Interpreting in the Mental Health Setting May, 2018 El Paso, Texas Click to edit Master title style • Broadly: – What is mental health interpreting – How is it different from other ‘terping? – Who you will work with Click to edit Master subtitle style – How to handle various situations – Taking care of yourself This will not make you an expert! Presented by Steve Hamerdinger © 2018 All Rights Reserved • Community interpreting vs. mental health interpreting: what’s the difference? • “I Don’t DO mental Health interpreting!” – Are you sure??? Mental health interpreting can happen in unexpected times and places •Medical settings ● Educational settings •VR/social services • Interpreter training has been a response to • There are several models of interpreting: historical antecedents – Helper – Machine (or conduit) – Communication facilitator – Ally – Cultural mediator Steve Hamerdinger, LifeSigns. © 2018. All rights Reserved Page 1 Interpreting in the Mental Health Setting May, 2018 El Paso, Texas • Cultural mediation model is growing in acceptance – especially since start of 2000s (c.f. Executive Order 13166) – Driven, in part, by spoken language interpreters • Reaction to the Conduit Model • Opposition from some because it is “unethical” Equal Access Equal Outcome Thought: – Attempts to put interpretation into a cultural – Charge arises from a world view informedIs itby better the to context “machine model” allow a – “Our job is to give ‘equal access’ to the • For example: “State School” is misleading – misperception information!” especially when talking to “mental health” types! based on • Another concern relates to trainingculturally and loaded professional maturation material to adversely effect – Beginning interpreters untrained/unprepared to consumer handle this level of professional responsibility outcomes? • Opposition from some because it is “unethical” • Alabama MHI concept is an outgrowth of – Charge arises from a world view informed by the both the Cultural and Ally models with “machine model” important twists – “Our job is to give ‘equal access’ to the – Several key precepts: information!” •The interpreter is part of the treatment team and • Another concern relates to training and impacts the treatment process professional maturation •The interpreter is usually the only one on the team who is aware of the complex interplay of various – Beginning interpreters untrained/unprepared to sequelae of deafness handle this level of professional responsibility •Interpreting is a practice profession rather than para-profession Steve Hamerdinger, LifeSigns. © 2018. All rights Reserved Page 2 Interpreting in the Mental Health Setting May, 2018 El Paso, Texas • Developed from a knowledge-driven viewpoint • Accurate interpretation involves: rather than a skills-driven viewpoint – The structural differences between languages – Early efforts (1995 – 2003) in Missouri – How each language is seen and used by each • “Minimum Competencies” culture – Alabama State Code – 2003 Prior to MHIT • Emphasis on training, application most training in – The “thought worlds” of the parties involved and demonstration • Mandated 40 hours of specialized MH interpreting training – the MHIT Project were of the (Full information at www.mhit.org) “how do you sign _________” variety “What’s Going On With You?” • Further, accurate interpretation depends • In a psychiatric hospital between night nurse and clear understanding of: patient • In an emergency room between a doctor and a quietly – Context seated patient – Intent of the communicants • In an emergency room between a doctor and a patient – Purpose of the message with his foot facing the wrong way • In the police station between mother and son • Between close friends who haven’t seen each other in a long time Cheerfully plagiarized from Robyn Dean Cheerfully Plagiarized from Dean and Pollard • Clinicians use language to test hypotheses as to what is going on with a consumer – What things (“demands”) might be operating in the following opening of a clinical session: “How have you been doing since the last time we met?” • First we have to understand how mental illness overlays the process Cheerfully plagiarized from Robyn Dean Steve Hamerdinger, LifeSigns. © 2018. All rights Reserved Page 3 Interpreting in the Mental Health Setting May, 2018 El Paso, Texas • DSM-V Definition: • Major types of mental illness: – A mental disorder is a syndrome characterized by – Psychosis clinically significant disturbance in an individual's •Fundamental mental derangement (as cognition, emotion regulation or behavior that reflects schizophrenia) characterized by defective or lost a dysfunction in the psychological, biological, or contact with reality developmental processes underlying mental functioning. • An expectable or culturally approved response to a Remember: common stressor or loss, such as the death of a loved The signs for disorders I use here may be OK for using one, is not a mental disorder. with professionals but are not effective with consumers Emphasis mine • Major types of mental illness: • Major types of mental illness: – Psychotic disorders – Psychotic disorders •Schizophrenia is the most familiar form •Schizophrenia is the most familiar form – It is organic and incurable – Delusions – Most admissions and residents of public mental hospitals – Hallucinations – Chronicity and severity mean costly and difficult to treat – Disorganized thinking/speech – Public policy - homelessness, notorious crimes – Grossly disorganized or abnormal motor behavior Sensory Modalities • Erroneous beliefs • Auditory that usually involve • Visual a misinterpretation • Olfactory of perceptions or • Gustatory experiences, not • Tactile supported by reality – Bizarre and non- bizarre https://www.youtube.com/watch?v=LWYwckFrksg Steve Hamerdinger, LifeSigns. © 2018. All rights Reserved Page 4 Interpreting in the Mental Health Setting May, 2018 El Paso, Texas “I am Godd.” “I used to play with Napoleon as a young boy. We built a wagon together.” • Major types of mental illness: “My mother is Elizabeth Taylor. My father is Andrew Coumo.” – Psychosis •Schizophrenia is the most familiar form “The TV tells me what to do and I communicate with the TV by placing notes into the vents in the back of the TV.” – It is organic and incurable – Most admissions and residents of public mental hospitals “I am pregnant with 99 babies. They won’t come out.” – Chronicity and severity mean costly and difficult to treat “I am a CIA baby. The CIA talks to me through my hearing aids and tells me – Public policy - homelessness, notorious crimes what to say.” “Orange is the CIA, Green is the army, Black is evil – except for interpreters…” “Every night someone sneaks into my room and takes apart my clothes and then re-sews them a size smaller.” • Major types of mental illness: – Psychosis •Schizophrenia is the most familiar form – Positive symptoms: thought insertion and broadcasting, loose association, hallucinations (auditory visual, tactile, olfactory,) delusions, paranoia, – Negative symptoms: flat affect, lack of pleasure and motivation, and social isolation • Major types of mental illness: • Major types of mental illness: – Bi-polar and related disorders – Bi-polar and related disorders •Manic – Can be accompanied by delusions and •Hypomanic hallucinations •Major depressive – Behavior problems when manic •Mixed – Possible suicide when depressed Steve Hamerdinger, LifeSigns. © 2018. All rights Reserved Page 5 Interpreting in the Mental Health Setting May, 2018 El Paso, Texas • Major types of mental illness: • Major types of mental illness: – Bi-polar and related disorders – Depressive Disorders •Thought to have genetic, biological and environmental causes • Major types of mental illness: • Major types of mental illness: – Anxiety disorders – Trauma- and Stressor-Related Disorders •Panic Disorder •Post-Traumatic Stress Disorder •Phobias •Generalized •Anxiety Disorder There are enough phobias out there to give you phobophobia – Schizoid Personality Disorder: • Major types of mental illness: Individuals with schizoid personalities tend to be introverted, withdrawn, solitary, emotionally cold, and distant. They are often absorbed with their own thoughts – Personality Disorders and feelings and are fearful of closeness and intimacy with others. •Borderline Personality Disorder* is common and – Paranoid Personality Disorder: People with paranoid personality disorder are often untrusting, unforgiving, and tough to treat prone to angry or aggressive outbursts without justification, because they – You absolutely must avoid dual relationships in this perceive others as unfaithful, disloyal, condescending, or deceitful. This type of person may also be jealous, guarded, secretive, and scheming, and may appear to case - You cannot let yourself become a pawn! be emotionally “cold” or excessively serious. – Schizotypal Personality Disorder: These people may have odd or eccentric manners of speaking or dressing. Strange, outlandish, or paranoid beliefs and thoughts are common. They may react inappropriately or not react at all during a conversation, or they may talk to * People with this disorder are prone to unpredictable outbursts of anger, which sometimes manifest in self-injurious behavior. Borderlines are highly sensitive to rejection, and fear of abandonment themselves. They can also display signs of “magical thinking” by saying they can may result in frantic efforts to avoid being left alone, such as suicide threats and attempts. see into the future or read