Paralinguistic demands in interpreter-mediated Mental Health Act assessments: perspectives from mental health professionals, interpreters and service users

This article explores the perspectives of multiple stakeholders regarding interpreter-mediated Mental Health Act (1983) assessments (MHAAs) in England, elicited as part of the Interpreters for Mental Health Act assessments (INforMHAA) study (2021–2024). Semi-structured interviews with 17 Approved Mental Health Professionals (AMHPs), four spoken and six signed language interpreters and four service users and carers were thematically analysed using the Demand Control Schema theoretical framework. The focus is on the paralinguistic demands faced by interpreters specifically in relation to the disordered communication that can manifest during a MHAA; not what is said but how it is said by the person being assessed, and the strategies (controls) that need to be employed by interpreters in order for AMHPs to get the information they need during the assessment. We suggest that if AMHPs and interpreters work collaboratively as a team, this should mitigate the paralinguistic demands, enhancing assessment effectiveness. The study highlights the need for specialised mental health interpreter training and improved AMHP–interpreter collaboration. This research contributes to the limited literature on interpreter-mediated statutory mental health assessments and points to the advantages of joint training in this specialist field of practice.