The Linguist

The Linguist 56,6 – December 2017/January 2018

The Linguist is a languages magazine for professional linguists, translators, interpreters, language professionals, language teachers, trainers, students and academics with articles on translation, interpreting, business, government, technology

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20 The Linguist Vol/56 No/6 2017 www.ciol.org.uk FEATURES Sue Leschen considers the increasing challenges of working with vulnerable patients at mental health hearings M ental Health Review Tribunals (MHRT) are independent quasi- judicial bodies set up to safeguard the rights of those detained ('sectioned') under the Mental Health Act (MHA) 1983. The remit of the MHRT panel is to review whether or not to continue detention. It comprises a judge who is in charge of the hearing, a consultant psychiatrist who is independent of the hospital that the patient is detained in, and a specialist lay member who has detailed knowledge of the MHA and mental healthcare issues. When necessary, the Tribunals Service will also book an interpreter for the hearing. MHRT hearings take place in a meeting room in the hospital where the patient is detained. Hearings can be attended by the patient, family members, the patient's lawyer (if they have one), the patient's psychiatrist, any other professionals involved with the family, such as social workers, midwives and health visitors, an interpreter booked by the lawyer and the Tribunals Service interpreter. The professionals will provide oral and/or written evidence, and may be questioned by the panel. The patient and their family members will then be given the opportunity to speak. Finally, the panel will retire to consider their decision before returning to the hearing room. Hearings are usually preceded by separate visits to the ward by the panel psychiatrist and the patient's solicitor. Tribunals Service assignments The procedure sounds relatively straightforward, but put one or more interpreters into the mix and it's not so simple. A booking by the Tribunals Service does not always result in interpreting work. On one assignment, the patient was a British national who had lived in France for many years and (not surprisingly) had indicated a preference on the MHRT application form to speak in French at the hearing. However, the panel decided that my presence was superfluous (and a burden on the tax-payer) because the patient's first language was English. They signed me off on arrival – prior to the hearing and without giving the patient the opportunity to meet me. It wasn't my role to argue for the patient's human rights, but I was shocked that such a decision had been made, given the vulnerability of a sectioned client. A visit to the ward with the patient's lawyer to take instructions prior to the hearing may not result in instructions being obtained. On the day of the hearing, the patient may refuse to see their solicitor and/or attend the Mental clarity hearing. Even if the patient decides to cooperate, their instructions may be nonsensical, for example "the spirits told me to take an overdose", which has to be interpreted even if it doesn't appear to make any sense. In this case, the interpreter may well appreciate the significance of the spirit world to the client's culture and belief system, while the lawyer and panel may not. The interpreter may make a judgement call as to whether it would be appropriate to make a cultural intervention at this point, but they must be careful not to introduce incorrect information by misunderstanding the reasons for the reference to the spirit world. Cultural interventions can be minefields in legal settings – especially where the interpreter introduces information that the client wouldn't have known about without the intervention. Instructions can also be hard to obtain from the patient if their family members are also present. On a recent assignment, the patient's partner completely dominated the visit with his views regarding discharge and I found myself interpreting almost exclusively for him. To make matters worse, he had brought the couple's children with him, which created audibility problems as initially I had to contend with a toddler watching noisy cartoons on a IMAGES © SHUTTERSTOCK

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