‘I wish to speak to a psychiatrist, please’: psychiatric vocabulary in phrase books

Phrase books play an important role for many tourists and travellers in helping to manage everyday situations. Whether or not individuals with mental health problems can express their needs in local languages using the vocabulary found in commonly available phrase books has not been assessed.

We wished to ascertain whether the expression of basic psychological distress was possible using widely available phrase books and whether vocabulary requesting access to psychiatric services was covered. Seven publishers of phrase books were identified: Teach Yourself, Dorling Kindersley Eyewitness, Lonely Planet, Berlitz, Rough Guide, Collins and BBC Active. For each publisher we aimed to assess phrase books in Spanish, Portuguese, Mandarin Chinese and Polish. All seven publishers produced phrase books for Spanish and Portuguese, two did not publish a Mandarin Chinese phrase book and one did not publish a Polish one. We assessed whether a particular phrase book contained a section on health and vocabulary regarding symptoms of depression, anxiety, psychosis, suicidal ideation, asking to see a psychiatrist, requiring psychotropic medication, specifically explaining that one is taking psychotropic medication, explaining that one is taking lithium. We obtained a total of 25 phrase books from the seven identified publishers.

All the books had sections on health: 12% (n=3) had vocabulary for depression and 40% (n=10) had vocabulary for anxiety disorders. Two of the publishers had produced phrase books which contained a word for ‘anxious’ in the general dictionary, without any cultural context, 16% (n=4) had a (context-free) expression for ‘I feel strange,’ but none had a word for ‘psychosis’ or stated how to say ‘I have a diagnosis of schizophrenia.’ None had any of the other vocabulary elements surveyed.

Publishers of phrase books were contacted for their comments and advice before the survey. The one representative of a publishing house who responded informed the authors that phrase books follow a set template closely (personal communication with Anna Stevenson, Harrap Publishing Manager, Chambers Harrap Publishers, 26 October 2007). It would be irresponsible to suggest that anything more than very basic expression of psychological distress and relevant needs would be possible using a phrase book. Cultural sensitivity would be required to help facilitate effective communication of the most immediate needs. However, as phrase books are prepared according to a template, it would seem a straightforward matter for psychiatrists to approach the publishers of phrase books with a few suggested phrases. Perhaps this is an opportunity to the specialty to work with the publishers to help, in a small way, make the lives of our patients easier.