Improving feeling of control and trust in interpreter-mediated mental health consultations.

Language barriers are among the most critical factors in health care disparities. Low language proficiency is consistently associated with a high prevalence and severity of mental health disorder symptoms. Despite the advantages of working with an interpreter, most practitioners report difficulties, especially with trust and the feeling of control. The main objective of this exploratory qualitative intervention research is to examine the impact of training when working with interpreters and their inclusion in follow-ups. This impact is evaluated in the changes in feelings of control and trust for the practitioners who received the training, for the trained interpreters included in follow-ups and for the patients of these follow-ups. Semistructured interviews were conducted with individuals involved in five follow-ups at four public mental health clinics in Paris, France. The project had two phases: before (N = 18) and a few months after (N = 12) the training. Interviews were transcribed and thematically analyzed. Before the training, practitioners perceived the potential for collaboration with interpreters and the complexity of triadic consultations. Interpreters expressed irritation and disappointment at the lack of recognition, and patients seemed confident because they had already built a relationship with practitioners. After the training and inclusion of interpreters, trust is better established between interpreters and practitioners, which has substantial effects. All the protagonists state that trust positively impacts the relationship with patients and the therapeutic process. Although some practitioners still doubt the sessions' control, the intervention helps them to gain knowledge and critically examines their clinical modus operandi. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

[PLAID-Care: Research into the reduced use of coercion in France]. / PLAID-Care : une recherche sur le moindre recours à la coercition en France.

The use of coercion is a common practice in psychiatry despite its deleterious effects and insufficient evidence of benefits. It is so deeply rooted that the mention of establishments that make little use of it arouses a form of incredulity. However, the history of psychiatry and the international literature provide numerous examples of a psychiatry that is hardly coercive and numerous experiences of a reduction in the use of seclusion and/or restraint in psychiatric facilities. Today, in France, there are also less coercive establishments, which, for example, do not use mechanical restraint, have all their units open, or have reduced their use of seclusion and restraint. With regard to the stated policy objectives of reducing the use of coercion, it is surprising that most of these facilities receive little attention. PLAID-Care research aims to contribute to the visibility and analysis of these institutions and the factors involved in the reduced use of coercion. While these factors have already been identified in the international literature, the research is based on the multiplication of disciplinary perspectives (nursing, sociology, anthropology, geography) and the mobilization of a multi-level analytical framework that allows us to embrace their multiplicity and better understand their articulation. The originality of the research also lies in its historical dimension, which allows us to understand, on the scale of an institution, how a policy and practices aiming at the least recourse emerge and are consolidated. The project timeline is divided in three tasks: firstly, an inventory of "low-coercion" facilities in France; secondly, we will select and research four traditionally "low-coercion" facilities in France; thirdly we will focus on recently emerged "low-coercion" practices. PLAID-Care aims to revitalize French research on this theme which to date has been relatively lagging behind the numerous international studies. It will bring together and articulate the knowledge, tools and forms of organization and collaboration that contribute to making a policy of lesser use of coercion operational.