Effectiveness of mental health services for deaf service users
Mental health issues can affect anyone regardless of ability or disability. However, those who are deaf or hard of hearing can face additional barriers in accessing effective mental healthcare. This article will explore the challenges deaf individuals encounter when seeking treatment for mental health conditions. It will also examine recent efforts to improve mental health services and make them more accessible and responsive to the needs of deaf service users.
Barriers to Care
One of the biggest obstacles deaf people face is a lack of communication accessibility. Many therapists, psychiatrists, and other mental health professionals do not know sign language and have not received training in working with deaf clients (Barnett et al., 2011). Without an interpreter or other accommodation, deaf individuals cannot effectively communicate private details about their mental state, history, or symptoms. This communication barrier alone can prevent or delay someone from getting an accurate diagnosis and appropriate treatment plan.
Even when interpreters are provided, there are still issues. Finding qualified sign language interpreters who are also knowledgeable about mental health topics can be difficult (Barnett et al., 2011). Video remote interpreting is an option but comes with its own challenges, such as potential lags or disruptions in the virtual connection. In-person interpreters also raise privacy and confidentiality concerns if the same interpreter is used for ongoing therapy sessions (Barnett et al., 2011).
Cultural and social factors also impact deaf people’s mental health and treatment experiences. Many deal with feelings of isolation due to communication barriers with hearing people and lack of inclusion in mainstream society (Barnett et al., 2011). The deaf community itself has a distinct culture and language that mental health professionals may not be familiar with or sensitive to. Additionally, past experiences of discrimination, such as abuse at sign-language-deficient residential schools for the deaf, can negatively influence help-seeking behaviors (Barnett et al., 2011).
Improving Access to Care
In recent years, more efforts have been made to expand the availability of culturally and linguistically appropriate mental healthcare for deaf individuals. Some communities have developed deaf-specific outpatient mental health clinics with staff who are fluent in sign language (Barnett et al., 2011). Telehealth has also shown promise for increasing access through video-based therapy and psychiatry using remote interpreters (Barnett et al., 2011).
Training programs are working to increase the number of mental health providers with sign language skills. For example, Gallaudet University, a renowned school for the deaf, launched a Clinical Mental Health Counseling program in 2016 to prepare counselors to work with deaf clients (Gallaudet University, n.d.). Additionally, national organizations like the National Association of the Deaf offer continuing education courses for current professionals on topics like working with interpreters, deaf culture competence, and evidence-based practices (National Association of the Deaf, n.d.).
Standardized screening and assessment tools are also being adapted for deaf individuals. Researchers at the University of Arkansas developed a culturally-sensitive version of the Beck Depression Inventory in American Sign Language (Vernon & Leigh, 2007). Similarly, Boston Children’s Hospital created a video-based screening tool for detecting symptoms of autism in deaf youth (Glickman, 2009). Such culturally-validated measures help ensure deaf clients receive accurate diagnoses.
Future Directions
While progress has been made, more work is still needed to eliminate disparities in mental healthcare for deaf communities. Areas that require ongoing attention and research include:
Expanding the availability of deaf-accessible outpatient clinics, especially in rural areas.
Increasing the number of mental health providers fluent in sign language through targeted recruitment and training programs.
Developing and validating additional culturally-appropriate assessment tools for conditions beyond depression and autism.
Promoting use of telehealth and video remote interpreting to connect deaf clients with qualified providers anywhere.
Addressing stigma and lack of mental health literacy within deaf communities through community education and engagement.
Advocating for insurance coverage of sign language interpreting in mental health settings on par with spoken language services.
Conducting more research on evidence-based therapies and their outcomes when delivered with and without interpreters.
Conclusion
With continued efforts to remove barriers, adapt services, and increase provider cultural competence, the mental healthcare system can become fully accessible and responsive to the needs of deaf individuals. Overcoming communication, cultural, and social challenges will require ongoing collaboration between deaf communities and professionals. But progress so far demonstrates that, with the right supports, deaf people can and should have the same right and opportunity to effective mental healthcare as others.
References
Barnett, S., McKee, M., Smith, S. R., & Pearson, T. A. (2011). Deaf sign language users, health inequities, and public health: opportunity for social justice. Preventing chronic disease, 8(2), A45.
Gallaudet University. (n.d.). Clinical mental health counseling. Retrieved from https://www.gallaudet.edu/graduate-catalog/clinical-mental-health-counseling
Glickman, N. S. (2009). Cognitive–behavioral therapy for deaf and hearing persons with language and learning challenges. New York, NY: Routledge.
National Association of the Deaf. (n.d.). Continuing education. Retrieved from https://www.nad.org/resources/american-sign-language/continuing-education/
Vernon, M., & Leigh, I. W. (2007). Mental health services for deaf people: A brief history and discussion of issues. In L. J. Robbins (Ed.), Therapy with deaf clients from diverse groups (pp. 3–26). Boston, MA: Pearson Education.
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