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Approximately 42 million people worldwide are displaced due to persecution, war or natural disaster (UNHCR, 2008). Many seek refuge in countries far from their own. Where host countries supply refugee mental health services, these services rely heavily on the work of interpreters. Despite interpreters being exposed to significant client distress, little attention has been paid to the impact of mental health interpreting on the well‐being of interpreters themselves. This study set out to build on limited previous work in this area.A total of 157 interpreters contracted by Glasgow Translating and Interpreting Service, UK, were surveyed in April 2007. Responses were analysed using grounded theory analyses. Of the 18 interpreters who responded, 56% reported having been emotionally affected by mental health interpreting, 67% reported that they sometimes found it hard to put clients out of their minds and 33% reported that interpreting for clients with mental health difficulties had had an impact on their personal life. Respondents experienced a range of emotions in relation to their work, including anger, sadness, hopelessness and powerlessness, and 28% reported sometimes having difficulty moving onto their next job due to distress associated with a previous client. These findings are discussed in relation to good practice guidelines.

Working across languages is playing an increasingly important role in the delivery of mental health services, notably through psychotherapy and psychological therapies. Growing awareness of the complex processes that ensue in working across languages, including the presence and role of an interpreter, is generating new conceptualisations of practice, but there is a need now to evidence how these impact on service users. The paper aims to discuss these issues.

This paper discusses the model for working with interpretation developed by Mothertongue multi-ethnic counselling service, which conceptualises the therapeutic process as working within triangular relationships consisting of service user, therapist and interpreter. Second, the paper discusses the qualitative, practice-near methods applied in, and findings from a pilot study to evaluate the interpreter's role.

Three patterns of response to interpreters were identified: negative impacts on the therapy, the interpreter as conduit for therapy and the therapist and interpreter jointly demonstrating a shared enterprise. It is concluded that the method and findings of the pilot justify a larger study that will further evaluate the experiences of service users and continue to develop and test conceptualisations for best practice.

Working across languages is now recognised as an increasingly important aspect of therapy in contexts where migration has created new demographics. This paper contributes to the discussion of working therapeutically with people with mental health difficulties across languages. Its originality lies, first, in the discussion of a new clinical approach to working with interpreters, and second in the methods used to access the views of service users about their experiences of interpreters.

This paper explores the central role a language interpreter can play in the process of the therapeutic relationship. Although others have described the changes to the therapeutic dyad that the presence of a third party (an interpreter) brings, little attention has been paid to the advantages and additional opportunities of this altered therapeutic situation. This paper details these gains and further argues that clinicians who are willing to gain experience of working with interpreters will find that benefits accrue at the micro and macro levels: at the micro level, through enhancement of their work with individual non English speaking clients, and at the macro level through learning about different cultural perspectives, idioms of distress and the role of language in the therapeutic endeavour. This is in addition to developing skills to fulfil legal and professional requirements relating to equity of service provision. Some ideas are offered to explain the negative slant than runs throughout the literature in this area and tends to colour the overall discussion of therapeutic work with interpreters and, before the final section, makes some specific suggestions which may help maximise the gains possible in such work while reducing difficulties.

The purpose of this paper is to systematically appraise the effect of use of interpreters for mental health problems in old age. The primary objective of the review is to assess the impact of a language barrier for assessment and management in relation to mental health problems in the old age. The secondary objectives are to assess the effect of the use of interpreters on patient satisfaction and quality of care, identify good practice and make recommendations for research and practice in the old age mental health.

The following data sources were searched for publications between 1966 and 2011: PubMed, PsycINFO, CINAHL and Cochrane Library. The authors found in previous reviews that a substantial number of papers from developing and non-English speaking countries are published in journals not indexed in mainstream databases, and devised a search strategy using Google which identified a number of papers, which could not be found when the search was limited to scientific data bases only (Farooq et al., 2009). The strategy was considered especially important for this review which focuses on communication across many different languages. Thus, the authors conducted a search of the World Wide Web using Google Scholar, employing the search term Medical Interpreters and Mental Health. The search included literature in all languages. The authors also searched the reference lists of included and excluded studies for additional relevant papers. Bibliographies of systematic review articles published in the last five years were also examined to identify pertinent studies.

Only four publications related specifically to “old age” and 33 addressed “interpreting” and “psychiatry” generally. Four articles presented original research (Parnes and Westfall, 2003; Hasset and George, 2002; Sadavoy et al., 2004; Van de Mieroop et al., 2012). One article (Shah, 1997) reports an “anecdotal descriptive account” of interviewing elderly people from ethnic backgrounds in a psychogeriatric service in Melbourne and does not report any data. Therefore, only four papers met the inclusion and exclusion criteria and present original research in the field of “old age”, “psychiatry” and “interpreting”. None of these papers present UK-based research. One is a quantitative study from Australia (Hasset and George, 2002), the second is a qualitative study from Canada (Sadavoy et al., 2004), in the third paper Van de Mieroop et al. (2012) describe community interpreting in a Belgian old home and the final paper is an American case study (Parnes and Westfall, 2003).

Interviewing older patients for constructs like cognitive function and decision-making capacity through interpreters can pose significant clinical and legal problems. There is urgent need for training mental health professionals for developing skills to overcome the language barrier and for interpreters to be trained for work in psychogeriatrics.

The literature on working through interpreters is limited to a few empirical studies. This has serious consequences for service users such as lack of trust in services, clinical errors and neglect of human rights. Further studies are needed to understand the extent of problem and how effective interpreting and translating services can be provided in the routine clinical practice. It is also essential to develop a standard of translation services in mental health that can be measured for their quality and also efficiency. At present such a quality standard is not available in the UK, unlike Sweden (see www.regeringen.se/sb/d/3288/a/19564). This omission is disturbing – especially when decisions on human rights are being considered as part of the Mental Health Act. Such a standard can best be achieved by collaboration between medical profession and linguists’ professional associations (Cambridge et al., 2012).

Whilst translation/interpretation has been addressed more generally in mental health: specific considerations related to old age psychiatry are almost absent. This needs urgent rectification given that a large proportion of older people from BME communities will require translation and interpretation services.

In a companion paper, we have argued that therapeutic work with interpreters has been viewed more negatively than is warranted, and that the inherent advantages of this way of engaging with the non English speaking client have been minimised or ignored. This paper seeks to explore the aspects that may underlie the reluctance of clinicians to engage with therapeutic work with interpreters. Difficulties often appear to be centred on the anxieties provoked by working in the three‐way therapeutic relationship rather than in the traditional therapeutic dyad. It is also possible that the highly traumatised nature of some clients, who may be refugees or asylum seekers fleeing from political violence, also complicates such work. The intention in this paper is to consider both the dynamics of the three‐way relationship and the impact of traumatic experience, when relevant, on therapeutic work with interpreters, and to suggest how the pulls inherent in such work might be managed. It is hoped that by exploring these problematic areas, some light can be shed on the difficulties that all clinicians can experience but can equally overcome.

We examine the concepts of stress, distress, and eustress and develop three tenets that are used to relate these concepts to three major theories or models of occupational stress. Selye's concept of eustress or “good stress” appears to be largely ignored in the literature, while the Yerkes Dodson Law is illustrated as a model for management practice. We suggest that the meaning assigned to the word stress has shifted from Selye's original formulation, and that this shift, in conjunction with the use of the Yerkes Dodson Law leads to inappropriate management of stress in organizations. We conclude that the concept that some stress is good and enhances performance should be rejected in favour of more useful and accurate concepts.

The literature tends to use ‘asylum seeker’ and ‘refugee’ interchangeably, creating uncertainty about the mental health of asylum seekers. However, asylum seekers occupy a unique position in British society which differentiates them from people with refugee status and which may have implications for their mental health. For example, ‘asylum seekers’ are supported and accommodated in dispersal areas under the National Asylum Support Service and they are not entitled to work. This mixed‐methods study investigated asylum seekers' symptoms of psychological distress, using mental health screening questionnaires (N = 29) and asylum seekers' subjective experiences of the asylum process, its potential impacts on their mental health, and participants' suggestions for tackling mental health needs, using in‐depth interviews (N = 8). Asylum seekers, refugees and practitioners working with asylum seekers were consulted from the outset regarding the cultural sensitivity of the measures used. Given the potential limitations of using ‘idioms of distress’ across cultures, interview data provided rich descriptive accounts which helped locate the mental health needs that the asylum seekers experienced in the specificities of each participant's social context. Asylum seekers originated from 13 countries. The results revealed that psychological distress is common among asylum seekers (for example anxiety and post‐traumatic stress), but so are post‐migratory living difficulties (for example accommodation, discrimination, worry about family back home, not being allowed to work). They also report mixed experiences of health and social care services. These results suggest that asylum seekers' unique social position may affect their mental health. Implications for practice are presented and potential limitations highlighted.

This article reports the outcomes of a study on communication support, commissioned to develop a borough‐wide strategy in 2003 by the London Borough of Tower Hamlets.The research stems from a recognition of communication as a key to successful delivery of public services and enhancement of a multicultural community.The focus is on ‘communication’ (rather than ‘language’), since it captures issues beyond the exchange of information through words: interpersonal interactions and relationships, techniques and modes of organising information exchange. Language is a key component within the broad ambit of communication mechanism and skills. Hence interpretation and translation are perceived as models of communications support alongside advocacy, integrated team, multilingual professional team, family/friends and minors, supported language, symbols and signs, and Plain English.While engaging in the debate and highlighting some of the broader issues concerning communication support services, the focus is on the following main issues:• policy frameworks and guiding principles in communication support• methods and techniques for needs assessment, monitoring and evaluation of communication support• communication support provision in Tower Hamlets including quantifying need, actual state of provision and users' perceptions.Probably among the first of its kind, the strategy draws on existing knowledge and good practice to develop a common framework for public services in Tower Hamlets. It is believed that it will serve a pioneering role in co‐ordinated existing and developing coherent approaches to communication support.

This article examines current issues in the use of interpreting services, as experienced by refugees and asylum seekers in the UK. The paper begins with a review of relevant literature on interpreting services and relates it to the service context and the specific needs of refugees and asylum seekers. There follows a discussion of a small‐scale research project carried out with interpreters working in these services. Recommendations are made which include the need to educate all three parties (the professional employing the interpreter, the interpreter and the client) in not only best practice and practical techniques of working with interpreters, but also broader issues such as the complexity of the interpreting process, the importance of establishing trust, competing agendas and negotiation of meaning that are implicit in the interpretation process.