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'You're Speaking My Language' - Mental Illness in the Deaf Community

 

Imagine that the only language you know isn’t widely understood, but you need to communicate a variety of differentthings just to get through the day.  Add to that, you think you are experiencing signs of mental illness. If you are deaf, and think that you’re hallucinating, how do you even describe what you’re experiencing, and to whom?

The challenge of finding specialized mental health care burdens those who are Deaf or Hard of hearing with an even larger disadvantage. Finding providers who offer qualified interpreters or who can communicate themselves via American Sign Language (ASL) can be extremely difficult, especially if that individual is also experiencing psychosis. 

In the Greater Cincinnati area, a one-of-a-kind program offering specialized help to this unique population has been available since 1993.  GCB’s Deaf Services is the only program of its kind in the southwest Ohio region serving long-term clients in the areas of employment, medical and housing assistance, in addition to psychiatric and care management services. Some clients have been receiving services for more than 20 years.

There are currently nearly 60 clients, ranging in age from 19-74 with an average length of service of seven years.  Deb Mann and Sharon Gardner are the program’s Deaf Services Specialists, Andrew Stryker is the Program Manager, and Marcia Johns is the Integrated Counseling Therapist, and fluent in ASL. All uniquely qualified, both Deb and Sharon were born with severe hearing loss, while Marcia and Andrew are hearing.

“The percentage of deaf population with some form of mental illness is slightly higher than the hearing population,” says Andrew.  “They have additional environmental challenges, risk factors – learning, emotional coping, relationship development, body language, etc. 

Offering services to psychiatric patients who are deaf, especially to persons who lack full language competency, requires clinicians to know sign language as well as the deaf cultural dynamics.  “The ability to communicate is at the heart of good mental health,” says Marcia.  “There are providers in the hearing community, but their qualifications may be limited.” 

 “English is a deaf person’s second language,” says Deb, “so learning how to read and comprehend the written word is much more challenging for someone who hasn’t been exposed to language since the day they were born.  Rules are more difficult to comprehend; it’s not easy to always know where to go for help.  It can feel very isolating, especially when there isn’t always an interpreter available.” 

For a deaf person. how do clinicians distinguish between cultural language limitations from thought disturbances, or mental illness? How are abstract English concepts such as “delusion” or “hallucination” to be explained or understood by a mentally ill deaf person?

“Even though it’s harder for deaf people to describe, the symptoms of mental illness are the same in both deaf and hearing,” says Marcia. “But interpreting the diagnostic criteria is different.  You have to understand the culture and real world experience.  It often takes detective work to understand what they’re experiencing.”

Deb and Sharon focus on helping clients transition to a more independent life, while teaching what is appropriate vs. non-appropriate behavior and expectations in the hearing world.  “Typical challenges can be ordering your own food at a restaurant, or communicating with a bank teller or doctor,” says Deb. 

Shonda was born to hearing parents who were overprotective and kept her ‘sheltered’ most of her life.  “I learned that it was ‘dangerous’ out there,” she says.  “I avoided interacting with people on the outside because I worried I would misunderstand them.  It was just easier to stick close to home.”

But Shonda wanted more for her life, and after years of being unemployed and enduring an abusive spouse, she sought out GCB for therapy and help in finding meaningful work.  “I wanted to get past feeling intimidated amongst hearing people,” she said. “GCB helped me understand who I am so I could improve myself, mentally and emotionally.”

This population can’t just ‘go anywhere’ for help,’ Marcia says.  “For those in this program, there really is nowhere else to go.”

 

Jill Wallace-Cooper