. They also pointed out that sometimes similar or related research has already happened (the dementia proposal); or that an idea (the deprivation project) had been previously pitched but not in a successful way. They said that a project such as the BSL corpus project would preserve old signs and regional variations, but a funder would require it to contribute to new academic theory, which is often a big challenge in applied projects. The idea that won the audience vote was Audrey Cameron’s: she suggested to work with Science Centres to give science teaching tessions to deaf children in BSL, and study how we think about science in sign language: a wonderful combination of doing exciting research in combination with direct benefits for deaf children.

A few academics and community activists/representatives came forward to pitch an idea that they had prepared in advance – the range of ideas covered:

BSL deprivation of deaf children (Tom Lichy)

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A Scottish BSL corpus project (Gary Quinn)

The Deaflympics 55 dB cut-off (Philip Gerrard)

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Sign language use in deaf people with dementia (Avril Hepner)

Mouthing in BSL (Adam Schembri)

The impact of isolation on mental health (Herbert Klein)

And science learning in BSL (Audrey Cameron)

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The panel consisted of academics and community representatives: Bencie Woll, Terry Riley, Graham Turner, Gordon Hay and Emma Ferguson-Coleman.

The second interactive session was called “Heriot Watt goes to Hollywood”, facilitated by Annelies Kusters and Gary Quinn, in which 6 short films were showed that were created by Heriot-Watt BSL section staff, PhD students, postdocs, BSL students and community members. The issues included: deaf people not learning about research findings after a project is concluded; having to sign epic consent forms in English; working with interpreters during research projects; the fact that participants often don’t want to admit when they need more clarificaton from academics; deaf people not knowing about Deaf Studies concepts but hearing interpreter students do, which can intimidate deaf people; deaf academics “leaving the community behind” to give presentations at international conferences and publish books. With the films, we tried to tackle issues in a humorous albeit serious way.

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The Hollywood session led to lively discussions, and during the next session on the next day, a manifesto workshop was facilitated by Dai O’Brien, Jordan Fenlon and Annelies Kusters, in order to address the same issues with the aim of taking action in the shape of a manifesto. Everyone got involved, the discussions were recorded, and Dai, Jordan and Annelies will take this forward. They will summarise the videos and use the summary to create a first rough draft of the manifesto which will then be presented and further discussed during the next BtG conference.

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Some issues that were discussed during the Hollywood and manifesto sessions included: how are research findings made accessible and attractive for community members? In the case of participants who directly contributed to a research project, it is important to ask how they want access to the findings, eg. some might want a summary in BSL and others might want the full article in English. In case of the broader community there are a number of options. Who wants to watch a two hour signed report on academic topics? Other options include short signed summaries, documentary films, interactive websites and texts in plain English. It is important to make research meaningful and interesting, and that also often means that reports should be kept short. When giving live presentations, it’s important to consider where the event is hosted: a relaxing/safe space such as a trusted deaf club with a pint in the hand, or pizza in a chilled out place, fosters a very different kind of atmosphere than an university auditorium. An issue that surfaced multiple times during the conference is that researchers are increasingly proactive in trying to make their research accessible in BSL but members of the deaf community might not know the BSL report exists (such as the earlier mentioned dementia project). So, how can people learn what research is happening and where, and where can they find it? The clever use of hashtags and Facebook groups is one means but it was also suggested that a centralised website with a “research map” would be helpful.

It is not clear yet where the 2018 iteration of BtG will be organised. We hope that during the next BtG conference, we can discuss actual examples of “good practice” in research and community involvement and impact, and how these might inform the BtG Manifesto.

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DESIGNS project update

By Audrey Cameron

Click here to see this blogpost in British Sign Language.

After our initial blogpost about the new DESIGNS: Deaf people in employment project in January 2017, which gave an overview of the project and talked about the kick-off event in Dublin, we have since held a community information event at Heriot-Watt University in June 2017, where we had various presentations from different members of the Designs project team. The event was attended by approximately 35 deaf BSL users, interpreters, and various advisory group representatives. The event was livestreamed through the Designs Facebook page, and the video is still available to watch.

We are now very excited to able to welcome Dr Audrey Cameron to the DESIGNS team. Audrey is a Deaf BSL user and has been appointed as the postdoctoral research associate for the project (two days per week). She brings a wealth of experience of research and working with the British Deaf Community. Audrey’s now into her fourth week and, having gone through the usual induction processes here at the University, she’s ready, along with the rest of the project team, to start identifying and contacting people to ask them to share their thoughts with us about the access issues for deaf sign language users around employment here in the UK.

A key part of this project involves interviewing people about the challenges facing deaf sign language users who are either employees, self-employed, managing their own business or looking for employment. We’ve prepared letters of introduction, explaining a little about the project and why we’d like to meet with people and these are now ready to go out.  A series of questions have been devised that are designed to help steer our conversations with participants and we’ve prepared the necessary consent forms. In the meantime, a couple of interviews have already been undertaken.

We’re also on the look out for volunteers to participate in focus groups to help us explore and develop resources that will help break down the barriers facing deaf sign language users that have been identified by the people we’ve been interviewing.

To complete the picture, we will be meeting with BSL/English Interpreters to find out from them what they see as the access issues for the deaf sign language users they work with in employment related settings.

One other thing we will be doing is collecting case studies of positive examples of where deaf people are successful in their workplace and how they work with interpreters. Here’s a good example from a recent article in the Deaf community online blog, the Limping Chicken, about Toby Burton, who is the Chief Financial Officer of Global Circulation at The Economist.

If you are interested in participating in our project or have any questions please let us know. Or if you think you have a positive case study to share with us, do get in touch.

Audrey Cameron can be contacted by email: Audrey.cameron@hw.ac.uk

Congress of the International Federation of Translators & Interpreters, Brisbane, Australia, August 2017

by Jemina Napier

 <Click here to see the blog post in International Sign>

 Recently I went to Australia as I had been invited as a keynote speaker at the International Federation of Translators & Interpreters (FIT) world congress in Brisbane. This was a historic moment at the FIT congress, as it was the first time they had experienced a keynote presentation on the topic of sign language interpreting. The fact that I chose to deliver the keynote address in Auslan (Australian Sign Language) also made a greater impact on the audience as I discussed the importance of recognizing signed languages as real languages on a par with spoken languages. Through my presentation I dispelled various myths about signed languages and confirmed for many reasons why signed languages should be considered as equal to spoken languages.

The congress was attended by over 800 delegates from all over the world representing a vast array of spoken languages, and the delegation was made up of translator and interpreter practitioners, educators and researchers. There were also approximately 20-30 (deaf & hearing) Auslan/English interpreter members of the Australian Sign Language Interpreters Association (ASLIA) present at the conference.

At the end of the congress, each of the keynote speakers was asked to summarise their experience of the conference and present any key highlights or themes we felt that were worthy of note. I noticed one theme that was embedded within, and pervaded all, the presentations that I saw throughout the conference. This was the theme of ‘power’. For example, in one presentation about the Australian Aboriginal Interpreting Service, the importance of family connections was discussed and how hard it can be to navigate interpreted interaction when your interpreter is a family member, and the potential disempowerment Aboriginal Australians may experience when family members also have to interpret for them. Power dynamics were explored in relation to medical interpreting, and how interpreters’ decision-making can impact on the rapport between doctors and patients. Similarly, interpreters are in a powerful position in police interpreting, when their interpreting decisions can have a significant impact on people’s lives.

As I have already mentioned, in my own keynote address I discussed various issues in relation to signed languages, and it occurred to me that the theme of power was also evident in my own presentation – in the fact that I chose to present in Auslan. I could make that choice. This is about power of language choice. Many of the (spoken and signed language) users that translators and interpreters work with do not have that choice, therefore they do not have that same level of power. As a hearing person, I am in an immensely privileged position to be able to make that language choice: to choose one day to present in Auslan, and the next day I could present in spoken English. My language choice can also be determined by who the interpreter might be that is interpreting for me from Auslan into English, and whether I feel comfortable with them ‘being my voice’ or whether I would rather speak for myself. Many of my deaf friends and colleagues don’t have that choice. They don’t have the power that I have.

This issue links with a previous research project I have been involved in – the Translating the Deaf Self project – which examined whether deaf people feel that they are ‘known’ by hearing people through translation, i.e., do they feel represented by interpreters. Many of the deaf participants in our study reported that they felt that they have little choice when it comes to working with interpreters, and face challenges and barriers to feeling like they are adequately represented. (A full copy of the research report is available if you would like more detail: email j.napier@hw.ac.uk).

So this experience has made me further reflect on my position: who I am; and how important it is to acknowledge one’s positionality as a researcher (see Young & Temple, 2014; Napier & Leeson, 2016; Kusters et al, 2017). I was invited to be a keynote speaker at the FIT Congress as a result of my international profile as a sign language interpreting researcher. But ultimately I was a hearing person talking about signed languages. I chose to present in sign language, and the fact that I did that did make an impact on the FIT congress audience, as it brought into evidence – ‘made real’ – many of the issues I was talking about. But we need to see more opportunities for deaf people to talk about their language and their experiences as deaf sign language users.

I thoroughly enjoyed the FIT Congress. It was a wonderful experience, and I felt very honoured to have been invited. It was an important event for FIT in having the first keynote about sign language and sign language interpreting, so I recognise and respect that. But at the same time, my attendance and presentation at that congress has made me think about my work; my language choices; my power. So I decided to write this blog to acknowledge more widely that I recognise this privilege; this power. It’s made me think about my future attendance at conferences; my language choices; who I want to have an impact on through my presentations; and whether deaf people are involved. This is something that I felt important to share through this blogpost.