Abstract
OPEN ACCESS Citation: Al Kalaf H, Jenks C, Mösko M, Sanders T, Schouten B (2025) When migrants do not speak the host country’s language but need mental health care: A protocol for developing a communication intervention. PLoS One 20(12): e0338040. https://doi. org/10.1371/journal.pone.0338040 Editor: Annesha Sil, PLOS: Public Library of Science, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND Received: November 6, 2025 Migrant clients frequently encounter communication barriers in mental healthcare, primarily driven by language differences that complicate the expression and understanding of psychological distress. Language barriers also affect mental healthcare providers (MHCPs), who often report low confidence and limited skills in navigating cross-linguistic encounters. Inadequate access to trained interpreters, uncertainty about their roles, and a lack of structured training leave MHCPs underprepared to ensure accurate communication and offer person-centred care. Strong collaboration between MHCPs, clients, and interpreters can significantly reduce communication barriers, fostering shared understanding and trust. However, existing initiatives to address language-related challenges in mental healthcare for migrants remain fragmented, lack cultural sensitivity, and are rarely designed or evaluated systematically. This study addresses this need by designing, developing, implementing, and evaluat- Accepted: November 14, 2025 ing a structured communication intervention that aims to strengthen MHCPs’ ability to Published: December 5, 2025 provide care for migrant clients who face language barriers. The intervention map- Copyright: © 2025 Al Kalaf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: All relevant data are within the manuscript and its Supporting Information files. Funding: This study was funded by Volkswagen Foundation (Grant number: ID: 9B368, awarded ping (IM) framework is used to conduct an extensive needs assessment, including interviews with MHCPs, clients, and interpreters across multiple countries, to identify communication challenges and inform intervention design. The training program was co-developed with stakeholders and pilot-tested to assess clarity, engagement, and practical relevance. The resulting evidence-informed program seeks to improve therapeutic communication and ultimately support better mental health outcomes for linguistically diverse migrant populations. PLOS One | December 5, 2025 1 / 16 to Mike Mösko. Funder website: https://www. volkswagenstiftung.de/en The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing interests: The authors have declared that no competin