We have all been there...
The doctor or Nurse Practitioner is talking with the patient about the need to take his meds faithfully for his chronic disease, and the patient goes quiet for a minute. He says in a low voice that there is really no point in his taking the medicine because his life is not worth living anyway.
The provider does a reset, and so do you. You both realize that this encounter has changed from a businesslike discussion of how to manage hypertension to a discussion about mental health.
The provider needs your support, as the interpreter, to follow her lead. The moment that a patient discloses his frame of mind and his difficulty in coping is a moment that requires calm, focused attention to silences as well as to words.
THIS IS A PIVOT
Watch to see how the provider adjusts her tone and her body language, and most probably, how she slows down and lets the moment develop. This is a time to build trust, to let the patient think, to not hurry him.
There are several things that you can do during the interpreting encounter to support good communication when mental health or mental hurt is discussed.
Be aware immediately of your own response to the patient’s disclosure. If you have a negative response, such as wanting the patient to not be so needy, or feeling uncomfortable with the patient’s statement in any way, sequester that reaction behind a barrier. Your role as part of the care team is not to jolly the patient out of his downcast state, nor is your role to want him to feel different. It is his life, and his hurt, and he is here for help.
Pay close attention to the words the patient uses, and the way in which he uses them. If he does not finish his sentences, or if he uses language in an unusual way, be sure to convey the exact same use of language in English. You can use the Interpreter Voice to state to both the patient and provider that you are conveying the patient’s message the same way that he is saying it.
Pay close attention to how the provider phrases comments to the patient. Is she asking questions? Is she making statements? Is she being persuasive, or supportive, or testing to see how deep the pain goes? If the patient were English-speaking, the provider could get across this nuance to the patient. As the interpreter, you have the difficult and important job of conveying the exact same nuance.