Deafness with Mental Health Issues
Deafness is a blanket term that includes many conditions. Approximately 1 in 1000 people are born profoundly Deaf or become Deaf prior to developing speech and verbal language. Most of these Deaf people use British Sign Language (BSL) as their preferred mode of communication.
Deaf people from part of a Cultural and Linguistic minority who are often discriminated against by the hearing population. Communication is of central importance in the assessment and treatment of Mental Health problems. Deaf people are greatly disadvantaged in accessing mainstream Health Services and particularly Mental Health Services.
Specialist Mental Health Services aim to provide for Deaf people using BSL and in Deaf aware milieu. Most Deaf people can benefit from access to specialist education, health services particularly specialist Mental Health and Forensic Mental Health Services. Deafness, because of resultant communication issues serves to isolate Deaf people in a hearing milieu.
Consequences of Deaf People having Mental Health problems
Deaf people can be misdiagnosed because hearing professionals without an awareness of Deafness or a facility in British Sign Language cannot assess their mental health need. The Department of Health has publicised advice Towards Equity and Access (TEA 2005). Deaf people remain seriously disadvantaged and cannot access mainstream Mental Health programmes and Rehab and Treatment programmes available, sometimes even with use of BSL Interpreters.
Emotional Implications of Deafness
Deaf people are prone to Frustration, Anxiety, Low Mood states, and occasionally challenging behaviour. Many Deaf people lack insight into the nature of their difficulties which add to problems in explaining and sharing their feelings. The majority of GPs and Mental Health professionals do not have facility in BSL or Deaf Awareness, and therefore the emotional and mental health problems can gradually deteriorate. The problems are further compounded by misdiagnosis and lack of access to appropriate treatment.
Cognitive impact of Deafness with Mental Health Issues
Psychological implications of the impact of deafness relate to the cause of deafness, age of onset of the deafness and experience of deprivation.
Deafness can be associated with neurological damage and learning disability, which have adverse psychological effects on mental state and behaviour. Deafness before acquiring speech (pre-lingual deafness) is distinct from deafness after acquisition of speech (post lingual deafness). Rarely development of pre-lingual deaf children is compounded by communication difficulties, which impact on the deaf child's linguistic, social, emotional and psychological development.
Deprivation experienced by deaf individuals can restrict integration, reduce experiences, limit the individual's ability to express themselves. Deprivation experienced by some deaf individuals can affect the development of Theory of Mind. Deprivation causes the individual to miss environmental feedback about socially appropriate behaviours, which affects the individual's socio- moral reasoning and attendant behaviour. Some deaf people have limited understanding of social aspects of life and develop poor coping strategies to manage their emotional states and their behaviour.
Rehabilitation of patients with Forensic Mental Health Issues
Deaf people with forensic mental health issues have specialist needs that can only be met by professionals who have Deaf awareness and communicate using British Sign Language. Deaf individuals can be found Unfit To Plead due to lack of understanding of arrest procedures, inability to instruct Solicitors and inability to follow court proceedings. Rehabilitation and treatment often requires preparatory work to develop emotional language and to educate them about processes related to the law. Treatment programmes such as SOTP, Anger Management, Substance Misuse programmes, have to be adapted to meet their needs. Treatment programmes are invariably of much longer duration than those of hearing people.
Services offered for Deaf patients with mental health issues
The service is designed to meet the needs of individuals with physical disabilities and/or sensory or cognitive impairments. The facilities enable the highest possible quality treatment and care to be provided to meet the care needs of the individual
Useful Links for dealing with deafness
Royal National Institute for Deaf People (RNID)
UK Council on Deafness