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Navigating Mental Health Act Assessments – Insights from Jemina Napier’s Research

Introduction

At The Together Conference 2024, Professor Jemina Napier delivered a compelling session on the role of sign language interpreters in Mental Health Act (MHA) assessments. Her research project, INforMHAA, explores the complexities of interprofessional collaboration, the linguistic and ethical challenges faced by interpreters, and the importance of ensuring equitable access for Deaf individuals undergoing MHA assessments.


While MHA assessments are typically conducted in-person, the insights from this session have far-reaching implications for interpreters and translators across various domains—including remote interpreting settings such as VRS (Video Relay Service) and VRI (Video Remote Interpreting).** The session highlighted best practices, ethical considerations, and strategies that interpreters can implement to enhance communication access and safeguard Deaf clients' rights.


Key Takeaways for Interpreters and Translators


1. Mental Health Act Assessments Are Legally Complex

Jemina’s research highlighted that MHA assessments are high-risk, high-stakes situations. Approved Mental Health Professionals (AMHPs) must make legally binding decisions about whether a person should be detained under the Mental Health Act, often within strict time constraints.

For interpreters, this means:

  • Preparation is crucial—yet interpreters often receive little to no briefing before an assessment.

  • Emotional resilience is key—interpreters may be present when life-altering decisions are made, and service users might not fully understand their legal rights.

  • Interpreters play a critical role—ensuring accurate interpretation while navigating medical, legal, and mental health terminology.

For VRS/VRI interpreters, this raises an important question: Can remote interpreting ever be appropriate in high-risk mental health situations? While remote access may be a short-term solution, interpreters need to identify when in-person support is essential.


2. Trust and Confidentiality in the Deaf Community

A recurring theme in the research was how trust plays a crucial role in mental health interactions. Deaf clients often express concerns about confidentiality, particularly in small Deaf communities.

Common challenges include:

  • Familiarity with interpreters—which can provide comfort but may also cause distress if the Deaf service user fears being recognised.

  • Fear of information being shared—even though interpreters adhere to strict confidentiality guidelines, perceived risks can deter Deaf people from disclosing sensitive information.

  • Over-familiarity leading to bias—interpreters who frequently work with the same client may unintentionally develop preconceived expectations, impacting their neutrality.

For remote interpreters, this is highly relevant. A Deaf person in crisis may feel hesitant to use VRS/VRI if they recognise the interpreter. This highlights the need for clear ethical protocols, ensuring that remote interpreters navigate issues of confidentiality, professional distance, and trust effectively.


3. The Role of Interpreters in Interprofessional Collaboration

One of the most striking findings from the INforMHAA project was the lack of collaboration between interpreters and mental health professionals.

  • AMHPs may mistrust interpreters, fearing that crucial legal or medical terminology may not be accurately conveyed.

  • Interpreters are often left out of pre-session briefings, limiting their ability to perform their role effectively.

  • A lack of training for both professions means AMHPs do not always understand the role of an interpreter, while interpreters may not fully understand mental health frameworks and legal obligations.

This is a wider issue in interpreting and translation. Whether in legal, medical, conference, or VRS/VRI settings, interpreters need to advocate for better interprofessional collaboration.

What can interpreters do?

  • Request a briefing before high-stakes assignments (where possible).

  • Clarify expectations—establish whether the professional understands the interpreter’s role and limitations.

  • Advocate for better interpreter training for professionals working in sensitive settings.

For remote interpreters, this may involve:

  • Asking hearing professionals to slow down and adjust their communication style.

  • Advising service providers on best practices for working with interpreters in high-risk situations.

  • Flagging when an in-person interpreter may be necessary.


How This Affects Interpreters Working in Any Setting

While this research was focused on Mental Health Act Assessments, it raises wider considerations for all interpreters and translators, particularly those working remotely.


🔹 Recognising When Remote Interpreting Is Not AppropriateInterpreters must be able to assess whether VRS/VRI is the right medium for a particular situation. In mental health, legal, and medical settings, miscommunication can have severe consequences.

🔹 Ethical Considerations in Remote InterpretingThis research reinforces the importance of:

  • Maintaining neutrality while showing empathy.

  • Ensuring clear communication despite remote limitations.

  • Understanding when to step back and recommend an in-person interpreter.

🔹 Advocating for Better Training and PoliciesThis session highlighted a gap in training—not just for interpreters, but for the professionals they work with. Whether in mental health, legal, corporate, or public service settings, interpreters must be proactive in shaping best practices.


Final Thoughts

Jemina Napier’s INforMHAA project provides essential insights into the complexities of interpreting in legally and emotionally high-risk settings. It also raises important ethical and professional questions that interpreters across all domains should consider.


For those working in VRS/VRI, this research reinforces the need to set clear boundaries, advocate for appropriate support, and ensure Deaf clients receive the best possible access to services.


While interpreting is often seen as a linguistic task, this session served as a strong reminder that it is equally about collaboration, ethics, and safeguarding the rights of Deaf people.


What Do You Think?

🔹 Have you encountered challenges with trust and confidentiality in your work?

🔹 Do you think remote interpreting can ever be appropriate in high-risk situations?

🔹 How do you manage interprofessional collaboration in your assignments?


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