The third wheel? Exploring the challenges of working with sign language interpreters in mental healthcare

Due to the limited number of deaf or sign-fluent clinicians in the UK, many deaf people who use British Sign Language (BSL) as their first or preferred language receive mental health care through a non-deaf, non-signing professional with a sign language interpreter. For effective therapeutic work with BSL-using deaf clients, it is essential to understand how this interpreted communication differs from direct communication. If clinicians become distracted by the interpreting process or distrust the interpreter, these concerns may overshadow their therapeutic work. Such distractions consume energy and shift focus away from the deaf client, potentially compromising the quality of care. Interpreting between English and BSL is a complex task that requires navigating two distinct languages, cultures, and modalities. The significant linguistic differences between English and BSL mean that accurate translation is often not as straightforward as simply matching one word in English with one sign in BSL. Rapport-building strategies, like eye contact and tone of voice, are re-located to the interpreter. A greater understanding of the interpreting process can reduce clinicians’ unease. Building rapport with interpreters through pre- and post-session briefings helps establish trust, enabling clinicians to place more confidence in interpreters and maintain better focus on their clients.