Article Transcultural Psychiatry 50(4) 493–514 ! The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1363461513494993 tps.sagepub.com Mediating words, mediating worlds: Interpreting as hidden care work in a South African psychiatric institution Je ´ nine Smith Stellenbosch University Leslie Swartz Stellenbosch University Sanja Kilian Stellenbosch University Bonginkosi Chiliza Stellenbosch University Abstract Many mental health clinicians in South Africa use informal interpreters, who are employed to perform other functions, such as cleaners and security guards; there are no formally trained interpreters. Drawing on qualitative semistructured interviews, this paper examines the experiences of informal interpreters working within a psychiatric setting. Furthermore, this paper explores how working in this invisible capacity affects informal interpreters’ views of themselves and the contribution they feel they are making by acting as interpreters. An interpretative phenomenological approach enabled an in-depth analysis of the experiences of the ad hoc interpreters. The results of this study reveal a dilemma. On the one hand, informal interpreters interviewed jeopardize ethical principles by breaching confidentiality and reporting on patient behaviour with- out their consent. On the other hand, they report fulfilling an additional beneficial role in terms of the overall care of patients which goes beyond the ambit of the interpreting session. The impact and extent of the informal interpreters’ involvement in care could not be ascertained solely from the data obtained in this study, but it is clear that informal interpreting may usefully be viewed as a form of hidden care work. A detailed ethnographic study aimed at exploring this further is therefore recommended. Corresponding author: Leslie Swartz, Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602, South Africa. Email: Lswartz@sun.ac.za