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– Language barriers make refugee care difficult – New system improves dialogue between patients and therapists in psychiatry and psychotherapy
Courtesy KIT: The success of psychiatric and psychotherapeutic treatment depends crucially on the quality of communication between therapist and patient. For refugees, however, this often fails due to language barriers. As part of the BMBF RELATER project, the Central Institute of Mental Health (ZI) in Mannheim and the Karlsruhe Institute of Technology (KIT) want to develop a portable, secure and scalable translation system for diagnostic interviews with refugees from the Arab-speaking world.
“Despite the global network, our communication often fails due to different languages,” explains Professor Alexander Waibel of the KIT Institute of Anthropomics and Robotics. “This is also shown in the care, treatment and integration of refugees without knowledge of the German language.” Linguistic and cultural differences can lead not only to misunderstandings but, at worst, to misdiagnosis, especially for patients. with psychiatric disorders. Therapists rely on professional but mostly unskilled translators, who are usually unfunded and generally not present in emergency situations. Frequent changes of location also make it difficult for refugees to contact the therapist.
“With the RELATER project, we want to improve exchanges between refugees and professionals, especially in emergency situations, in order to allow a correct diagnosis and prompt treatment based on it,” says association coordinator Professor Andreas Meyer-Lindenberg, president from ZI and Medical Director Department of Psychiatry and Psychotherapy. “It is also planned to develop a smartphone application that enables continuous contact with the therapist,” adds Professor Heike Tost, head of ZI’s Systemic Neuroscience (SNiP) working group. With the help of the new smartphone translation system, partners in the joint project “Removing language barriers in refugee protection” (RELATER) under the leadership of ZI want to eliminate language barriers, encourage interaction and improve intercultural skills in psychiatry and psychotherapy. To this end, a self-learning translation system should support the internationally established diagnostic tool MINI (Mini-International Neuropsychiatric Interview). The machine translator should be used in initial diagnostic interviews with refugees in whom suspected mental disorder is used and continuously optimized.
For the first time, the research network brings together psychological and psychiatric knowledge with the huge advances in multilingual communication, machine learning and mobile communication technologies. “The project shows how basic research can be oriented in the best sense to social problems,” emphasizes Alexander Waibel. First, scientists want to develop a server-installed, locally-installed prototype that can be used quickly in larger clinics with their own infrastructure. They then want to further optimize this device for a portable device, independent of the Internet, and finally make it available as a smartphone app. In a national clinical study with refugees whose mother tongue is Arabic and who is registered with an initial reception center, the self-learning system should then be evaluated. The mobile platform created in the RELATER project will also be available for sustainable interaction between patients and therapists.
In addition, the smartphone app in its final version should take into account nonverbal and paralinguistic expressions such as gestures, facial expressions, or patient volume. “Especially the symptoms of mental illness are highly dynamic and context-dependent. Similarly, smartphone-based systems are available for recording, for example through electronic journals, so-called electronic journals,” says Professor Ulrich Ebner-Priemer. , head of the mental mHealth lab at the Institute for Sport and Sports Science of KIT.
The joint project, launched in February 2019, is funded by the Federal Ministry of Education and Research (BMBF) for four years, with about 3.8 million euros. The Institute for Anthropomatics and Robotics (IAR) and the Institute for Sport and Sports Science (IfSS) are involved in the project on behalf of KIT.
About ZI
The Mannheim Central Institute for Mental Health (ZI) represents internationally-renowned research and pioneering treatment concepts in psychiatry and psychotherapy, child and adolescent psychiatry, psychosomatics, and addiction medicine. Its four clinics guarantee the psychiatric care of the Mannheim population. People with mental illness of all ages can count on the most advanced treatments based on international knowledge. In psychiatric research, ZI is one of the leading institutions in Europe. The institute works closely with Heidelberg University and Heidelberg University’s Mannheim Medical School. With over 1,300 employees, ZI is one of Mannheim’s top employers.
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