Types of Interpreters: Benefits & Limitations

Professional In-House Interpreters

Description: Agency employs and trains interpreters who are available for interpreting languages that are most frequently represented in the particular patient population.

Benefits	Limitations
Available during operating hours. Consistent personnel fosters rapport and trust with clients and health care providers.	Not a feasible, cost-effective alternative for small agencies. Not all languages covered.

On-Call Interpreters

Description: Agency maintains a list of interpreters of various languages who are willing to interpret as need arises. May be paid or volunteer.

Benefits	Limitations
Covers a broader variety of languages.	May have questionable interpretation abilities unless there is testing or accreditation of interpreters May be trained or untrained. Untrained interpreters make more errors: omissions of pertinent information, additions of information that the client did not say, substitutions of information, condensed summaries that omit details, and breaches of confidentiality (Lee, 1977; Marcos, 1979) Dependent upon the availability of the interpreter at the time one is needed.

Benefits

Limitations

Covers a broader variety of languages.

May have questionable interpretation abilities unless there is testing or accreditation of interpreters
May be trained or untrained.
Untrained interpreters make more errors: omissions of pertinent information, additions of information that the client did not say, substitutions of information, condensed summaries that omit details, and breaches of confidentiality (Lee, 1977; Marcos, 1979)
Dependent upon the availability of the interpreter at the time one is needed.

Bilingual Staff

Description: Health care staff (nurses) or support staff (e.g., dietary aides or security personnel) are temporarily utilized as the need arises to interpret for patients with whom they would otherwise have no contact.

Benefits	Limitations
Availability	Inconsistent availability May experience conflict of duties between the roles for which they were hired and the ad hoc interpreter duties. May create resentment in staff member or co-workers. May be unfamiliar with specialized vocabulary. Usually untrained. Untrained interpreters make more errors (see above).

Family Members of Friends

Description: Family or friends who accompany the patient to the health care organization are used as interpreters

Benefits	Limitations
Availability	Untrained, thus likely to make errors (see above). Usually unfamiliar with specialized vocabulary. May interfere with family dynamics, confidentiality, or revelation of sensitive information. Use of children for interpretation is never appropriate except in emergency situations until other alternatives can be arranged.

Benefits

Limitations

Availability

Untrained, thus likely to make errors (see above).
Usually unfamiliar with specialized vocabulary.
May interfere with family dynamics, confidentiality, or revelation of sensitive information.
Use of children for interpretation is never appropriate except in emergency situations until other alternatives can be arranged.

Telephone and Video Based Interpreter Services

Description: Commercial companies or local agencies provide off-site interpreting services via phone or video connections either with the patient and provider together or at different locations. Phones with two handsets are available for examination rooms. Multiple companies provide the service. Posted rates range from approximately $2.00 to $4.00 per minute for phone based interpreting, and some companies charge other fees.

Examples of companies include:

Language Line Services (formerly AT&T) www.languageline.com
1-800 Translate www.1-800-translate.com
Phone Interpreters www.phoneinterpreters.net

Benefits	Limitations
Cover up to 170 languages Available 24 hours/day, 7 days/week. Many interpreters are native speakers with training in interpretation and health care terminology. Rapid access. Some companies use interpreters who have been tested for competency	Examination rooms need to have phones, preferably with two handsets or a speakerphone for easiest use. Otherwise, patient and provider need to hand the handset back and forth. Most agencies require prior arrangement to establish an account. Interpreters may or may not be trained in mental health applications. Video applications have been found to be highly effective, but the equipment and arrangements tend to be expensive.

Benefits

Limitations

Cover up to 170 languages
Available 24 hours/day, 7 days/week.
Many interpreters are native speakers with training in interpretation and health care terminology.
Rapid access.
Some companies use interpreters who have been tested for competency

Examination rooms need to have phones, preferably with two handsets or a speakerphone for easiest use. Otherwise, patient and provider need to hand the handset back and forth.
Most agencies require prior arrangement to establish an account.
Interpreters may or may not be trained in mental health applications.
Video applications have been found to be highly effective, but the equipment and arrangements tend to be expensive.