When You Don't Speak the Language

Posted on June 24, 2016

Here, my lack of Chinese excluded me from the conversation and forced me to focus on how the patient walked into the room, their posture and body language as they sat (or not) in the bright orange examination chair, how they looked (or not) at Dr. Wei, their facial expression, how much they spoke, for how long, and how their speech sounded.

Each of these data points is included in the “mental status exam,” a bedrock tool in Psychiatric clinical assessment. Observations of the patient’s body language, speech, and expression are combined with the patient’s answers to questions like “How’s your mood?” or “What’s on your mind?” The mental status exam provides a clinical framework for thinking about the patient’s condition and assessing how best to help.

One critique of the mental status exam is its inherent subjectivity—what seems like “fast speech” to one clinician may not seem as fast to another. What seems like appropriate body language in one culture might be totally bizarre in another context. And there’s the problem of describing in prose what you observe with your senses: not everyone’s a Hemingway.

By measuring a patient’s speech, we can say it has a speed of 200 words per minute, a volume of 70 decibels, and a pitch of 180Hz—which is much more useful and reliable than simply describing it as “fast.” Having a measurement also allows us to directly compare one patient’s values to another patient’s, to a group of healthy people, or even to that same patient’s value as they (hopefully) change through treatment. Natural language processing could also identify people who are at risk for specific types of mental illnesses.


Category(s):Health / Illness / Medical Issues, Mental Health Professions

Source material from Scientific-American