What role does language play in healthcare?

A wide range of studies investigates the potentially detrimental consequences of poor communication in medical contexts. Possible adverse effects include, to name but a few, serious medical errors, threats to patient safety, avoidance to resort to care, and lack of true informed consent. Overall, patients who face communication difficulties are more likely to experience worse healthcare quality and outcomes.

A further layer of complexity is related to mental healthcare: in these contexts, language plays an even more central role, since it serves as the medium through which patients disclose their inner thoughts and feelings, as well as being the channel through which therapeutic interactions take place. For these reasons, institutions such as the American Medical Association (AMA) advocate for the role of patient-centred communication to guarantee patients’ autonomy, ensure equity among different populations and provide quality care. This is especially significant in the case of persons who are more likely to experience communication difficulties, such as speakers of minority or immigrant languages.

The relevant literature has recognised the employment of language-concordant staff, if available, as the ideal solution to overcome language barriers, followed by or on par with professional interpreters. Conversely, several studies underline potential issues deriving from the employment of untrained interpreters.

Of course, different speakers may have different needs. For instance, a migrant person who does not speak the language(s) of the host country may not just need an interpreter to assist them, but someone who can also act as a cultural mediator.

On the other hand, speakers of an autochthonous minority language may require other types of services, such as the employment of language-concordant staff. These communities, historically associated with a particular territory and who became ‘minorities’ as a result of a reconfiguration of international borders, may often be expected to simply adapt to the majority language of the state they find themselves living in. However, in situations of stress, pain and fatigue these patients may struggle to express themselves in their second language; this may be especially problematic in the case of vulnerable groups, such as young children, elderly people, persons with learning disabilities, and patients needing the assistance of mental health, dementia or stroke services. Other persons may not lose fluency in their second language, but still feel more comfortable and at ease if they are given the option to use their minority language.

Especially in domains like public healthcare, resources tend to be scarce and demands high; the importance of linguistic services can therefore be easily overlooked. If we are serious about guaranteeing everyone’s right to quality healthcare, it is however crucial to start considering language awareness and communication as an essential part of it.