In mental health care, there is a lively debate about whether this type of help should be adapted for patients who have their roots in ‘cultures’ outside the borders of the countries they now live in. For several reasons, I will not enter this debate here. First of all, because it is my strong conviction that people will come to understand one another as soon as they are interested in each other and each other’s backgrounds. Culture, as a consistent pattern of norms and values, does not determine or cause behaviour. It is at best a pattern that one can detect in someone’s behaviour (Verheggen, 2005). Second, related to our topic here, I think that a lot of misunderstanding between people with different national and linguistic backgrounds arises because they literally do not understand one another. Needless to say, you have to have an interest in getting to know each other in order to be willing to bridge the language gap by, for example, engaging an interpreter. The first step towards a (mental) health care that is accessible for all is to establish a well-equipped interpreter service included in insurance-covered care. This chapter deals with the subtleties of interpreter-mediated talk in mental health care.

Interpreting in mental health care is a subcategory of healthcare interpreting (see Chapter 15 on healthcare interpreting). Sometimes there is also an overlap between mental health interpreting and judicial settings (see Chapter 12 on legal interpreting). This happens when patients are admitted to mental health institutions against their will and a judge has to hear the patient and his lawyer in order to make his judgement. In mental health care, there is hardly any way to diagnose and treat except through language.

Not surprisingly, interpreters working in the field of health care are relatively often engaged in mental health sessions. Interpreters are employed in sessions with various mental health providers, each type of session with its own characteristics and demands on the interpreter. This means that interpreters have to adapt their role according to the type of patient and type of session, and also to the idiosyncratic preferences of each individual mental health provider. Constructive cooperation thus depends on the alignment of the mental health provider, the interpreter and their mutual patient. Despite the different styles that are prevalent in the field, the author has a preference for a specific role, based on both theoretical arguments and her own experience, as will become evident in this chapter.