Things to Consider When Working with a Deaf Service User

1. Things to Consider When Working with a Deaf Service User Prevalence of mental health in deaf population ¼ of the whole population have mental health problems. Deaf people are almost twice as likely to experience mental health problems (40% -TEA report) There are increased emotional/behavioural disorders. More PDs. Comparable rates of schizophrenia but have more visual hallucinations. Prelingually Deaf have more tactile and visual hallucinations, a feeling of being spoken to, lips moving, hands signing. Others have some auditory. Tactile can be explained as a person’s perception of a voice.

2. Things to Consider When Working with a Deaf Service User cont’d Access to MH • Assessments tend to be longer • Appointments require more time • Assessments are multi layered-assessing communication, language, social inclusion, social/emotional delay as well as mental health • Education and treatment programmes adapted; break down to basic information, poor understanding of the body and health issue due to education practices and access to information. • Paucity and dysfluency of BSL not to be mistaken for thought disorder. • Difficulty with time lines is often seen as well as placement and subject identification. • Visual resources; pictures, widgit, photos

3. Things to Consider When Working with a Deaf Service User cont’d • Difficulties with group work • Difficulties accessing employment and inclusion in local services • Crisis difficulties, HTT and interpreting, accessing help for the person living alone • Small deaf community and concerns re confidentiality with interpreters as many are from deaf families and attend varying appointments so they get to know a lot about 1 person • Difficulties with family education, BFT due to lack of common language • Using interpreters doesn’t automatically give access to full language. They cannot comment on style, rate, form or content of language • Possible admission locally prior to specialist hospitals

4. How We Can Support You To Support Your Deaf Service Users • Advice on adaptation of assessment and treatment tools which are designed for hearing people. Limited literacy and reading skills ~ 8yrs • Deaf English-not thought disordered • Skills in recognition of emotions and feeling and how to express these with SUs who have little or no language learned to understand or recognise own feelings. Possession of a language system is necessary to facilitate abstract thinking, so lots of ToM lacking. • Support/supervision/advice to local Care Co-ordinators who will be accessing and signposting to local services and crisis management. • Joint working and RC collaborations • Medical specialist expertise and advice, for example, medications having differing effects depending on differences in brain physiology eg: due to meningitis • Consideration of Differential Diagnoses – eg: tinnitus • Working in collaboration with local mental health services – CMHT, drug/alcohol, PD teams, LD teams

5. Use of Interpreters • Generally localities have contracts with Interpreter agencies. • Different interpreters; BSL, SSE, hands on for deaf-blind, deaf blind manual, relay. • Prep the interpreter about what the discussion relates to. • The SU may have a preference; worries about confidentiality, gender of interpreter. • Sit next to the interpreter so the deaf person has eye contact with you both. • Speak at normal rate. • The interpreter signs consecutively but may be slightly behind so allow time for the deaf person to respond or clarify issues. • Check they have understood, change the wording of the question if so. • The interpreter may ask for clarification if they have not understood or they think the Deaf person has not understood. • Everything is interpreted so any aside comments will be translated or even bodily functions!! • MENTAL HEALTH EXPERIENCE! Interpreters may try to make sense of thought disorder if not experienced.