Interpretation Project

Using the 2016 Census data, the Mental Health Commission of Canada released a paper in February 2019, demonstrating that immigrant, refugee, ethnocultural and racialized (IRER) groups, experience a range of equity issues that can impact their mental health and wellbeing, including discrimination, underemployment, low-income, education and language barriers (MHCC 2019, 22). The rapid growth of IRER populations presents New Brunswick, along with other provinces across the country, with a responsibility to provide equitable, quality health services that meet their needs. 

Overall, immigrants arrive in Canada with better mental and physical health than the Canadian-born population, but after seven years in Canada, this “healthy immigrant effect” is lost. Evidence suggests that, in particular, immigrants from racialized groups and refugees are at risk for deteriorating health soon after arrival. Among people living with mental health problems or illnesses from immigrant, refugee, ethnocultural or racialized populations, health service use is low (MHCC, 2019).

Ultimately, the settlement, integration, and success of newcomers is a shared responsibility across sectors. Health and social service decision makers would benefit from considering the above findings as they develop strategies to increase access to culturally and linguistically appropriate services.

• Identify challenges, needs and best practices related to New Brunswick’s multilingual population accessing qualified interpreters in health, mental health and addictions contexts.
• Explore models for coordination and consistency of interpretation and translation service delivery across the New Brunswick.
• Provide interpretation training for community interpreters, settlement staff and service providers in health, mental health and addictions contexts.

• Lack of adequate training for community interpreters and for service providers.
• Current funding for in-person interpretation is mainly offered to refugees under the government-assisted refugee (GAR) program with a limited funding period of 1 year. 
• Varying standards and protocols for onboarding and accessing interpretation services across the province.
• Data on language needs is not collected within the healthcare system.
• There is no one agency or centralized department responsible for ensuring people have access to interpretation services.
• Remuneration is inconsistent for interpretation services.
• Many healthcare professionals are still resorting to family members or friends for interpretation.
• Practitioners and specialists are refusing to serve patients who have language barriers.
• Extra time rarely allocated for appointments where interpretation is required.
• Community interpreters in New Brunswick, have limited opportunities for specialized training in health, mental health and legal contexts as well as ongoing professional development. 
• Lack of training in cultural competency or working with refugees, ethnocultural and racialized people among healthcare professionals.

New Brunswickers need access to healthcare in a language that they can understand.

• People who do not speak English or French fluently have barriers when they try to access healthcare (the same is true for other services). Without adequate language support, the quality of their health care may be severely compromised.

Patients with language barriers face poor healthcare access.

• Not able to discuss their health concerns with healthcare providers, resulting in miscommunication or misdiagnosis. 
• More likely to be readmitted to the hospital or receive inappropriate care.
• Provision of informed consent, a legal requirement that protects patient autonomy is undermined. 
• Healthcare providers may resort to family members and friends for communication, undermining privacy for the patient and raising concerns about conflicts of interest. 

Trained interpreters are essential to address language barriers in healthcare.

• Effective interpretation can improve access to and quality of healthcare, ensure informed consent, and maintain privacy. 
• Interpreters who have additional training in medical terminology and understanding of healthcare organizations’ systems and processes are most effective.

NB needs to enhance language interpretation services to promote health equity.

• Access to trained interpreters and coordinated language interpretation services are needed.
• Coordinated language interpretation services provide a centralized way for patients, families, health care institutions and providers alike to have immediate access to interpretation in a wide range of languages, across multiple health care settings in many different modes. 
• Public Service Providers could effectively address language barriers by scaling up local innovative face-to-face and telephone service models with trained interpreters to deliver on the promise of excellent care for all. 

1. Increase funding to expand and integrate professional interpretation services within Canadian healthcare system as a strategy for not just overcoming linguistic barriers, but for promoting accessible, equitable and high quality healthcare services to all Canadians regardless of ethnicity, race, class, gender, linguistic and cultural background. 
2. Establish government funding formulas for the reimbursement of healthcare institutions that provide interpreter services.
3. Provide training for health professional and other service providers in the use of interpretation services. 
4. Develop and pilot a centralized model of interpretation service provision to improve consistency and coordination across the province.