Validation of an Automated Online Language Interpreting Tool - Phase Two.

The investigators propose to develop and test a novel automated asynchronous interpretation tool. The proposed project builds on previous research, piloting the automated asynchronous interpretation tool. This 5-year project will be conducted in two phases. In Phase 1 the investigators iteratively evaluate and refine the automated asynchronous interpretation tool already developed in prior studies. In Phase 2, the investigators evaluate this tool using a two-group randomized cross-over trial. Investigators compare:

• Method A (current gold standard of in-person real-time interpreting practice). A Spanish-speaking patient is diagnostically assessed in-person by an English-speaking psychiatrist through a Spanish-speaking interpreter.
• Method B (comparative practice - ATP). A Spanish-speaking patient is interviewed in Spanish by a trained mental health interviewer. The interview is recorded in real time, translated into English using the automatic interpretation tool and adding sub-titles to the video file, and sent to an English-speaking psychiatrist to asynchronously - that is, at a later time - review the video and make a diagnosis.

All patients will undergo evaluation by both methods. Half of the patients will be randomized to be assessed by Method A first, followed by Method B and half to be assessed by Method B first, followed by Method A. The specific aims of the study are :

• Aim 1: To iteratively evaluate and refine the automated asynchronous interpretation tool already developed in prior studies.
• Aim 2: To compare patient satisfaction of Method A vs. Method B.
• Aim 3: To compare the diagnostic accuracy and psychiatrist inter-rater reliability of Method A vs. Method B and demonstrate psychiatrist inter-rater reliability for Method B.
• Aim 4: To compare the interview and language interpretation quality and accuracy of Method A vs. Method B.

Inclusion criteria

Inclusion Criteria: Hispanic patients with significant Limited English proficiency (LEP)

• aged 18 or older
• diagnosis of a mood disorder, anxiety disorder, or substance/alcohol abuse disorder(s)
• Diagnosis of a chronic medical condition
• referred by PCP or self-referral with PCP informed

Exclusion criteria

Criteria:

• less than 18 years
• imminent suicidal ideation and/or plans
• immediate violent intentions or plans
• significant cognitive deficits
• patient who's PCP recommends not participating.