Understanding Language Barriers to Mental Health Services of Non-Anglophone and Non-Francophone Patients From the Perspective of Psychiatrists, Administrators, and Patients
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Kasraei, Farzad
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Kasraei, Farzad. 2019. Understanding Language Barriers to Mental Health Services of Non-Anglophone and Non-Francophone Patients From the Perspective of Psychiatrists, Administrators, and Patients. Master's thesis, Harvard Medical School.Abstract
Introduction: Canadian patients face barriers in access to mental health care if they do not speak the official languages of Canada English or French. Canada does not have a law supporting the use of professional interpreters and many practitioners and hospitals must rely on informal interpreters despite the proven risks for patients (for example patient safety and quality of care) and health providers (for instance Malpractice and complaints). We conducted a qualitative evaluation to better understand the language barrier for mental health access from the perspective of patients, mental health clinicians and healthcare administrators.Methods: Data collection consisted of 21 in-depth interviews with 11 patients and 10 psychiatrists and high rank officials. We performed an inductive content-focused analytic approach to understand and Interpret experience of patients and psychiatrists/administrators. We transcribed audio recorded interviews , and translated them into English and reviewed in detail then loaded into Dedoose. After a careful review, we identified the texts relevant to the research questions and coded them for each group of patients and doctors and admins separately, including labels, definitions and illustrative quotes with specific examples from the transcripts for each code. After another comprehensive review, we completed content analysis, and applied codes to similar texts on data. Then we grouped similar codes into broader categories and an iterative approach for category development was used. We labeled each category , and elaborated and illustrated them with excerpts from the data. We examined categories then interpretively and grouped them together linking ideas to form a broader concept, from which we developed analysis of the research .
Results: The study found that availability of professional language assistance rehumanizes non-English, non-French language speakers seeking mental health services in Quebec. Providing mental health services by using professional interpretation makes the patients feel they have been treated as a human being and also patients feel they receive appropriate and effective care. Another finding was that while both groups of patients and psychiatrists trusted more in professional interpreters rather than family members or a lay person or hospital staff, there were certain cases that mistrust could happen. Lack of a proper provincial language policy about non-francophone non-anglophones and also lack of language standards in healthcare settings were other significant issues raised by participants.
Conclusions: Lack of a law in Canada to support the right of patients for having access to such language assistance services was prominent. And furthermore, the battle between English and French leads to neglecting other patients who don’t speak either of them. Also, hospitals lack standards of care for those non-francophone-non-Anglophone patients can cause more issues. Integrating this to action and policies and budget forecasts and make hospitals have it as a standard of care are recommended.
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