A Great Leap Forward: Improving Language Access for New Yorkers with Psychiatric Conditions
OMH News; Samantha Diaz, MA Cand., Oscar Jimenez-Solomon, MPH, Jennifer Humensky, PhD, Doris Chang, PhD, Wilma Alvarado-Little, MA, MSW & Roberto-Lewis-Fernández, MD, March 2015
On October 6, 2011, New York State took a great leap forward to ensure the access of over 2.5 million New Yorkers to services provided by state agencies. That day, Governor Cuomo issued Executive Order 26, which requires all state agencies to provide language interpretation services for individuals with limited English proficiency (LEP), to translate documents into the six most prevalent languages in the State, and to develop a language access plan to comply with this order.
Additionally, the New York State Office of Mental Health (OMH) launched an initiative to assess language access at OMH-operated facilities, identify any gaps, and develop an agency-wide plan for enhancing language access in New York State. OMH commissioned the New York State Psychiatric Institute Center of Excellence for Cultural Competence (NYSPI-CECC) to survey OMH facilities about their language access practices. The NYSPI-CECC is now pleased to present the report “Language Access Needs in New York State Office of Mental Health Facilities Prior to Implementation of Expanded Language Access Strategies in 2011-2012”.
This report presents the results of a survey conducted by NYSPI-CECC with representatives of clinical units in OMH programs to learn about their language access services and the challenges they face in providing these services. All programs delivering clinical services in facilities operated by OMH in 2011-2012 (142 programs across 26 facilities) were invited to participate, of which a total of 95% were surveyed. The survey found that OMH programs serve a linguistically heterogeneous population of New Yorkers. Programs in areas with a high concentration of individuals with LEP had high levels of utilization of bilingual clinicians and professional interpreters. Nevertheless, the survey also found that, in the time period of 2011-2012, the use of family and friends as interpreters as well as provision of services in English to individuals with LEP were still substantial, particularly in programs that served few individuals with LEP and programs outside of the New York City metropolitan area.
Key barriers to the use of professional interpreters included the need of additional staff training on how to partner with interpreters, difficulties with and limitations of telephonic interpretation, and time constraints. OMH programs relying on family and friends ad-hoc interpreters reported reasons such as consumer preference, staff’s attempt to increase trust and engagement of consumers and families, staff and consumer dislike of telephonic interpretation, and consumer concerns about confidentiality.
During and after the collection of data for this report, OMH developed several policies, procedures, and initiatives to increase language access and the use of trained interpreters across OMH facilities, building on the lessons of preliminary findings from the data analysis and in consultation with NYSPI-CECC.
These include the implementation of compliance requirements, standardized training and compliance reporting, tools to facilitate reporting, translation of legal forms and vital documents, and listings of available resources, including interpreter resources. Based on the need for additional staff training, OMH established in 2011-2012 a process for staff training and training reporting. In each facility, the designated language access coordinator (LAC) and education training director coordinates staff training in the provisions of Executive Order 26. As a result, all OMH employees received the initial training by December, 2013, and receive annual training on an ongoing basis. New employees receive this training during New Employee Orientation. Rates of staff training are reported to the BCC. The BCC, on behalf of OMH, then completes an annual Compliance Report to the Governor’s Office.
Furthermore, OMH is currently exploring the use of cutting-edge technology to increase language access through the use of Video Remote Interpreting. OMH is also evaluating a plan to qualify bilingual staff as language interpreters to improve access to trained in-person interpreters across state facilities.
Building on the findings of this survey and in support of OMH’s efforts to improve language access in the State, the NYSPI-CECC is currently working on two timely and innovative projects:
a. Web-based Interpreter-Negotiated Services (WINS): A pilot study to test the feasibility and acceptability of an approach that trains interpreters to assume a more active role in clinical encounters, helping clinicians and consumers to clarify vital cultural information and avoid cross-cultural miscommunication that can affect consumer engagement and participation, treatment planning, and service provision.
b. Language Matters New York: A project to develop and disseminate consumer empowerment and provider training tools on working with interpreters in mental health settings. Quick guides for providers (Do’s and Don’ts: Guidelines for Clinicians Working with Interpreters in Mental Health Settings), more extensive provider guidelines for working with interpreters, and other practitioner training resources are being developed by the NYSPI-CECC. This project is also developing consumer empowerment videos and printed tools for the two largest non-English speaking populations in New York State – Spanish and Mandarin speakers – to educate and empower individuals with LEP about the benefits of working with qualified interpreters and the availability of trained interpreters for mental health encounters.
For more information and resources on language access in mental health settings, visit the NYSPI-CECC website.
The NYSPI-CECC is one of two OMH-funded Centers with the mission of studying and disseminating best practices in the delivery of culturally competent mental health services to underserved populations affected by cultural and linguistic barriers.