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Use of Language Services in Psychiatric Disability Rehabilitation and Support Services - Information and Guidelines (October 2006)

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• Key message
• Policy context
• Language services funding
• ONCALL credit lines
• Guidelines for using interpreters in PDRSS settings
• Guidelines for translations in PDRSS settings
• Attachment 1: Good practice in working with interpreters in mental health settings

Key message

Psychiatric disability rehabilitation and support services (PDRSS) are required to use professional language services (interpreting and translating) for consumers and carers who cannot speak English, or who speak limited English.

For most PDRSS, access to funding for language services (interpreting and translating) is via a credit line provided by ONCALL on behalf of Department of Human Services (DHS). A small number of PDRSS receive direct funding for language services and do not have access to a credit line.
This document provides:

• an overview of the policy context for using language services in PDRSS.
• information about language services funding in the PDRSS sector, including recent changes to funding arrangements.
• information about ONCALL credit lines, including conditions of use for PDRSS eligible to access language services funding through this source.
• guidelines for using interpreters in PDRSS settings.
• guidelines for translations in PDRSS settings.
  

Policy context

Effective mental health care depends on good communication with consumers and families/carers. Inadequate communication with people who have limited English proficiency restricts their access to and understanding of mental health services, and also has a profound impact on their experiences and quality of their care when they do gain access. Access to culturally and linguistically appropriate information is also vital in educating consumers' families and carers, and supporting them in the caring role.

The Standards for Psychiatric Disability Rehabilitation and Support Services (2004) state that PDRSS should deliver non-discriminatory support that is sensitive to the gender and social and cultural values of service users and their families and communities. Examples include the standards relating to access ('access processes should be culturally and language sensitive'-Standard 11.2.3) and assessment & review ('assessment [should] be conducted in the preferred language of the participant and their carers'-Standard 11.3.8).

It is the responsibility of the PDRSS provider to deliver services in a manner that is understood by the consumer. The Department of Human Services' (DHS) Language Services Policy outlines the requirements necessary to enable people who cannot speak English, who speak limited English, or who use sign language as their primary mode of communication, to access professional interpreting and translating services when making significant life decisions and where essential information is being communicated.

Language services funding

The 2005-06 State Budget provided an additional $55,000 recurrently to allow PDRSS to access specific funding for language services.

Between August 2005 and September 2006, all PDRSS accessed this funding via a credit line. Changes to DHS language services funding, applicable from 1 October 2006.

• Most PDRSS continue to access language services funding via a credit line, but there is a new provider (ONCALL)
• A small number of PDRSS will receive direct funding for language services (based on a proportional allocation of the overall funding) and will not be eligible to use the credit line. This applies to PDRSS that are part of organisations using significant amounts of language services ('large-scale' users)

For more information about the changes to language services funding go to www.dhs.vic.gov.au/multicultural

ONCALL credit lines

Interpreting and translating services provided by ONCALL on behalf of DHS are delivered through specific 'credit lines'. In metropolitan regions, there are separate credit lines for specific programs, including a specific PDRSS credit line. In rural regions, credit line funding is pooled across all relevant DHS programs, so there is one credit line per region.

Credit lines have a monthly spending cap, and can be accessed on a 'first-come, first served' basis by authorised services.

Bookings for language services are made directly with ONCALL (Tel: 03 9867 3788). Agencies authorised to use a credit line are given a personal identification number (PIN), which they quote when requesting translating or interpreting from ON CALL (see below).

Agencies can find their PIN on the Funded Agency Channel. Alternatively agencies can find out their PIN by telephoning ONCALL on the above number or by placing a query through email at language.services@dhs.vic.gov.au

Conditions of use for PDRSS

The following specific guidelines apply to the use of ONCALL credit lines by PDRSS.

1. The credit line can be used for on-site interpreting (of all community languages and Auslan), telephone interpreting, and translations costing under $500 (see point 7).
2. Language services provided through the credit line are restricted to direct service delivery situations, such as interviews, consultations with consumers and/or their families and carers, or group situations that are focused on mental health outcomes for consumers.
3. Language services can be provided to families and carers, as well as consumers, where the involvement of the former is integral to achieving agreed service outcomes.
4. The credit line PIN obtained by the PDRSS credit line must be used only when providing PDRSS activities funded by the Mental Health Branch, DHS. The use of the PDRSS credit line when the client is receiving other services-for example, legal aid-is not permitted.
5. Agencies using the credit line should put in place strategies to ensure efficient use of the interpreting and translating resources available through the credit line. This should include: strategies for minimising 'no shows' (e.g. placing a reminder call to the client the day before the appointment); use of telephone rather than on-site interpreting when conveying brief or perfunctory information; and, where possible, 'grouping' of appointments for clients who speak the same language.
6. Agencies are responsible for ensuring that their staff are familiar with processes for accessing the credit line and with guidelines for its use, including (1) the present guidelines (2) information provided by ONCALL, and (3) the DHS Language Services Policy.
7. Translations costing in excess of $500 require approval from the DHS Mental Health Branch. This process will be handled by ONCALL when the service is requested.
8. ONCALL will give priority to the translation of documents that facilitate direct client care or support.
9. The ONCALL credit line is not intended to be used for the translations of large documents, nor documents of an administrative or promotional nature (for example, minutes of meetings; annual reports; corporate or business plans; mission statements or organisational goals; advertising and agency publicity).

Guidelines for using interpreters in PDRSS settings

PDRSS have a 'duty of care' responsibility to ensure that an accredited interpreter is used when:

• a consumer, carer or family member does not fully understand what is being told to him or her because of difficulty in communicating in English.
• a consumer, carer or family member requests an interpreter.
• a staff member cannot understand the information being conveyed by a consumer, carer or family member.
• the client's mental health outcomes are likely to be compromised by inability to converse in his or her preferred language.

The use of families and carers-and particularly children under 18 years-as interpreters should be avoided, except in emergency situations where no viable alternative option exists.

Staff should inform consumers and their families/carers of their right to use interpreting services if and when needed.

The DHS Language Services Policy provides detailed guidelines for when services must use an interpreter. The need for an interpreter should be assessed at entry/intake to the service and whenever critical information is being imparted. Examples of key points in the PDRSS process where an interpreter may be needed include:

• During assessment of service needs.
• When obtaining consent to release of information.
• In the development and review of Individual Program Plans.
• In crisis situations and/or where the consumer's mental health has deteriorated.
• Where carers or family members with difficulty in English communication are present or become involved in the consumer's care.

When working with interpreters, PDRSS staff should observe the 'good practice' principles outlined in Attachment 1.

Further information about using interpreters and useful tools

Action on Disabilities Within Ethnic Communities (ADEC) provides information and training on the use of interpreting services, and other aspects of service provision to multicultural communities (telephone 03 9480-1666).

The VTPU publication, Guidelines for Working Effectively with Interpreters in Mental Health Settings, (External link) provides detailed information about the use of interpreters in mental health services. The document is available online at: www.vtpu.org.au . A training DVD for working with interpreters in a mental health setting has also been developed by the VPTU.

For advice and guidance on working with Auslan interpreters, consult the Working With An Auslan (Australian Sign Language) Interpreter Fact Sheet, available from the VicDeaf website.

Interpreting symbols and cards for consumers to identify their language and need for interpreting assistance are available from the Victorian Office of Multicultural Affairs , (External link) emailing interpretercard@dvc.vic.gov.au or phoning 9208 3166.

To assist a consumer to identify the language they speak services can develop a poster from the tool Find your language in the Health Translations Directory

Guidelines for translations in PDRSS settings

In the case of translations of information sheets and documents, agencies are encouraged to check whether relevant translated information currently exists and to examine opportunities for sharing such information with other organisations, or adapting it.

The Mental Health Branch produces a range of translated information for non-English speaking consumers and carers. Other sources of translated information on mental health topics include:

• Action on Disabilities Within Ethnic Communities: telephone 03 9480-1666 to access audio tapes on mental illness in a range of community languages
• Victorian Transcultural Psychiatry Unit (External link)
• Health Translations Directory
• Better Health Channel (External link)
• Multicultural Mental Health Australia (External link)
• SANE (External link)
• NSW Transcultural Mental Health Centre (External link)

Attachment 1: Good practice in working with interpreters in mental health settings

• Ensure that you know which language (and dialect) the consumer speaks: do not assume the language spoken from the consumer's country of birth
• Check whether there may be an ethno-political divide between consumer and interpreter
• Check whether the consumer and interpreter may know each other socially (a possibility in small ethnic groups)
• Check whether the gender of the interpreter is important to the interview
• Ensure that the interpreter knows the purpose of the interview
• Be aware of the needs of the interpreter (particularly in stressful and difficult circumstances) and keep in mind the complexity of the interpreter's task
• Introduce all people present to one another and explain the role of each person
• Explain to the consumer and carers/family members that the interpreter is bound by a code of ethics and is required to observe confidentiality
• Speak to the consumer directly: do not say to the interpreter "Ask her if…"
• Use short simple sentences and speak in plain English, avoiding the use of jargon, slang, and colloquialisms
• Allow enough time for questions and answers to be interpreted-this may extend the time needed for the interview
• Do not ask for a 'literal translation' as mental health terms may not have a direct translation in the consumer's language. The interpreter's role is to convey an equivalent meaning.
• Be aware that the interpreter is not a mental health expert and should not be asked about the mental state of the consumer
• Although the interpreter may be asked about cultural background issues, he/she is not a cultural consultant, and may be from a different class or culture to the consumer
• Review the session with the interpreter after the interview, and ask whether there were any interpreting difficulties
• Include the interpreter in any debriefings necessitated by incidents or occurrences that he or she was party to.