Counting the cost of language services in psychiatry.

OBJECTIVE

To document interpreter utilisation at a major South African mental hospital over a 2-month period in 1993.

DESIGN

A survey was conducted by requesting clinicians to complete a questionnaire each time they required an interpreter.

SETTING

Seven admission wards at a Western Cape mental hospital and an emergency psychiatric service at a general hospital.

PARTICIPANTS

Twenty-nine clinical staff members.

MAIN OUTCOME MEASURES

Number of patients requiring an interpreter, who provides interpreting services; interpreter availability; and duration of interview.

RESULTS

One hundred and forty-eight predominantly Xhosa-speaking patients (20-30% of admissions) required interpreting. Interpreter services were available immediately in 69% of cases. Nursing staff provide 67% of the interpreter service, while cleaning staff provide 10%. There were 93.5 documented hours of interpreting. One person employed as an interpreter in 2 wards had longer interviews on average than the other staff members. The opportunity cost of using nurses and cleaners as interpreters amounts to R1 504 for the period of the study.

CONCLUSIONS

Psychiatrically educated staff are clearly preferred as interpreters. A significant proportion of patients are being assessed through the use of family members, cleaners and other inappropriate people. The financial burden to the hospitals of not providing an interpreter service is small, but the impact on working conditions and service to patients is considerable.