Lost in translation? The importance of qualified interpretation
- Anne Kristine Bergem
- Jun 18
- 16 min read
Interview with Professor Berit Berg
The Nordic Psychiatrist have been fortunate to get hold of professor Berit Berg, a professor with in-depth knowledge of people’s experiences of communication via interpreters and how to improve the use of interpreters in the healthcare sector and other public services. Her experience is that many people's first reaction is that there are many problems associated with the use of interpreters. Professor Berit Berg was the main author of the report "Experiences of minority language speakers with interpreting in encounters with public services" published in February 2023.
You can read a summary of the report below by expanding the chapters
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Summary
The starting point for this report is the introduction of the new Interpreting Act that applies to all minority language speakers who need linguistic support in their encounters with the public sector. The Interpreting Act requires public service providers to use interpreters if the interlocutors cannot communicate through a common language. In addition, sign language users and speakers of Sami languages are entitled to interpreters through the National Insurance Act and the Sami Act, respectively. Both sign language and Sami are official languages in Norway, making the language issue an important part of their history, culture, and identity. Sami is also an official administrative language in the Sami administrative area. Like other minority language speakers, speakers of newer minority languages are covered by the Interpreting Act, but do not have the individual rights that apply to sign language users and Sami speakers. For all language groups, the Public Administration Act requires the public sector to ensure that users receive sufficient information about services from the public sector, which in many cases will involve the use of interpreters if the parties do not have a common language. The Interpreting Act further clarifies this by imposing on public sector a duty to use interpreters where the parties cannot communicate through a common language.
The purpose of the project
The project on which this report is based was commissioned by the Directorate of Integration and Diversity (IMDi) and was carried out in the period February – December 2022. The purpose of the project has been to obtain knowledge about minority language speakers’ experiences with and perspectives on the use of interpreters in encounters with the public sector. This knowledge will form the basis for implementing the Interpreting Act, as well as ensure equal public services for minority language residents in Norway. The project was carried out by a group of researchers at NTNU Social Research in collaboration with co-researchers with expertise in different minority languages. In the project, we interviewed informants from the following language groups: Sami, sign language and seven newer minority languages: Arabic, Polish, Kurdish, Dari, Pashto, Swahili, and Tigrinya. In addition, we have had a particular focus on minority language speakers who identify as LGBTIQ+, a group that often finds itself in a particularly vulnerable situation.
The report is based on a total of 35 individual interviews with minority language speakers. In addition, we have participated in meetings and had conversations with representatives of several of the language groups, and we have reviewed written material that can shed light on the user perspective related to the topic of interpreting. The conversations and interviews have been aimed at giving insight into how interpreting can contribute to equal services and legal rights for the individual. The overall theme of the report is minority language speakers’ experiences with the use of interpreters, including knowledge about the use of interpreters and barriers to using interpreters. Themes that are associated with this are confidentiality, trust, and legal rights. The qualifications of interpreters are also a key issue, especially in contexts where minority language speakers believe that interpreters are not proficient enough – whether in the minority language, in Norwegian or in both. Among Sami speakers, the majority understand and speak Norwegian well, but not sufficiently in all situations (such as at doctor’s appointments). This means that parts of the messages communicated can be lost, both to and from the minority language speaker. In connection with these topics, we find both similarities and differences across the language groups. Gender and age also come into play, not least in relation to interpreting needs in different situations. Health is mentioned as one such area where many report a need for an interpreter. This is partly because health issues often cause stress, which causes “the words to disappear”, as many put it. Many also mention that health-related topics require a vocabulary that many do not have in Norwegian. For speakers of newer minority languages, the need for an interpreter will usually decrease as their Norwegian language skills improve. However, this does not apply to sign language users, who in most cases will need an interpreter all their life, nor will it apply to all Sami speakers.
Challenges
Challenges we have identified in relation to minority language speakers’ experiences with interpreters can be summarized in the following four points:
Challenges related to competence.
Challenges related to access.
Challenges related to trust.
Challenges related to legal rights.
The competence challenges concern the competence of interpreters. The Interpreting Act requires public service providers to use qualified interpreters. In the case of sign language interpreters, a bachelor’s degree in sign language interpreting is required to be eligible for work as an interpreter. For the other language groups, the minimum requirements that are significantly lower. For interpreters in newer minority languages, qualifications vary significantly. In several languages there are government-authorized interpreters, which is the highest qualification level, but there are also interpreters who do not meet the minimum requirement. Insufficient linguistic and interpreting skills are described as an important challenge by many speakers of newer minority languages.
Access challenges are mentioned by all groups but appear to be a particular challenge for minority language immigrants. The provision of interpreting services for this group is unregulated, which means that there are actors in the field who can neither document interpreters’ qualifications nor have interpreters available at the time when minority language speakers need them. Often this is because interpreters work freelance. When it comes to Sami-language interpreters, systems have been established for the provision of interpreters in the field of health, and interpreters can be commissioned through competence environments established in Sami areas. In the field of sign language, interpreters have ordinary employment conditions and are booked through NAV. Sign language users can book an interpreter themselves, while for the other language groups, public service providers handle the booking. Most informants describe this as a straightforward system, provided that the services remember to book an interpreter. In municipalities with many minority language speakers, good routines have generally been established when it comes to booking interpreters, but in many places the system is vulnerable. Thus, there is a need for a system where minority language speakers can book interpreters themselves.
Trust challenges are discussed by all minority language speakers. Trust comprises many aspects, from the interpreter keeping appointments and proving to be linguistically and interpretively qualified, to them complying with the duty of confidentiality. When the issue of trust is discussed, it is particularly the duty of confidentiality that interviewees are concerned with. Everyone we have spoken with considers this to be an important topic, but it varies whether they have experienced that the interpreters have breached their duty of confidentiality. The sign language users convey a great deal of trust in interpreters, while the newer minority language speakers have more mixed experiences.
Legal rights challenges may involve misunderstandings that arise due to inadequate information or linguistic misunderstandings that can potentially have serious consequences for the minority language speaker. Such misunderstandings can occur in all parts of the public sector but have particularly important consequences in areas such as health and the judiciary, and may, for example, lead to decisions in asylum cases, police cases, child welfare cases, divorce cases, benefit cases, etc. being made on an incorrect basis. The challenges in the field of interpreting are interrelated, and in sum, all have consequences for the legal protection of the minority language speaker. If the interpreter’s competence is not good enough, this will affect what is communicated. If the duty of confidentiality is not complied with, this will influence what the minority language speaker will be open about and what they will not. In our interview material, it is especially persons who identify as LGBTIQ+ who are explicit about this. Many say they avoid using an interpreter because they do not know if they can trust that the interpreter complies with the duty of confidentiality.
Recommendations
The experiences of minority language speakers that we have gathered in this report show that the picture is complex. Most of the variation is related to the historical and legal position of the different groups. Here, it is the speakers of newer minority languages who experience the greatest challenges. The Interpreting Act imposes a duty on public service providers to use qualified interpreters in meetings with minority language speakers, where interlocutors do not speak a common language. However, minority language speakers have no individual right to an interpreter. This distinguishes them from the other two groups, where sign language users are entitled to interpreters under the National Insurance Act and Sami speakers have rights under the Sami Act.
Our recommendations cover both user and system level. The recommendations are based on the concrete descriptions communicated to us through the user interviews and, by extension, the implications this has at the system level.
1. Introduction of a right to an interpreter for newer minority language speakers in meetings with the public sector
The Interpreting Act requires public bodies to use interpreters if the interlocutors cannot communicate through a common language. However, the Act does not give speakers of newer minority language the right to interpreters, like sign language speakers and Sami speakers already have today. A right can contribute to make these minority language speakers a more active party and reduce the power imbalance in meetings with public services. By establishing a right to an interpreter, they will be able to assess their need for an interpreter themselves and, by extension, also be given the opportunity to book an interpreter themselves for meetings with public services.
2. Training in the use of interpreters for minority language speakers
Quality in conversations involving interpreters presupposes that both parties have knowledge of this as conversational form. The knowledge related to how interpreted conversations unfold, about the interpreter’s role and about the ethical obligations of the interpreter. Knowledge about interpreting can help reduce misunderstandings, and it can make the minority language speaker more aware of which expectations and demands they may direct at the interpreter.
3. Training for public sector employees focusing on the Interpreting Act
The training must focus on both the intentions of the Interpreting Act and key provisions such as the obligation to use qualified interpreters and the prohibition against using children as interpreters. The information must partly be communicated through written material (web-based) and through information channels that different parts of the public sector use in training and dissemination of information. Specifically, the training must include:
Booking an interpreter.
Requirements relating to qualifications and the right to appeal.
Information about the interpreter’s role – rights and ethical guidelines.
The role of interpreter, preparation and conducting a conversation with an interpreter.
4. Use of interpreters as a compulsory subject in professional education
Practitioners within health, welfare services, refugee services, education, and police are the public service employees who most often encounter minority language speakers. It is particularly important for them to acquire knowledge about norms and regulations related to the use of interpreters through their education. The education should include practical training in the use of interpreters – not just theoretical knowledge.
5. Increased focus on ethical issues and on interpreting in vulnerable situations.
In the education of interpreters, greater emphasis should be placed on interpreting in vulnerable situations. The ethical obligations of interpreters must comprise attitudes towards vulnerable groups and training in interpreting in situations where the minority language speaker will receive or convey messages that are emotionally demanding. This may, for example, be conversations about health-related issues, in the case of accidents, court cases, asylum cases, child welfare cases or other conversations that revolve around sensitive themes or dramatic events.
6. Development of a better booking system for interpreting services and improved employment conditions for interpreters.
For newer minority languages, interpreting services are an unregulated market where there are major differences from municipality to municipality. Private interpreting services dominate in large parts of the country and many of these cannot guarantee that interpreters meet the requirements of the Interpreting Act. A future model may be based on further developing of the register of interpreters so that it can also fulfil such a function. Other models should also be studied. Such studies should also look at regulation of pay and working conditions for interpreters.
7. Development project to contribute to greater awareness of the importance of good interpreting services.
In public services that often use interpreting services, a development project should be established where public employees receive training in the use of interpreters. The aim must be to gain knowledge and awareness related to one’s own use of interpreters. At the organizational level, a development project can help to bring forth a system for integrating interpreting services into daily work.
8. Supervision and notification.
Minority language speakers may find themselves in situations where they depend on interpreting, which makes it difficult to report or complain about poor interpreting. The unequal power relationship between users on the one hand and interpreters, interpreting services and public service providers on the other hand can make it difficult to speak up if they experience a breach of good interpreting practice. We propose a system where the County Governor has a duty to monitor compliance with the Interpreting Act, and to recommend that consideration should be given to introducing a reporting system where minority language speakers can report such breaches anonymously.
The summary is from the report written by Berit Berg, Stina Svendsen, Turid Sætermo, Mari Bore Øverland og Odd Morten Mjøen et al. «Minoritetsspråkliges erfaringer med tolking i møte med det offentlige». NTNU Samfunnsforskning. Trondheim, februar 2023.
Berit Berg: "I would like to quote a colleague who investigated the use of interpreters in conversations between psychologists and patients. He starts his lectures with the rhetorical question: "Is it better not to understand what the other person is saying?" Of course, there are greater challenges in communication when you cannot speak directly to each other. You also lose body language, which supplements what is being said while it is being said. However, I believe we must focus on the opportunities. The alternative to using an interpreter is not being able to communicate at all."
In the report she was the lead author of, they looked at minority language speakers in a broad sense, including people from other countries who have come to Norway, indigenous peoples, and the hearing impaired.
In the new Norwegian Interpreting Act, public institutions are required to provide an interpreter.
"Unfortunately, the law is not a rights-based law, which means that people are not entitled to an interpreter when dealing with private actors, such as private psychologists and psychiatrists. The only ones who have a legal right to an interpreter are the hearing impaired."
Professor Berg believes that it is a major problem that interpreting is not a right for individuals, as this means there is no requirement for private service providers to provide an interpreter. She believes that society must take responsibility.
"There are many important private actors who work with minority language speakers, ranging from large organizations to individual therapists. I wish that everyone, regardless of size, accounted for the use of interpreters in their budgets."
Since the Sámi languages, the languages of the Indigenous people, are official languages under the Constitution, Sámi speakers have the right to communicate in their own languages. The same rights do not apply to people who come from other countries.
"The development of interpreting services has been rather haphazard. There is a public interpreting service, and municipalities have their own. In addition, there are several private providers. Increased immigration has led to a greater need for interpreting services."
Interpreting in mental health
In Norway, 20% of the population are minority language speakers, and in Oslo, the figure is 30%. Most have a short period of residence and do not master Norwegian very well beyond basic "everyday communication."
"One can be quite good at Norwegian without mastering the repertoire necessary to be understood in conversations related to mental health and psychological issues. The same can apply to interpreters. They may be very proficient in Norwegian, but without mastering the terms and concepts related to psychiatry."
Since in several countries there is a stigma attached to mental health issues, it can become three times more difficult to talk about mental health:
"They cannot speak in their native language, they lack the necessary vocabulary, and on top of that, they are limited by taboos and may not really know how to approach difficult topics."
Professor Berg emphasizes that she has never worked as a therapist, but that in the 1980s, she participated as a social worker in a project aimed at preventing health issues among people who fled Chile after the coup.
"I worked alongside a psychiatrist who spoke fluent Spanish. In addition, we had an interpreter who followed the project throughout. He mentioned that he had to translate words and concepts he had never encountered before. The topics were experienced as anything from embarrassing to painful and difficult. For me, it was a gift to have the opportunity to research the use of interpreters later."
One of the experiences Professor Berg has had is that it is not appropriate to use individuals who are familiar to the patient as interpreters.
"In the beginning, we thought it might be easier to gain trust that way, but it has become very clear to me that being a good interpreter is not just about being bilingual or proficient in multiple languages. Being an interpreter must almost be considered a profession, I would argue. When you study to become an interpreter, you learn about the role of the interpreter and receive education on many levels, which is verified through exams. The qualification requirements are well described in the report."
Professor Berg now believes that it is almost worse to use an unqualified interpreter than to use none.
"There are urban legends about people having had the wrong leg amputated due to misunderstandings. In the field of mental health, a well-known problem is that mental disorders and intellectual disabilities are often mixed up or confused. A mother may be concerned about her child and end up with a referral for assessment in mental health care, when the child has an intellectual disability. The rest of the conversation becomes meaningless if such a misunderstanding occurs at the start."
Reducing the risk of misunderstandings
Qualified interpreters are also trained to ask clarifying questions if there is something they do not understand. For unqualified interpreters, it can be easy to guess instead.
"Unqualified interpreters may have a greater need to "prove" that they are competent and might believe that asking clarifying questions means they are not good enough. This poses a significant risk of incorrect translations and contributes to misunderstandings."
Preparing interpreters before sessions is also important, and it is the therapist's responsibility.
"It is easier to translate accurately if one can prepare in advance. Perhaps one can review specific words and concepts. When using sign language interpreters, it is quite common for the interpreters to be given context before interpreting. If a lecture is to be interpreted, it is standard practice for the lecturer to send their PowerPoint presentation to the interpreters beforehand, and the interpreters can reach out if they need additional information to do the best possible job. It should be the same in all interpreting situations."
In some situations, phone interpreting may be preferable. For example, in gynecological examinations, many people find it beneficial to avoid having a stranger present in the room.
"Many professionals may be skeptical about using interpreters over the phone or via a screen, but in user surveys, many prefer this form of interpreting and find it less disruptive. It becomes easier to remember that you are communicating with the person sitting in front of you. The advantage is also that this method always allows for access to highly qualified interpreters. It is easier to get a good phone interpreter than an interpreter who must come in personGeography no longer becomes a determining factor for availability."
Professor Berg says she often hears statements like "It's so difficult to get an interpreter," but it turns out that the professionals haven't tried.
Professor Berg believes that the interpreter also gains significance for those they interpret for, beyond just being a translator.
"This is not something we can demand, and it's not really part of the role, but sometimes we see that the interpreter means something more. I remember a reception center for unaccompanied minor asylum seekers. We used a lot of phone interpreters, but one day the interpreter came in person. A little boy exclaimed with joy, "It's the voice!" For him, it was important to have a face to relate to."
Confidentially and trust
Professor Berg experiences that healthcare professionals hide behind confidentiality in situations that require an interpreter.
"Confidentiality was never meant to hinder good communication. If one truly wants to help a patient, it is necessary to ensure that the interpreter is well-prepared so that the conversation is helpful to the patient."
Professor Berg believes that it is not difficult to obtain the patient's consent to make the necessary preparations.
"When scheduling a conversation and agreeing to use an interpreter, it is possible to agree that the interpreter will have the opportunity to prepare for the words and concepts related to the topics that will be discussed in the conversation."
She also believes that it is wise to evaluate interpreted conversations afterwards.
"Many interpreters can provide valuable feedback on what could be done differently next time. An interpreter with extensive experience has a lot to teach. If the therapist and patient are satisfied with the interpreter, it often works well to get the interpreter's phone number directly to decide for the continued process. It is beneficial to have the same interpreter throughout the entire process."
In her work with minorities, Professor Berg has experienced that patients appreciate interpreters who not only can translate between two languages but also have a strong understanding of culture.
"I remember an elderly Sámi man who referred to "the good interpreter," meaning the one who knew something about reindeer herding. Reindeer herding was not the topic of the conversation, but for the elderly man, it instilled trust that the interpreter understood the significance of reindeer herding in Sámi culture."
Respect for others and their way of life is central to being a good interpreter.
"Sometimes, people may have been in Norway for a long time without learning the language. If the interpreter becomes impatient or expresses frustration or irritation over the patient not having learned the language "yet," it can be very painful for the patient. There can be many reasons why this has happened: limited schooling, mental exhaustion, or other factors. I have experienced interpreters physically present expressing frustration with the patient. That is not acceptable."
Professor Berg has good experience with the public interpreting services in Norway. The experience with private providers is somewhat more varied.
"Once, I experienced a company listing a level 6 for their interpreters. There are only 5 levels for interpreters in the public sector. They refused to disclose the interpreter's education. Of course, the interpreter could have shared their education with me if I had met them in person, but it is problematic when private actors do not adhere to the system."
All good interpreters are registered in the interpreter register. As a practitioner, you can check whether an interpreter offered by a private provider is registered. If they are registered, they should be qualified.
If someone is skeptical about using an interpreter in conversations, Professor Berg encourages them to speak with colleagues who have used interpreters frequently.
Those who are skeptical are often people who have never used an interpreter. Once you gain some experience, you can see all the benefits. □
