The first instance when Adele Routliff attempted to use sign language to talk with her Deaf mother in public was met with resistance. Her mother, in response, “put her hands on mine and placed [them] back in my lap. In other words, no, we don’t sign in public.” Having been raised in a residential school for the Deaf where using sign language was prohibited and punishable, her mother learned to associate signing with shame, confining it to private spaces. Adele couldn’t grasp her mother’s apprehension at the time and continued to sign, even as her mother’s expression shifted to one of fear. “I didn’t understand it then,” she admits. “But now I realize it was about shame.”
Adele has since become a certified American Sign Language-English interpreter and is dedicated to increasing awareness about deafness. She works to bridge communication barriers and emphasizes the importance of mental health within Deaf communities. Her own experiences inspired her to train as a mental health interpreter, conduct workshops aimed at improving interpreting skills, and create a training program for new interpreters in collaboration with Canadian Hearing Services.
For a long time, mental health in the Deaf community has been largely disregarded, receiving little focus until recent years. Dr. Cathy Chovaz, who leads the Centre for Deaf Education and Accessibility Forum (CDEAF) and teaches psychology at King’s University College (Western University), provides mental health services to Deaf individuals. Her research indicates that Deaf individuals are at greater risk of experiencing depression and anxiety, exacerbated by significant hurdles in the justice system, education, and healthcare. Dr. Chovaz found that many healthcare practitioners lack the training needed to identify mental health issues in Deaf patients, resulting in frequent misdiagnoses or undiagnosed cases. Deaf individuals often encounter unique challenges that elevate their risk factors, such as limited early exposure to sign language, communication barriers within their families, neurological conditions associated with certain types of deafness, and experiences of trauma or abuse.
Challenges Faced in Mental Health Interpreting
Given the obstacles Deaf individuals face, it’s no wonder that interpreters working in medical and mental health environments encounter their own set of heightened challenges.
Interpreting sign language necessitates that the interpreter utilize both facial expressions and body language to communicate effectively with both Deaf and hearing individuals. This task can be emotionally and physically demanding. Interpreters must also maintain their role as a neutral party, faithfully conveying every word signed, regardless of their personal discomfort. One anonymous mental health interpreter (let’s name her Jane) reflected on the difficulty of this aspect: “There have been times I felt like I needed to wash my mouth out with soap,” referencing certain language she had to interpret. “You almost want to say, ‘It’s not me, it’s them.’”
As an interpreter, you walk into some of the most personal moments in people’s lives. I’ve been present at births, deaths, and funerals. I’ve witnessed families in turmoil.
Jane elaborated that interpreters are trained to remain neutral, yet it’s challenging to suppress natural human reactions to distressing situations in medical and mental health contexts. “You’re told you’re just there to convey language—to uphold professionalism, establish boundaries, and be conscious of how you present yourself,” she explained. This is particularly important in emotionally charged situations that interpreters frequently navigate. As Adele noted, “You walk into the most intimate moments in people’s lives as an interpreter. I’ve been at births, I’ve been at deaths, and I’ve been at funerals. I’ve been there when families have exploded.”
Health Risks Involved in Helping Others Communicate
Medical interpreters assisting hearing patients have a vital role in helping individuals with limited English proficiency navigate healthcare. However, this work can also come with considerable emotional stress. They often find themselves in high-pressure environments where they must deliver tough news, bridge cultural differences, and facilitate conversations among doctors, patients, and families. Studies reveal that interpreters, particularly those dealing with cancer patients and children, frequently experience elevated stress levels and struggle with their own mental well-being while providing support to others.
Studies indicate that interpreters, especially those working with cancer patients and children, often encounter high stress levels and have difficulty managing their own mental health while they support others.
This emotional toll isn’t exclusive to interpreters of spoken language; it also affects sign language interpreters who encounter their own set of unique challenges in medical contexts. While research findings vary, recent studies suggest that consistent exposure to emotionally charged or traumatic material significantly heightens sign language interpreters’ susceptibility to vicarious trauma and secondary traumatic stress, with unhealthy mental health outcomes reported in as many as 83% of interpreters. Jane described a particularly taxing assignment: “I realized I was unable to control my feelings any longer, which impacted my ability to interpret professionally. So, I had to step away.”
The Role of Mindfulness in Supporting Sign Language Interpreters
Those working in high-stress scenarios, particularly in medical and mental health settings, may benefit from preventative strategies. One promising method is incorporating mindfulness practices. While this area is not extensively researched, some studies indicate that mindfulness can aid interpreters in managing work-related stress. A recent investigation adapted the Mindful Practice® in Medicine (MPIM)—a validated mindfulness program developed by two physicians aimed at enhancing coping skills and reducing burnout—for medical interpreters.
Results demonstrated that the program effectively alleviated distress among both spoken and sign language medical interpreters. Additionally, participants appreciated the opportunity to openly discuss their stressors in a supportive environment with fellow medical interpreters. This sense of community not only made them better empathetic listeners but also offered a valuable space to process experiences and devise mindful approaches for dealing with work-related challenges.
Integrating mindfulness techniques into interpreter training and providing continuous professional development could help interpreters manage emotionally charged scenarios more effectively, enhance self-awareness, and develop emotional regulation skills to build resilience against burnout. This way, interpreters, like Jane, can recognize when they are stretched too thin. Jane, while not formally trained in mindfulness, mentioned that it has been beneficial for her. A simple practice like parking her car farther from her workplace to take a longer walk has helped her process her day. Likewise, Adele has learned to stay aware of her feelings and identify her limits. While both have been fortunate to discover mindfulness independently, the field could greatly benefit from instituting formal mindfulness training for interpreters, which could substantially minimize the stress associated with challenging interpretation duties.