Current school-based mental health support for children from multilingual backgrounds can be "lost in translation" because it is reliant on good proficiency in English, a new study warns.
Alongside language barriers, cultural differences and mental-health related stigma mean some aspects of the psychological therapies children can access in schools may be less effective and inaccessible for those who speak English as an additional language,
The study says greater linguistic flexibility, including more choice over the languages used, are needed to improve mental healthcare for children with EAL.
Researchers interviewed educational mental health practitioners (EMHPs) who administer low-intensity psychological therapies to EAL pupils with mental health difficulties in schools. The study was carried out by Katie Howard and Darren Moore from the University of Exeter.
Most of the mental health practitioners interviewed described the linguistic challenges faced by EAL pupils when participating in psychological therapies, particularly when discussing emotions in their non-native language. This restricted EAL pupils' inclusion and engagement in psychotherapeutic interventions.
They described how conversations were frequently 'lost in translation' and meant children often received less comprehensive mental health support due to misunderstandings and miscommunication.
Dr Howard said: "If EAL pupils have difficulty understanding the mental health practitioner supporting them or feel misunderstood during sessions, then it is possible that support intended to alleviate their mental health difficulties could actually exacerbate the problems it seeks to address. EMHPs were generally sceptical that psychological therapies were as effective for EAL pupils as their monolingual peers, citing the reliance on the English language as the medium for therapy as a central barrier:
Practitioners noted how the lack of a direct translation for key terms also made it more difficult for young people to discuss the support with their families in their home language, resulting in reduced parental input.
Indeed, Dr Howard said, "The study also found that language barriers were especially prominent among the parents of EAL pupils, resulting in lower parental engagement and attendance, which are often crucial to the success of psychological support.. For example, the reliance on written materials was identified as particularly problematic for parents. Consequently, a more frequent drop-out rate among EAL families was reported."
Many of the practitioners reported that there were no or limited translated materials available to share with EAL pupils and their families, and that interpretation was either unavailable or hindered the therapeutic relationship.
EMHPs also considered school-based mental health support to be culturally inaccessible for many EAL pupils and their families, describing a 'shame factor' associated with mental health among some ethnic groups, which served as a barrier to access. For this reason, practitioners often found gaining parental consent difficult.
To remedy some of the challenges and concerns raised by the study, Dr Howard said: "Increasing access to psychological therapies for EAL pupils will mean placing more emphasis on linguistic flexibility as practitioners in this study consistently highlighted the need for language choice, reduced reliance on written materials, and creative strategies to overcome language difference
