Last year, a young woman named Fatima found herself admitted to a state hospital in Northern California after experiencing a mental-health episode. The problem? Fatima didn't speak English and was feeling confused and scared. Unfortunately, the hospital staff didn't have any interpreters who could communicate in Fatima's native language, Arabic.

The staff did their best to communicate with Fatima using sign language and translation apps, but their efforts fell short. Fatima's feelings of isolation and frustration continued to grow. It wasn't until the hospital made the decision to bring in an in-person, onsite interpreter named Maria that everything changed.

Maria, an interpreter working for a language-services provider, spoke Arabic and was able to effectively communicate with Fatima. Maria became a constant presence at Fatima's caregiver appointments, helping her understand her treatment plan and creating a more comfortable environment during her time at the hospital. Through Maria's assistance, Fatima was finally able to explain her experiences in Syria and the events that had led to her mental health episode.

With a mutual understanding established, Fatima began to make significant progress in her treatment. She gained a deeper understanding of her illness, developed coping mechanisms, and even participated in group therapy sessions. After a few months, Fatima was discharged from the hospital, equipped with the skills to manage her illness, and live a more fulfilling life.

Other non-English speaking patients at the hospital reported similar satisfaction, as they could now fully express themselves with the help of professional interpreters.

The influx of patients in state hospitals is inherently unpredictable. It's impractical to expect these facilities to have staff interpreters for every language spoken by patients. However, by partnering with a language service provider like LanguageLine, state hospitals can ensure that all patients receive necessary care while also boosting staff productivity and efficiency.


State hospitals play a vital role in the mental health care system. Also known as public mental hospitals or psychiatric hospitals, they provide inpatient and outpatient treatment for people with mental illness. State hospitals typically have a larger capacity than private psychiatric hospitals, and they often serve a more diverse population.

According to the National Center for Health Statistics, last year there were 50 million visits to state hospitals across the United States. Over 7.5 million of those visits – or 15 percent – were by non-English speakers.

In New York, 20 percent of patients at state hospitals were non-English speakers. That number was even higher in California, where 22 percent did not speak English.

This diversity can present a challenge to effective care.


Language barriers often lead to significant challenges for caregivers and patients in state hospitals, according to “Languages of Care in Narrative Medicine.”

(Language barriers) can make it difficult for patients to understand their treatment plan, to communicate their needs to their providers, and to participate in therapy sessions,” Marini said. “This can lead to poor health outcomes, decreased patient satisfaction, and increased risk of medical errors."

Language barriers also negatively impact physicians and other caregivers. Studies indicate that staff efficiency decreases when state hospitals are faced with language challenges, leading to additional costs from more tests and longer stays. Moreover, without a proper language plan, these facilities risk non-compliance with federal healthcare laws.

However, state hospitals can proactively address these issues by prioritizing language access services. By doing so, they can enhance patient satisfaction, improve health outcomes, and boost staff efficiency in a thoughtful and conscientious manner.


When state hospitals consider language-access partners, it’s crucial to prioritize providers that offer a comprehensive range of services. This includes the ability to provide in-person, face-to-face interpreters as well as professional on-demand interpretation that is available remotely. Both approaches have their unique advantages and are invaluable in their respective situations. By having access to both options, state hospitals can ensure effective communication in all scenarios, catering to the specific needs of each situation.

The benefits of onsite interpreters include:

Nonverbal Communication: In mental health situations, nonverbal cues and body language can be essential for understanding a patient's emotional state and facilitating effective communication. In-person interpreters have the advantage of being physically present, allowing them to observe and convey these nonverbal cues accurately.

Complex or Delicate Situations: Mental health situations can involve complex emotional expressions, nuanced discussions, and delicate topics. A physical presence can help capture the depth of emotions, facilitate therapeutic interventions, and ensure precise communication between the patient and healthcare provider.

Meetings Where There Is Unpredictable Crosstalk: Meetings over mental health can involve unpredictable speech patterns and people frequently talking over one another. This type of dynamic can be disorienting for a virtual interpreter who may not be able to see who is talking.

For these reasons, in-person, face-to-face interpreters may be preferable for scenarios like:

  • Initial assessments
  • Complex or sensitive cases
  • Group therapy or support sessions
  • Discussions about aftercare and medication management

Virtual, on-demand interpreters can be beneficial for other reasons:

Accessibility and availability: Virtual interpretation offers broader access to interpreters in a wide array of languages, ensuring comprehensive language coverage.

Convenience and flexibility: Virtual interpretation eliminates the need for scheduling and physical travel. It can be easily coordinated to meet the needs of both the patient and the healthcare provider.

Cost-effectiveness: Virtual interpretation can be less expensive, particularly when considering travel expenses and time constraints associated with in-person interpretation.

Reduced stigma: In certain instances, patients prefer the comfort of being in a physical space with only their caregiver, without a third person present.

For these reasons, virtual, on-demand interpretation may be preferable for situations like:

  • Urgent or emergency scenarios
  • Telehealth appointments
  • Follow-up or check-in sessions


With a long history of partnering with state hospitals, LanguageLine is a trusted provider of both onsite, face-to-face interpreting and on-demand, virtual interpreting services. Our professional interpreters are available every day of the year and proficient in over 240 languages, including American Sign Language. They undergo specialized training in mental health terminology and ethics, ensuring a deep understanding of the field. Moreover, our interpreters possess cultural competency along with linguistic fluency, ensuring effective communication across cultural boundaries. Our on-demand interpretation service is available in video and audio-only formats, serving various needs, including telehealth and remote appointments.

LanguageLine also provides:

  • Translation of all written materials, including patient forms, educational resources, treatment plans, discharge instructions, and websites
  • Testing and training of all bilingual staff and in-house interpreters
  • Cultural competency training to help staff navigate cultural nuances, beliefs, and practices
  • Compliance and reporting to assist state mental health hospitals satisfy regulations, including Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act.

We invite you to contact us so that we can learn more about your state hospital and the linguistic challenges you may be facing.

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