Deaf mental health care: Difference between revisions
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Deaf Mental Health Care is providing counseling, therapy, and other psychiatric services to people who are deaf and hard of hearing in ways that are culturally aware and linguistically accessible. [1] It also includes research, training, and services in ways that improve mental health for deaf people. These services consider those with a variety of hearing levels and experiences with deafness focusing on their psychological well-being. The National Association of the Deaf has identified that specialized services and knowledge of the Deaf increases successful mental health services to this population.[2] It is not possible to know the cost of services per deaf person served and the cost per year to the tax bill of an average taxpayer because these statistics are not available. However, some states such as North Carolina, South Carolina, and Alabama have specialized Deaf mental health services. The Alabama Department of Mental Health has established an office of Deaf services to serve the more than 39,000 deaf and hard of hearing person who will require mental health services. [3]
There are multiple models of deafness; Deaf mental health focuses on a cultural model in that people who are deaf view themselves as part of a socio-cultural linguistic community, rather than people with a medical deficit or disability. Accordingly, providing deaf mental heath care to people of the Deaf community requires services from clinicians, doctors, and interpreters who are trained with this perspective and the inclusion of deaf professionals in this system of health care.
Deaf children/Language Development
Early access to language in deaf children is important for normal development of language. Deprivation of language can negatively effect mental health and in severe cases can cause mental health syndrome.[4] Access to auditory and/or visual language is important and availability differs based on each child's abilities. Approximately 40% of deaf children also have additional disabilities. [5]
Many states have deaf schools and institutions that provide appropriate language models along with mental health services for their students and those in the surrounding Deaf communities. The Lexington School for the Deaf in Queens, New York provides a variety of educational and social services for the deaf.[6] The Texas School for the Deaf in Austin, Texas also provides a focus on mental health for students.
Deaf children in mainstream schools may be more neglected in the classroom than their hearing peers. It is also more common for deaf children to have a harder time making friends.[7] Bullying can occur frequently among children who are deaf or hard of hearing, which can lead to negative mental health outcomes. [8]
Education/Access
For a deaf person, obtaining access to proper medical treatment is challenging and they face a variety of obstacles in communication and access. This can include the way in which medical professionals initiate patient's various health exams without prior modification suitable for deaf individuals[9]. Communication challenges and lack of doctor awareness of the culture and language of the deaf can lead deaf patients to avoid making medical appointments. [10] An increase in the amount of professionals who are trained in American Sign Language (ASL) and have experience with Deaf culture increase positive mental health outcomes for deaf people. [11][12]
Aging and Deafness
Age-related hearing loss gradually occurs in most people as they get older, typically affecting those over the age of 65.[13] This type of hearing loss can lead to feelings of embarrassment and isolation due to the fact that those affected may no longer be able to hear family, friends, or simple everyday sounds. Those with hearing loss are less likely to want to engage in social activities due to frustration over not being able to hear. A study conducted by the National Council of Aging (NCOA) showed that a large portion of elders with hearing loss who were studied, reported symptoms of lasting depression. [14] Higher rates of exclusion from social and employment opportunities due to higher rates of miscommunication, making deaf adults more susceptible to mental illnesses. [8]
Studies have found that when a person becomes deaf at an older age, it has a less extreme impact on their mental health than it does when hearing loss begins at an earlier age[15]. However, those who were either born deaf or lost their hearing at a younger age and then age as a deaf person face some particularly difficult challenges. When a non-deaf person ages, isolationist tendencies are generally increased. This increase is even more drastic for deaf people. Furthermore, many technological advancements that are heavily dependent on auditory communication also present challenges to deaf people.[16]
Knowledge of professionals
The type and onset of deafness may cause different types of language disfluencies, diagnoses, and treatments of clients who are deaf.[17] Cultural knowledge, language skills (e.g., fluency in ASL or access to trained interpreters), and other social-cultural factors are part of the deaf mental health access model. Lack of knowledge about Deaf culture and sign language amongst mental health professionals can make it difficult for deaf people to access appropriate services. [18]
ASL Interpreting & Training for Mental Health
The National Association of the Deaf[19] has eight recommendations for qualifications of interpreters working in mental health settings: [20]
1) Fluency in American Sign Language
2) Fluency in English and register choices
3) Culturally competent
4) Attending a comprehensive training curriculum for mental health interpreting
5) Mentoring with experienced mental health interpreters (at least 50 hours)
6) Individual or group supervision and peer consultation
7) High standards of ethical practice
8) Knowledge of relevant ethical literature or decision-making models in interpreting
Specific knowledge/training in mental health contexts is necessary for adequate sign language interpreting for mental health clients. Accordingly, the State of Alabama requires "Certification of mental health interpreters for persons who are deaf" for interpreters to work in mental health contexts, and this certification must be renewed yearly by either: a) working 40 hours in clinical settings, b) attending 40 hours of training, or c) a combination of work in clinical settings and training equaling 40 hours. [1] To provide the opportunity for education and training the Alabama Department of Mental Health's Office of Deaf Services established the Alabama's Mental Health Interpreter Training Project. [2]
Books & Research
Mental Health in Deaf Adults Symptoms of Anxiety
Language Deprivation and Deaf Mental Health
- ^ Glickman, Neil S. (2013-01-04). Deaf Mental Health Care. Routledge. ISBN 1136682791.
- ^ "Mental Health Services". 2016-12-06.
- ^ "Deaf Services". www.mh.alabama.gov. Retrieved 2018-10-20.
- ^ Hall, Wyatte C.; Levin, Leonard L.; Anderson, Melissa L. (2017-6). "Language Deprivation Syndrome: A Possible Neurodevelopmental Disorder with Sociocultural Origins". Social Psychiatry and Psychiatric Epidemiology. 52 (6): 761–776. doi:10.1007/s00127-017-1351-7. ISSN 0933-7954. PMC 5469702. PMID 28204923.
{{cite journal}}: Check date values in:|date=(help) - ^ Dijk, Jan van; Nelson, Catherine; Postma, Albert; Dijk, Rick van (2010-06-28). "Deaf Children with Severe Multiple Disabilities". The Oxford Handbook of Deaf Studies, Language, and Education, Vol. 2. doi:10.1093/oxfordhb/9780195390032.001.0001/oxfordhb-9780195390032-e-012 (inactive 2018-10-18).
{{cite journal}}: CS1 maint: DOI inactive as of October 2018 (link) - ^ "Mission Statements & Basic Tenets – About Us – Lexington School & Center for the Deaf". www.lexnyc.org. Retrieved 2018-10-04.
- ^ Nunes, Terezinha; Pretzlik, Ursula; Olsson, Jenny (2001-10). "Deaf children's social relationships in mainstream schools". Deafness & Education International. 3 (3): 123–136. doi:10.1179/146431501790560972. ISSN 1464-3154.
{{cite journal}}: Check date values in:|date=(help) - ^ a b Akram, B; Nawaz, J; Rafi, J; Akram, A (2018). "Social exclusion, mental health and suicidal ideation among adults with hearing loss: protective and risk factors" (PDF). Development. 2 (3).
- ^ Fellinger, Johannes; Holzinger, Daniel; Pollard, Robert (2012-03-17). "Mental health of deaf people". The Lancet. 379 (9820): 1037–1044. doi:10.1016/S0140-6736(11)61143-4. ISSN 0140-6736. PMID 22423884.
- ^ Levine, Jack (May 8, 2014). "Primary care for deaf people with mental health problems". eds-a-ebscohost-com.libdata.lib.ua.edu. Retrieved 2018-09-30.
{{cite web}}: Cite has empty unknown parameter:|dead-url=(help) - ^ Vernon, McCay; Leigh, Irene (2007). "Mental Health Services for People Who Are Deaf". eds-a-ebscohost-com.libdata.lib.ua.edu. Retrieved 2018-10-01.
{{cite web}}: Cite has empty unknown parameter:|dead-url=(help) - ^ Pettis, Christy Linn (2014). "Individuals with Hearing Loss in Arkansas and Mental Health Service: Evaluating Accessibility". eds-a-ebscohost-com.libdata.lib.ua.edu. Retrieved 2018-10-01.
{{cite web}}: Cite has empty unknown parameter:|dead-url=(help) - ^ "Age-Related Hearing Loss". NIDCD. 2015-08-18. Retrieved 2018-10-15.
- ^ "How hearing loss can impact mental health". Healthy Hearing. 2015-09-17. Retrieved 2018-10-15.
- ^ Tambs, Kristian (September–October 2004). "Moderate Effects of Hearing Loss on Mental Health and Subjective Well-Being: Results From the Nord-Trøndelag Hearing Loss Study". Psychosomatic Medicine. 66 (5): 776–782.
{{cite journal}}: CS1 maint: date format (link) - ^ Shaw, Sherry; Roberson, Len (October 2013). "Social Connectedness of Deaf Retirees". Educational Gerontology. 39: 750–760.
- ^ Crump, Charlene; Hamerdinger, Stephen (2017). "Understanding Etiology of Hearing Loss as a Contributor to Language Dysfluency and its Impact on Assessment and Treatment of People who are Deaf in Mental Health Settings". Community Mental Health Journal. 53 (8): 922–928. doi:10.1007/s10597-017-0120-0. PMID 28229314.
- ^ "Deaf Community Mental Health and Barriers to Care". Verywell Mind. Retrieved 2018-10-18.
- ^ "National Association of the Deaf". National Association of the Deaf. Retrieved 2018-10-07.
- ^ "Position Statement on Mental Health Interpreting Services with People who are Deaf". 2015-03-07.