In this v/blogpost Jemina Napier from the SIGNS@HWU team in the Centre of Translation & Interpreting Studies in Scotland (CTISS) at Heriot-Watt University provides an overview of the process of creating a British Sign Language (BSL) glossary of key terms that are used in the UK related to domestic, sexual and gender-based violence (DSGBV) as part of the Justisigns 2 project.
The glossary includes 33 key most often used terms, providing the term, the definition and a suggested sign (or more than one sign, or a combination of signs) for the term in British Sign Language (BSL).
The terms selected and the decision-making for the signs suggested was through a collective process over three workshops, twice online and once in person over 2 days. The workshops involved professionally qualified deaf interpreters and translators and hearing interpreters that had experience of interpreting in DSGBV settings or had experienced DSGBV themselves (or through their families), and professionally qualified deaf Independent Domestic Violence Advisors (IDVAs).
The first online workshop involved initial discussions of what was important to consider for interpreters or support service professionals when working in this context, the important of information being available in sign language, and some preliminary discussion of the meaning of key terms. The follow-up online workshop continued on the same theme but it was decided that it would be more effective to bring everyone together for a face-to-face workshop over two days (given that there were no longer lockdown restrictions in place).
The same group worked in collaboration with representatives from Police Scotland, including three police officers who were fluent in BSL, conducting detailed discussions of the meaning of various DSGBV terms from the legal perspective and the lay perspective and identifying how to convey information clearly and visually in BSL (this involved debating the appropriateness of existing signs). The discussions were documented and drafts of the suggested signs were filmed.
The final 33 signs were then filmed in a studio, involving three deaf women who have all survived DSGBV and have also worked in various roles as translator, IDVA, BSL presenter and advocate, so they all brought a wealth of knowledge and experience to this topic (see below).
Lucy ClarkTasnim AhmedClare Chilton
The glossary will be launched during the UN Women 16 Days of Activism Against Gender-Based Violence, which runs from 25 November – 10 December 2022, but the glossary will be made available as a free resource through the SIGNS@HWU Justisigns 2 project webpage thereafter and we hope that it will be a useful resource for deaf people, interpreters, police officers and social workers, and anyone who is interested in discussing the topic of DSGBV in BSL.
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:
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?
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?
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।
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।
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 développé un site web bilingue en langue des signes britannique et en anglais, qui donne un aperçu détaillé du projet et de tous ses aspects, y compris une déclaration de position de l’équipe.
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.
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.
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.
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.
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.
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:
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?
When might it be more appropriate to use language concordant services (e.g. language/cultural advocates) rather than interpreters within AMHP practice and how?
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.
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.
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.
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.
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.
This blogpost is published to coincide with the publication of the DESIGNS research project report. This presentation was originally planned to be delivered at the Bridging the Gap 6 conference in Cardiff in November 2019, but due to technical issues with trying to live stream it could not happen. So instead we filmed our presentation and have created this blogpost to provide an English text equivalent. The goal of the Bridging the Gap conference series is to ensure that research taking place in academia is made available to the British Deaf community, and also that deaf BSL users can shape the research agenda. The 2017 Bridging the Gap conference was hosted at Heriot Watt University, so we hope that by making this blogpost it will some way make up for not being able to present at the 2019 conference.
Both of us work at Heriot-Watt University in the SIGNS@HWU team, which is affiliated to the Centre for Translation & Interpreting Studies in Scotland (CTISS), and we were the UK team in the Designs Project from 2017-2019. The project is now finished, and the aim of this blogpost is to provide a conclusion to our work by presenting our key findings and also to provide information about the resources that have been developed through the life span of the project that specifically pertain to the UK context. In the videos linked to this blogpost you will see a taste of the resources that we have created.
What was the DESIGNS Project?
The DESIGNS Project was about deaf people in employment and the key focus of the research was to examine how deaf people work best with interpreters in employment contexts, including getting a new job, continuing employment working alongside regular interpreters, and also how one’s career progresses and how one gains promotion in the work place.
Funding for the project came from ERASMUS+. The research delved into what it is like for deaf people and, importantly, for interpreters who work alongside deaf colleagues in employment settings, as well as finding out employers’ views about deaf people in the workplace. There were seven project partners working across four different countries, so we worked with partners in Ireland, Belgium and Germany, including the European Forum for Sign Language Interpreters (efsli) and the European Union of the Deaf (EUD).
The culmination of the project was a meeting at the European Parliament in April 2019 when we shared the findings and discussed implications at a concluding event hosted by the (then) deaf MEP Helga Stevens.
One of the key aims of the project was to develop resources and training materials, as well as guidelines to help interpreters, deaf employees and employers to understand best practice in the work place. The project team felt that it was important to have research as the foundation for our work so that the resources we developed had a solid evidence base and linked theory to practice.
DESIGNS project research phases
The research itself had four phases. In the first of those, the EUD conducted a survey via national deaf associations across Europe pertaining to numbers of deaf people in employment and numbers of those who are unemployed. The survey also asked questions about the payment and booking of interpreters as well as a number of other issues. In the second of the four phases, we conducted a global literature review in the area of deafness and employment. Thirdly, each of the universities involved in the project conducted either focus groups or individual interviews, which were either face to face or online. We asked questions of employers, deaf employees and interpreters to really understand how they felt about the barriers and challenges they face as well as positive stories from their employment experiences. We were keen to gather information about these positive experiences as the team’s goal was to produce best practice guidelines, rather than focussing on negative experiences and obstacles. In summary, the third and fourth phases were aimed at eliciting views from the three groups of stakeholders: deaf employees, employers and interpreters.
This blogpost focuses on the British data set and we will share with you our findings from the three stakeholder groups in the UK and show you some of the resources we have developed for use in the UK.
Research findings
We collected a wealth of data that we analysed for key themes and to identify gaps in existing knowledge.
We found that most people did not know what rights and what responsibilities they had and there were gaps in, firstly, organisational culture meaning the culture of the working environment and how it affects deaf employees. Secondly, we identified a gap in experience, thirdly a feedback gap and fourthly we identified systems gaps. An example of this being when deaf people finish school or university and attempt to transition into the workplace, many do not know how to find an interpreter, how to source funding to pay for support or how to work with hearing people. Many of our respondents went to deaf school and therefore struggled in an unfamiliar hearing environment. That is an organisational or cultural gap that we had not realised existed, as well as being a systems gap in terms of the lack of knowledge of where to find funding.
Also, most respondents reported feeling anxious about job interviews, again through lack of knowledge about how and when to source interpreters for the interview process. Further, they stated they lacked practice in interviews, interview techniques and how to work with interpreters in interview situations. The need for funding and where to find the funding was an identified gap. We would describe this situation as an experience and knowledge gap.
Many workplaces with multiple deaf employees make use of staff interpreters. Deaf respondents found this positive because it helps when the interpreters and deaf people are familiar with each other as this allows for smoother interpretation. Because the staff interpreters are familiar with the work place, it helps them to feel confident but a lot of people reported that they did not have access to regular interpreters and this creates a gap, as interpreters find it more difficult to interpret unfamiliar meetings, jargon and people’s names. Because of this difficulty, we identified that it is important for a regular pool of interpreters, familiar with the workplace, to be available.
This also helps interpreters to be more confident and competent in those work settings. There was a reported difficulty in finding the right interpreter because there are not enough interpreters and the demand exceeds the supply which sometimes resulted in respondents using Communication Support Workers (CSWs) not only due to the lack of interpreters but also because CSWs are cheaper for the company. So, not having enough interpreters is another gap.
Also, respondents commented on the importance of preparation so that interpreters know what to expect, as well as feedback to the interpreters from both hearing and deaf workers, which helps improve the standard of the interpretation and also encourages team work; the result being that deaf people are represented better. But many deaf respondents were nervous about giving feedback in case the interpreters took this negatively and then would not come back to work with them. This difficulty was expressed within the context of not having enough interpreters.
In relation to the UK Government’s ‘Access to Work’ scheme, many of our deaf participants reported that when starting a new job, they were unaware of how to apply, fill out the forms, etc., which led to delays of up to three or four months meaning it was difficult for them to start a new job without interpreting support. So, there is a need to change that situation and ensure immediate support is available because without such, hearing colleagues could misunderstand and get the wrong impression of their new deaf colleague.
Once in employment, a lot of our deaf respondents reported a lack of confidence in applying for promotion. This phenomenon could be linked to there not being enough interpreters or lack of available training. Deaf employees undertaking training have the additional burden of interpreter costs and questions remain over who will pay for interpreting services. For these reasons, it is more difficult for deaf employees to seek and gain promotion. Furthermore, not being able to hear means that they also miss out on office chat and gossip which may include informal information about pending available promotions. So, that’s another gap.
Also, hearing people are generally not familiar about how to work with deaf sign language users, so they experience anxiety and hesitation about how to relate to their deaf colleagues. These issues could be cross-cultural or due to misunderstandings and communication breakdowns. Thus, there is a need for training to be provided to non-deaf, or rather, non-signing personnel. The necessity of such training highlights the importance of the DESIGNS project.
The themes and gaps were identified as a pattern across three different countries: Germany, Ireland and the UK. We found a similar picture in each country so these issues are not only specific to the UK. They are widespread and similar in other countries too. What we have done here is used examples, such as Access to Work, that are specific to the UK to discuss the issues in relation to this country.
Project outputs
Training materials
Training materials were developed in parallel across the different countries. So, we’ve developed specific resources in BSL. We have videos and also a training course that all stakeholders could undertake together. There’s an e-guide presented in sign language for deaf community members and we have versions of this in BSL, Irish Sign Language (ISL) and German Sign Language (DGS). We have a written guide for employers and all of these materials are available through the Designs website.
We have now finished the project and most of the resources are now available through the website with everything we have learned. We would like to share some sample clips of materials and resources we’ve developed throughout the project.
The first videos focus on job interviews and show what it’s like when deaf people go for interviews with an interpreter to try to get a job. The videos can be used in training for all three stakeholder groups: employers, deaf employees and interpreters.
In the Job Interview: Scenario 1 video, the interpreter was booked at the last minute, being contacted on the morning of an interview due to take place that afternoon, meaning that neither of the deaf interviewee or interpreter were prepared; they did not have the opportunity to meet beforehand and neither really knew what was involved.
In the Job Interview: Scenario 2 video, we see what happens when there is preparation; both the deaf interviewee and interpreter preparing beforehand and discussing the interview.
We have used these two videos in the training that we did with hearing, non-signing employers from a range of different organisations. We showed them the video without subtitles, so they had to watch and listen to the interpreter’s spoken English interpretation of the deaf interviewee’s signed utterances. They could obviously access the interviewers’ speech as well. After showing them both videos, we ask them to contrast the two. When we asked the employers what they thought about the deaf candidate in the first video, they responded that they would not have given her the job as she did not sound confident and was hesitant. With regards to the second video, they reported that they would have given her the job.
It was only afterwards that we told them that the candidate’s signing was exactly the same in both videos, and the hesitation actually came from the interpreter in the first video due to lack of preparation. The employers were dumfounded by the difference the interpreter made in their perception of the deaf interviewee, which made them aware of this issue. From this example we can see how important it is for interpreters to be prepared, to know the person well and generally be ready to interpret for a job interview. It is unfair for deaf candidates if the interpreter is unsure about who is present, information about the company and so on.
We have also shown the same two videos in a masterclass that we held in Edinburgh in collaboration with Deaf Action, where we had three groups representing deaf people, employers and interpreters. We showed them the same two videos and followed exactly the same procedure and got a similar reaction from all three groups. It had an impact on all of them, for example the deaf participants fully appreciated how working with an unprepared interpreter could seriously damage their job prospects at interview and for the interpreters, the experience also underscored the importance of preparation. All three groups realised how important an issue preparation is.
Case studies
An important outcome of the project was to show different positive deaf role models in employment; success stories of those whose careers have gone well. So, we filmed various case studies of deaf people to share their experiences of how they have succeeded at work, including Toby Burton, who works in the finance industry.
We just picked one short clip from Toby’s video, as an example of a positive story that shows a deaf person being successful in his work and attaining a high-level position in industry. By showing what deaf people can do, the goal is particularly to encourage young deaf people by showing them what is possible through a variety of role models from a diverse range of backgrounds and in very different jobs, some working in deaf or sign language focused work and others not.
We also collected various case studies from a number of people across the three stakeholder groups of deaf people, interpreters and employers, in order to showcase good practice and give insights into experiences in deaf employment.
Our research showed that there did not seem to be enough visible deaf role models to show others how to succeed, as well as a lack of mentors, so it is even more important to have videos like these available.
Training course
The course curriculum contains a number of different modules, which are grouped to focus on the training needs of each of the three stakeholder groups. For the deaf participants, we focussed on their employment rights, such as interpreter provision as well as how to best work with an interpreter; and for the interpreter group, we gave similar information about how to build rapport with both the deaf candidate and the employers thereby creating a triadic relationship. For the employers’ group, we gave information about deaf people and their rights but also how to include them as employees in the workplace, dispelling any fears they may have and so on. So, the content of these modules can be made available to other institutions, such as universities or training centres and the videos and other training materials make up a whole package that can also be used for CPD workshops. In essence, these modules are available to pick and mix according to need and are freely available for anybody to use.
This is particularly useful for a deaf person starting a new job as they can select some of the materials to help their colleagues understand how best to work with them.
Example Session 4 is one example of one module content about what happens when deaf people graduate from college or university and how they then navigate the world of employment, including learning outcomes that link to videos and in this example, the video is a person from Ireland giving advice to deaf jobseekers.
Other materials
Other materials have been designed specifically for deaf communities in the form of a tailored E-Guide each for the UK, Ireland and Germany, which is like written guidelines but presented in the national sign language, in our case BSL, and give ten tips for deaf sign language users on getting a job. These videos will be useful for young deaf people because they are delivered in sign language.
We also produced a guide for employers, which comes in the form of a small booklet and it is aimed at employers who are preparing to bring a deaf employee into their workplace. It contains useful information gathered through our research from employers who told us what they needed to know.
The employer guide has been sent out to employers that were involved in the project so they can share it with others, and is available to download from the project website, so please feel free to disseminate it as widely as possible. We want to enable deaf people to have as smooth a transition into employment as possible.
Acknowledgements
The team owes a great deal of thanks to our project partners here in the UK. We could not have achieved all we did without strategic partnerships with different organisations, including the British Deaf Association, the Deaf Business Academy, the Association of Sign Language Interpreters UK, Deaf Scotland, Deaf Action, the Government Department of Work and Pensions, Alison Bryan at Deaf UK Jobs, Tony Barlow at Deaf2Work, as well as the former Scottish Association of Sign Language Interpreters; and VERCIDA, which is a platform for supporting employers who are interested in employing people with disabilities thereby increasing in diversity in the workplace. We were fortunate to work in partnership with VERCIDA as they gave us access to their sizable network of employers and can facilitate the dissemination of the training materials to employers.
We would like to extend our thanks to all the organisations involved across the UK that helped us deliver this project.
Finally, we could not have done carries out this project without the involvement of our deaf, employer and interpreter participants, so thank you to you all.
As mentioned in the March blogpost, the AHRC is keen to support the capacity building of young researchers, so Zoë McWhinney began her 20 day research internship with Heriot-Watt University at the beginning of June 2016 – spending two weeks on campus at Heriot-Watt University and then will be carrying out the rest of her internship by distance until the end of the project in October 2016. Zoë was involved in supporting the final Stakeholder Advisory Group meeting in June 2016, and is involved in various tasks for the remainder of the project (including drafting and translating this blogpost!).
Data collection
Our research focuses on what it is like for Deaf sign language users to be known largely through translation. The Deaf experience of being constantly interpreted is markedly in contrast to the general hearing population’s experience, even that of other linguistic and ethnic minorities. This experience often leads to an asymmetry of the ‘power dynamics’ and consequently the opportunities available to Deaf person in non-signing, hearing- dominated spaces. Some Deaf people’s well being may be adversely affected by the stresses created in such a situation – an area of exploration in this research project.
During the project, we have completed the following data collection:
3 parents of Deaf children participated in telephone interviews in spoken English
2 x focus groups were held with qualified sign language interpreters (7 interpreters in total) in spoken English
8 hearing colleagues of Deaf BSL users participated in face-to-face interviews in spoken English
3 Deaf BSL users who choose to speak sometimes in their professional work contexts participated in face-to-face interviews in BSL. We have coined the term ‘Deaf Contextual Speakers’ to explain how these Deaf BSL users sometimes use speech, even though they identify as BSL users.
2 x Community Participatory Groups were held in BSL with Deaf community members (7 in total). Each of the 2 sessions lasted for 2.5 to 3 hours and also had some activities to allow space for open discussions. The participants in this group were most responsive when watching and commenting on clips of scenarios with examples of Deaf and hearing people’s communication being interpreted by an interpreter.
5 x simulated recall interviews were held with Deaf professionals in BSL after one of the research team had filmed them in a real situation with interpreters. Originally we had planned to test the use of Think-Aloud Protocol (TAP) as a methodology (where people comment on what they are seeing while they are doing a task), but due to the complex circumstances and the reality of the participants being BSL users accompanied by interpreters in person, we adapted the approach to a ‘simulated recall (SR) interview’. The SR interviews involved participants being shown a video of themselves interacting with hearing persons via an interpreter and asking them questions about their experience of being interpreted based on what they could see in the video.
All the focus groups and interviews were semi-structured, with the participants given example questions and/ or topic outline beforehand. Time length for focus groups took from 1.5 to 3 hours, whilst the individual interviews took from 30 minutes to 1 hour each.
The research study gained full ethical approval from the Universities of Manchester and Heriot Watt.
Presentations of results
Presently, the team is conducting an in-depth qualitative analysis using both a thematic analysis approach and a critical inquiry methodology. The findings will be published in a range of academic journals related to social research, deaf studies and interpreting studies, as well as present at different conferences and community events. BSL access to the main findings will be made available online as well. For example, we presented some preliminary findings in a poster session at the 8th Critical Link International Conference on Community Interpreting between 29th June to 1st July 2016 at Heriot-Watt university; and will also be presenting a more detailed overview of results at the Association of Sign Language Interpreters UK Conference in Newcastle in September 2016.
Final Stakeholder Advisory Group meeting
On 7th June we had our third and final meeting with the Stakeholder Advisory Group (SAG) in Edinburgh, Scotland, with representatives from the British Deaf Association (Scotland), the Scottish Association of Sign Language Interpreters (SASLI) and Action on Hearing Loss (Scotland), where we presented the preliminary results from our analysis of the data. The role of the SAG has been to give the research team guidance on the research methods, data collection, recruitment of participants, interpretation of the results, and also about potential implications of the research, and we would like to thank all the people who have attended meetings throughout the project, including other representatives from Deaf Action in Edinburgh and Deaf Connections in Glasgow. One of the final recommendations from the last SAG meeting was for the project team to hold a roadshow to present the results of the project to members of the Deaf community in BSL. We will look for funding to enable us to do that.
What’s next?
The research team are now working with AC2.Com Productions and Mutt & Jeff Pictures to develop scripts for 3 short video dramas in BSL in order to illustrate some of the key findings from the research project. We plan to disseminate the videos through various platforms, including social media.
As well as working on the video production, Zoë will be assisting the research team to organise a dissemination event in September, where the whole team will present final results from the project and launch the videos. The event will be hosted in collaboration with our partner Action Deafness at their new venue at the Royal School for the Deaf in Derby – so look out for future announcements!
As many people in the Scottish Deaf community and BSL/English interpreting profession will know, this year is the first time that we have a group BSL/English interpreting students completing their final year of studying in a 4-year undergraduate programme. This is the only university in Scotland that offers a training programme that is approved by the Scottish Association of Sign Language Interpreters (SASLI) and the National Registers of Communication Professionals with working with Deaf and Deafblind People (NRCPD) as a route to professional qualification and registration to practice as a sign language interpreter. The first group of students will graduate in June 2016.
Students heading out on interpreting work placement for the first time
From January – May 2016 it is the current 4th year students’ final semester and one of the compulsory requirements is for students to complete an interpreting work placement. During this placement students will be shadowing professional interpreters in real interpreting assignments.
The aim of the interpreting work placement is to:
To give students the opportunity to access authentic ‘real-world’ interpreting situations
To provide students with the opportunity to observe the professional practice of qualified interpreters at work
To facilitate the opportunity for students to try interpreting in ‘real-world’ interpreting situations, in a safe and supported environment, where appropriate and with the agreement of all parties
To enable students to discuss, critique and reflect on their observations of other interpreters and their own professional practice
The interpreting work placement will take place in two 1-week blocks (22-26 February and 4-8 April).
The organisation of the interpreting work placement would not be possible without the support of the key organisations SASLI and NRCPD who have endorsed that interpreters can received Continuing Professional Development (CPD) points for acting as mentors.
But even more importantly, it could not take place without the collaboration and support of professional sign language interpreters in Scotland, who are giving their time, energy and commitment to supporting these students. We would like to specifically thank the list of interpreters below who have agreed to take on students this year:
Paul Belmonte (Edinburgh)
Andy Carmichael (Edinburgh)
Lesley Crerar (Aberdeen)
Andrew Dewey (Ayr)
Linda Duncan (Fife)
Marion Fletcher (Edinburgh)
Rebecca Goodall (Inverness)
Donna Jewell (Falkirk)
Brenda Mackay (Fife)
Paula Marshall (Denny)
Robert McCourt (Glasgow)
Mary McDevitt (Falkirk)
Drena O’Malley (Glasgow)
Mark Sherwin (Edinburgh)
Linda Thomson (Glasgow)
Helen Dunipace
Yvonne Waddell
We know that there are many more interpreters all over Scotland that might be interested in becoming a student mentor, and in future years we will be looking for more mentors as student numbers increase, so if you are interested please contact Jemina Napier as the interpreting placement coordinator by email.
We would also like to thank Deaf BSL users in Scotland in advance for their support of our students, and hope that you will encourage them in their efforts to develop their skills to become professional interpreters. The students to look out for are:
Rachel Amey
Jude Caldwell
Greg Colquhoun
Niamh Cochrane
Virginia Dugo
Scott Ellerington
Rachel Evans
Jill Gallacher
Nadia Krupova
Helena Laverty
Lisa Li
Grace McNeill
Samuel Rojas
Marie Elliott
Community placement
We would also like to acknowledge the support of all the organisations throughout the UK that are providing community work placement experiences for our 3rd year students. The 3rd year placement is different from the 4th year placement as it takes place over a whole year, and students are required to work in two different organisations where BSL is used every day so that they can have immersion in the language and culture of Deaf people every day. While on placement, the students do project work or other tasks (but not interpreting) and participate in general organizational activities.
This year is the second year that organisations have hosted students on community work placements, and we are appreciative of the efforts that the organisations go to in order to support our students to develop their BSL skills and Deaf community and cultural awareness.
It has been a steep learning curve for us at Heriot-Watt University and also for our community organisation partners, as this is a new approach to sign language interpreter training and as far as we know Heriot-Watt University is the first programme in the world to require students to take a 1-year language immersion community placement. We could not make this happen without the close collaboration with Deaf BSL users and Deaf community organisations.
Graham H. Turner, Coordinator of the BSL Community Work Placements notes that:
“Heriot-Watt’s BSL team members have many years’ experience of interpreter education. We were very conscious of the widespread feeling that university-educated interpreters tend to know what to do in the classroom, but do not have the kind of profound appreciation of Deaf lives that comes from being close to the ‘beating heart’ of the community. Our partners are working with us to change that. We simply couldn’t create on our campus the kind of learning experience that they can offer. If our programme fully achieves its aims, it will be in no small part because of the contribution partner organisations are making to developing the interpreters that they wish to work with in the future.”
So we would like to thank all of the organisations listed below who have so far hosted students on community work placement:
We are always looking for new community partners, so any interested organisations can contact Graham H. Turnerby email.
Finally, Gary Quinn, the Head of the BSL section at Heriot-Watt University says:
“As programme coordinator, I would like to thank all the interpreters and staff in the community organisations that are supporting the degree at Heriot-Watt University by giving our students the opportunity to develop more ‘real-life’ awareness of the Deaf and Interpreting communities in the UK. I know the students have appreciated your efforts to support their learning and each of you has contributed a vital part to our students’ development, which will undoubtedly make our graduates better prepared for the professional world of BSL/English Interpreting.”
In sum, we would like to acknowledge and thank everyone who has direct involvement in supporting students studying BSL/English interpreting at Heriot-Watt University and we wish our 4th year students who are about to go out on interpreting placement the best of luck and hope that they have a positive experience.
