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July 14, 2017

Receiving Treatment in the U.S. if I Don’t Speak English

Woman standing by the train

For those with limited english proficiency (LEP), facilities and practitioners use interpreters to communicate.

Some studies done on interpreters in treatment settings indicate that few interpreters provide accurate translations for practitioners. Limited access to health care can also be an issue when seeking eating disorder treatment.  Those who speak languages other than English are less likely to seek mental health services when referred for evaluation [1].

Developing culturally sensitive intervention models is a key component to reducing health disparities among non-English speaking individuals seeking treatment. Creating and maintaining peer and professional led support groups for non-English speaking individuals is important for consistent and professional care.

Considerations When Seeking Eating Disorder Treatment

When seeking eating disorder treatment, there may be issues when working with doctors and facilities.

In some areas of the country where non-English populations are high, there are more options for multiple languages to be offered among physicians and nurses. In less populated areas, the access to care may be less so. Regardless of the area of the country that you live in, you do have the right to request a trained interpreter for the services you are seeking to be able to clearly understand paperwork and treatment options [2].

Only 20 percent of Hispanics will talk to a physician about their mental health issues, according to a 2001 study [2]. With eating disorders, obtaining treatment can be life or death for many individuals. Being able to access care and understand the options available is essential to those with LEP.

An important part of seeking eating disorder treatment within the U.S. if you do not speak English is to ask providers questions about their practice and comfortableness with your cultural values and care concerns. Being able to feel connected with your practitioner or treatment team means knowing their comfortableness with working with you in your recovery.

Young woman stressed about her recoveryIt can help to ask your treatment team or facility if they have worked with others from your country of origin or culture before, if they feel comfortable with your personal and cultural beliefs, and do you feel that your cultural differences will work well together or not. This can help you make decisions on whether the clinician is a good fit for your recovery.

A 2012 study looked at how emergency departments used professional interpreters, untrained ad hoc interpreters, or no interpreters [3].

When the results came in, the team found that trained interpreters had less errors than untrained interpreters. It was also determined that using individuals who were not trained or loosely trained had dangerous results in consistent and quality care for patients.

Typically, if there are no trained translators, there is use of ad hoc translators, family members, other individuals from the waiting room and it can influence the care and meaning of the presenting issue.

Translation Services Available to You

There are organizations that provide interpreters either in-person or electronically.

One such option offers translation remotely. Both the patient and the treatment provider wear a headset that allows each individual to hear what the other is saying in their primary language. This can have downfalls of not having 100 percent language translation, but this system is very similar to the one that the U.N. uses for translation purposes [3].

Other companies have uploaded smartphone translation and interpretation applications that are specialized in common healthcare phrases.

There are many federal and state regulations designed to protect LEP patients from encountering healthcare barriers. According to the U.S. census data, more than 60 million individuals are non-English speaking [4]. Miscommunication can compromise patient safety and quality of care.

There are some technological solutions being developed, such as videoconferencing sessions with interpreters and smartphone applications that can act as digital translators, but most are in the infancy stages, and are expensive to purchase for most companies or treatment facilities.

Know Your Rights in Healthcare as a Non-English Speaker

Title VI of the Civil Rights Act of 1964 bans discrimination based on race, color, religion, sex or national origin for any federally funded program or agency [4]. The Culturally and Linguistically Appropriate Services (CLAS) was created to provide organizations who are funded federally with resources to provide non-English language services for those who request it. This includes translators and bilingual staff [4].

Woman riding her bike with her arms in the air

When seeking healthcare treatment when your language is non-English, it is important to know your rights [5]. Services available and things to consider when seeking eating disorder treatment are telephone language interpreters, which can be found online using keywords.

Often, family members or friends of the patient will be interpreters for care, but this is discouraged. Using a minor for interpretation services is also considered a breach of privacy and inappropriate when discussing treatment and care. It is acceptable, however, to be able to use staff within the treatment facility to translate, if received training as well as is bilingual.

In conclusion, seeking eating disorder treatment is possible in the U.S. and a non-English speaker. It is important to remember your legal rights, as well as know what to ask for when seeking translation services for eating disorder recovery.

Image of Libby Lyons and familyAbout the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice.

Libby currently works as a counselor at Fontbonne University and is a Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies.


[1] Reyes-Rodríguez, M. L., Ramírez, J., Davis, K., Patrice, K., & Bulik, C. M. (2013). Exploring barriers and facilitators in eating disorders treatment among Latinas in the United States. Journal of Latina/o Psychology,1(2), 112-131. doi:10.1037/a0032318
[2] (n.d.) Retrieved May 9, 2017 , from https://www.nami.org/Find-Support/Diverse-Communities/Latino-Mental-Health
[3] (n.d.) Retrieved May 15, 2017, from http://www.smithsonianmag.com/innovation/millions-americans-are-getting-lost-translation-during-hospital-visits-180956760/
[4] (n.d.) Retrieved May 20, 2017 from, https://www.ncbi.nlm.nih.gov/books/NBK19910/
[5] (n.d.) Retrieved May 20, 2017, from http://jaoa.org/article.aspx?articleid=2093746

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on July 14, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on July 14, 2017.
Published on EatingDisorderHope.com

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