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JADARA
Volume 45
Number 2
Article 3
November 2019
Mental Health Services for the Deaf: A Focus Group Study in New
York’s Capital Region
Heather K. Horton
University at Albany, State University of New York
Hee Chul Kim
Marley Mills
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Recommended Citation
Horton, H. K., Kim, H., & Mills, M. (2019). Mental Health Services for the Deaf: A Focus Group Study in New
York’s Capital Region. JADARA, 45(2). Retrieved from https://repository.wcsu.edu/jadara/vol45/iss2/3
MentalHorton
Health
Services
forServices
the Deaf:
A Focus
Study
et al.:
Mental Health
for the Deaf:
A FocusGroup
Group Study
in New Y
in New York's Capital Region
Heather K.Horton,Hee Chul Kim,and Marley Mills
University atAlbanyy State University ofNew York
Abstract
Improved functioning is typical when deaf mental health consumers are removed from
inaccessible programming and placed in accessible environments.Observed gains have longprovided convincing evidence that social interaction(in sign language)is essential to recovery
from mental illness. Still, many deafpeople reside in psychiatric settings alongside others with
whom they cannot communicate.A focus group was convened to investigate services in New
York's Capital Region.Identified barriers included lack ofdeafclinicians,scarcity ofqualified
mental health interpreters,and funding restrictions. Grass-root efforts are needed to advocate
for increased accessibility and a fuller range oftreatment options for deafconsumers.
Keywords: Deaf culture^ mental healthy incidence, prevalence, accessibility, interpreters, serious
mental illness.
Introduction
The development of effective mental health services for non-English
speaking populations in the US requires flexible and creative planning.
For the deaf, there exist finely tuned service streams in several geographic
pockets. Intensive networking and sharing clientele creates sets of
interconnected services—some dependent upon one another—that promote
healthy living and help prevent unnecessary hospitaHzation. A sm^ group
of experts (nationally) from wide-ranging disciplines are important sources
of knowledge regarding deaf psychology, the manifestation of psychosis,
and typical responses to medication, as well as developments regarding
treatment.
The present endeavor describes an effort to uncover current wisdom from
experts regarding mental health services for the deaf in New York's Capital
Region. We were interested in eliciting from stakeholders the influences
that challenge efforts to achieve psychological well-being for the population.
Stakeholders targeted for inclusion in a topic-based focus group were deaf
and hearing practitioners and advocates, as well as consumers of mental
health services.
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Incidence and Prevalence ofDeafness
The National Institute on Deafness and other Communication Disorders
(NIDCD)estimated that newborn hearing loss occurs 1.11 times per 1,000
live births, or 4,385 U.S. births per year(NIDCD,2005). Despite the fact
that 90% of all newborns are screened for hearing loss before they leave the
hospital,as many as 20% ofthose with permanent hearing loss at 9 months
of age are missed by current technology available for the early detection
of hearing impairment (Johnson et al., 2005). Furthermore, CDC data
revealed that in 2007, state programs for the early detection of hearing
impairment were unable to document whether diagnostic evaluations were
actually completed for 44.8% ofthe infants who failed the initial screening
(White, Forsman, Eichwald, 8c Munoz, 2010). As a result, a significant
percentage of children with hearing loss are not identified until the second
year offife or later.
\
The National Center for Health Statistics(NCHS)Centers for Disease
Control and Prevention has collected hearing status data continuously since
1962 via the National Health Interview Survey(NHIS).Using NHIS data
(averaged across 2000-2006),Schoenborn and Heyman (2008) determined
that the prevalence of hearing impairment in the adult population(18 years
and over) was 15.1%.Thus,approximately 34 million deaf adults resided in
the U.S. in 2006. When older adults were removed (i.e., those most likely
to have age-related hearing losses) and rates were based on Americans
between the ages of 18 and 64, the prevalence of significant hearing loss
was 4% or 7.5 million people (Schoenborn 8c Heyman,2008; U.S. Census
Bureau,2009).
Publications derived from the NCHS/NHIS data do not discern between
people born deaf(i.e., prenatal deafness) and those with acquired losses (e.g.,
adventitious or genetic postnatal deafness),and this data remains important
data to collect.The number of Americans who use sign language—another
issue of relevance to the Deaf community—also cannot be discerned from
the national data sets currently available. In a treatise related to the issue,
Mitchell,Young,Bachleda,8c Karchmer(2006) describe the persistent need
for information regarding the use of American Sign Language(ASL)that
is separate from data regarding deafness per se (e.g.,information regarding
hearing ASL users).
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One of the studies highlighted by Mitchell et al. (2006) served as a
potential model for future studies focusing on the prevalence of deafness
in the US.In 1971,Schein and Delk conducted the National Census ofthe
Deaf Population (Schein & Delk, 1974) and estimated that 410,522 deaf
Americans used sign language in their home (i.e., about 238 signers per
100,000 people). Similar investigations of the American deaf population
have not been conducted since.
The term pre-vocationally deafened (i.e., deafened prior to the age of20
years) reflects the population of interest herein and includes a substantial
number ofpeople who identify with deafculture.In aU,the deafpopulation
is exceedingly heterogeneous with regard to sign language use and level of
engagement with other deaf people.
Incidence and Prevalence ofSerious MentalIllness
Incidence of serious mental illness. Contrary to widespread belief, the
incidence of serious mental iUness (namely, schizophrenia) has prominent
variation over several criteria. For example, the incidence is significandy
higher in males, migrants, and those living in urban areas (McGrath &
Scott, 2006). In the U.S., estimates of the incidence of schizophrenia in
the general population (per year) range from 7 to 14 people per 100,000
(McGrath,Saha,Chant,6c WeUman,2006).
Incidence ofdeafness and serious mentalillness.Throughout much ofthe
20th century,the belief was maintained that the incidence ofschizophrenia
was higher among deaf people relative to hearing people. The idea may
have arisen from the disproportionate number of deaf people who were
institutionalized in psychiatric hospitals in the early 1900s (often evaluated
and diagnosed with schizophrenia by hearing people who did not know
sign language). Over time,the erroneous conclusion that higher prevalence
rates reflected an underlying higher incidence of mental illness was evident
in the literature (Critchfield,2002; Freeman,1989; National Association of
the Deaf,2003). At this writing,the true incidence of serious mental illness
in the deafremains unknown.
Prevalence of serious mental illness. Narrow and colleagues (2002)
determined a revised one-year prevalence rate of 20.9% for all psychiatric
disorders in the general adult population(18 to 54 years).The revised estimate
was derived from data collected by the National Institute ofMental Health
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Epidemiologic Catchment Area Program study([EGA] Robins 6c Regier,
1991) and the National Comorbidity Survey([NCS] Kessler et al., 1994).
The revised estimate falls well-below original estimates of37%[EGA]and
53%[NGS].When all ages are included(18 and over),Narrow,Rae,Robins,
6c Regier (2002) estimate that the one-year prevalence rate of any mental
disorder is 18.5%.
The prevalence ofschizophrenia is approximately 1.1% ofthe population
over the age of 18 (National Institutes of Mental Health [NIMH],2011).
At any one time,2.2 million people in U.S. suffer from schizophrenia (i.e.,
approximately 7.2 Americans per 1,000)(McGrath et al., 2008; NIMH,
2011). Based on a population of nearly one million in New York's Capital
Region, approximately 9,217 residents had schizophrenia in 2010 (U.S.
Census,2010a).
Prevalence of deafness and serious mental illness. Prevalence rates of
serious mental illness(e.g.,schizophrenia)in the general population may not
be appropriate for extrapolation to the deaf because of potential differences
in illness onset and trajectory.Though the total number of deaf people who
use sign language as their primary mode of communication is relatively
small, inadequate treatment in the early stages of mental illness may lead
to service dependency for the most ill. Thus, as others have discussed, the
number of deaf people receiving cosdy mental health services may be
disproportionately high relative to the general population (Freeman, 1989;
Fusick,2008; Gentili 6c Holwell,2011).
The true prevalence of schizophrenia in the deaf remains unknown;
however, investigations of deaf people with mental illness continue.
Across studies, cognitive, social cognitive, and symptom indicators of
schizophrenia are generally similar to those found among hearing people,
with a few notable exceptions (Atkinson, 2006; Black 6c Glickman,2006;
Haskins,2004;Horton,2010;Horton 6c Silverstein,2007;2008;2011).For
example, in a sample of 544 deaf and hard-of-hearing patients in upstate
New York,Pollard (1994)found prevalence rates of schizophrenia, anxiety,
mood, adjustment, and personality disorders (save antisocial personality
disorder) similar to a large hearing comparison sample (n=84,437). Earlier
work also found comparable prevalence rates of symptoms among hearing
samples(Grinker et al., 1969; Rainer,Altshuler, Kallman,6c Deming,1963;
Robinson,1978).
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The addition ofsurvey questions to the Census and the National Health
Survey are on the horizon because of efforts by advocates within the deaf
community.In the meantime an epidemiological studylike Schien and Delks
(1974),conducted by advocates from within the deafcommunity,would be
ofbenefit. Only then can we determine the true number ofdeafcommunity
members and the prevalence of mental illness within that community.The
number ofASL users (by age and hearing status) would be another helpful
by-product ofascertaining accurate population parameters.
Method
Rationale
The region where the focus group convened is comprised offour counties
(Albany, Rensselaer, Schenectady, and Saratoga) with a total population of
837,967 in 2010 (all ages)(U.S. Census Bureau,2010b). Extrapolating the
census-based estimate of a four-percent prevalence rate of deafness among
18—64-year-olds (Schoenborn & Heymanm, 2008), approximately 6,771
deaf people reside in New Yorks Capital Region.
The Americans with Disabilities Act ([ADA] Public Law 101-336,
1990) requires equal access to services for people with disabilities yet
studies continue to indicate that deaf people experience access difficulties
because of linguistic, cultural, and systemic barriers (Ebert 6c HeckerHng,
1995; Fusick, 2008; Gentili 6c Holwell, 2011; Harmer, 1999; lezzoni et
al, 2004; Thomas, Cromwell, 6c Miller, 2006). Current levels of health
disparity between deaf and hearing people make it reasonable to assume
that a significant number require mental health services (Barnett, McKee,
Smith,6c Pearson,2011).
Participants
Using the region's deafcommunity as the sampling frame,we purposively
sampled active mental health stakeholders for inclusion in the focus group.
Twenty potential participants, deaf and hearing, were identified via local
deaf informants.The criteria for inclusion were broadly defined as people
interested in deafness and mental health services for the deafin the Capital
Region. Potential participants received an email announcement soHciting
participation.
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In all, nine people (five deafand four hearing) attended the focus group:
three social service providers, four interpreters, and three mental health
consumers(each group was mixed with deafand hearing participants).The
groups of participants were not mutually exclusive; in addition to being
service providers for example two of the participants were also family
members of a deaf mental health consumer. Several other people were
present, but were not focus group participants: two certified interpreters
(Registry of Interpreters for the Deaf[RID]); two moderators (first and
second author); and one research assistant who videotaped the group for
later translation. The institutional review board (IRB) at the University of
Albany approved the consent,recruitment, and study procedures.
Procedure
A topic-focused group discussion allowed participants to share their
opinions,experiences,and beliefs asfreely as possible(Schulze6cAngermeyer,
2003). During the focus group, interactions among participants reduced
the amount of communication between moderators and group members.
Thus, the group dynamic superseded the influence of the researchers over
the interview process and allowed a more prominent role to the participants'
opinion (Madriz,2000).
We also considered the idea that focus groups are more appropriate for
eliciting responses that reflect the social realities ofthe interviewees(Kruger,
1994). We also hoped to take advantage of the idea that focus groups can
become a forum for change for participants and consumers both during
and after the focus group meeting itself (Race et al., 1994). Lasdy and
importantly, the methodology is especially consistent with deaf culture, as
gatherings of moderately large groups of deaf individuals are considered
opportunities for sharing information about topics often considered private
to hearing individuals (Steinberg, Barnett, Meador, Wiggins, 6c Zazove,
2006).
The focus group was held on May 19th,2009,at the University at Albany
in Albany, New York. After the study procedures were fully explained,
written informed consent was obtained from each participant. One-third of
the two-hour meeting was spent on introductions and reaching consensus
on a desired mode ofcommunication.Participants agreed that ASL was the
best communication method for the group; thus the interpreters sat next to
the one moderator (second author) who did not know sign language and
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quietly "voiced" (i.e., interpreted) the proceedings. Participants addressed
two primary topics during the focus group, both regarding mental health
services for the deafin the Capital Region: 1)current service opportunities;
and, 2) barriers and facilitators to accessing and using services. We were
primarily interested in the experience of deaf people requiring at least
minimal levels of ongoing mental health support.
Data Analysis
A paid native signer who was a child ofdeaf adults and an RID-certified
interpreter translated the videotaped data from ASL to English. The full
transcript was analyzed by means of an inductive formation of categories
aimed at understanding mental health service delivery in the region.
Data analysis was supported by Adas-ti software; the program facilitated
categorization by grouping the text into passages that corresponded to
particular ideas or themes.The second author conducted the initial coding
of the transcripts. Inter-rater reliabUity was garnered by the first authors
re-coding of the data. Differences in interpretation were discussed; themes
appeared to capture similar ideas and thus the essential quality ofthe text.
Results
Three primary themes emerged from the focus group discussion.The first
theme regarded several straightforward barriers to effective mental health
services; the second theme encompassed facilitators to providing effective
services; and the third regarded potential action steps for improving access
and dehvery of mental health services in the region.
Barriers to Effective MentalHealth Servicesfor the Deaf
Lack ofdeaf-ffiendly mentalhealth services. New York's Office ofMental
Health governs adult, child, forensic and research facihties for the entire
state (www.omh.state.ny.us). Capital District Psychiatric Center (CDPC)
provides inpatient services(among other services) for those with serious and
persistent mental illnesses in the Capital Region. With the exception ofthe
pubhc education system, the region does not include specialized services
for the deaf. General social service centers and other mental health and
substance abuse agencies offer services that are only marginally accessible
(e.g., interpreters present for several hours per day or week). By specialized
services for the deaf, we refer to facilities—and mental health programs
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in particular—that employ fiiU-time interdisciplinary staff who are fluent
signers,knowledgeable about deafness and deafculture.In all settings where
deafpeople frequent,communication and information access should be freely
available.
In the Capital Region,focus group participants made clear that the firststop for deafpeople with mental health concerns were places other deafpeople
work or frequent(e.g.,independentliving centers.DeafClubs,churches).Like
many ethnic,linguistic,and cultural groups,members ofthe deafcommunity
obtain information regarding mental health services from friends,family,and
other members of the community (Steinberg, 1991). Further complicating
access to mental health care is the fact that it is common for deaf people to
be unaware of existing local services (Steinberg, Sullivan,&Loew,1998).
The four-county region,inclusive of approximately two thousand square
miles, has a geographically widespread deaf population and several people
described this as being a hindrance to improving mental health services:
We must remember that the local deaf community [in
this region] is fractured.It is very difficult to get people
to band together and support one another, especially
for mental health needs.
Qualified mental health interpreters. Most participants, especially the
interpreters,described that few working interpreters understand deafculture
and possess mental health knowledge and experience(e.g.,"I started out as an
interpreter and soon realized that there were not a lot ofprofessionals locally
who understood deaf culture"). Similar to Briffa (1999), another participant
stated:
[MJany interpreters working in mental health settings
do not have enough background in mental health.
They are not able to see [the] subtle nuances that are
so important in this line of interpreting work. What
should be happening is teamwork between the therapist
and the interpreter, but what[happens instead] due to
budget constraints, is that the cheapest interpreter is
hired; this most likely means...[working with] underqualified individuals.
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Above and beyond locating,funding,and retaining qualified interpreters,
focus group participants emphasized the need to consider the fit between
the interpreter, the client, and the clinician; ideally compatibility should be
evaluated on a case-by-case basis (BrifFa, 1999; Comes 8c Napier, 2005;
Critchfield, 2002; Davis, 2005; de Bminn 8c Brugmans, 2006; Vernon 8c
Leigh, 2007). Discussants agreed that the most successful clinicians and
clinician-interpreter teams, in addition to possessing requisite diagnostic
and treatment knowledge,possess specific knowledge regarding the cultural
and linguistic characteristics of their clientele (Gutman, 2005; Haskins,
2004;lezzoni et al.,2004;Sussman 8cBrauer,1991; Vernon 8cMiller,2001).
Insurance-related barriers. Discussants explained that many agencies in
the region do not accept Medicaid as payment for mental health services.
Further, because Medicaid does not pay for interpreter services (i.e., ADA
is an unfunded mandate) opportunities are further limited for deaf people.
First,the cost ofinterpreter services was considered prohibitive for providers
and consumers alike; thus, even for providers accepting both public and
private insurance:
Many [still] cannot afford to pay for an interpreter,
especially those in private practice. Often, providers
will agree to make accommodations until faced with
the cost.
Second,rigid geographic boundaries within which one can receive mental
health services (described below) are harmful to the deaf primarily because
they further limit access to an already scarce pool of deaf-friendly services.
County-based services. The education and mental health systems in
New York serve as case examples of the barriers created by limiting service
options to ones home county. The Boards of Cooperative Educational
Services(BOCES) represents 37 education boards statewide (three in the
Capital Region). BOCES funding does not provide specific, deaf-centered
mental health services; the primary focus is on special education (e.g.,
deaf classrooms, interpreter services, social-emotional development). One
participant explained,"Deaf students cannot be referred outside of their
home county for mental health services with BOCES funding." A deaf
social worker from a community-based mental health center(CBMHC)
stated:
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[Since] money goes to the schools, we have to refer
outside [of BOCES] but the problem is there is no
place to which we can refer people. As others have
said,this is a problem in each county.
Thus, a piecemeal approach to mental health treatment begins for the
most impaired—typically provided by clinicians not familiar with deafness
and deaf culture.
Mental health centers are also county-bound in terms of deliverables.
However, a hearing social worker stated that one CBMHC located in
Rensselaer County did not "serve all parts of Rensselaer County." In one
case,"when I called regarding a deaf consumer, they stated services were
dependent on where in the county the consumer resided." Moreover:
I had a deaf consumer with Medicaid [living] in [a
county in the region] and I was unable to find any
mental health services for her. I even contacted
Medicaid and they sent me two numbers...one for
a psychologist who had retired and the other for a
pediatric psychologist (and my consumer was in her
40s). The[CBMHC]in [the county] would only see
her if she had a severe diagnosis, but would not do an
assessment.
The participant conceded that the incident occurred 2-3 years prior to
the focus group,and that since then,"things may have changed."
The following statement revealed the added value of just one deaf
psychologist to the Capital Region (psychologist s name changed):
I was unable to find any mental health services [for
some deaf clients] until Dr. Logan came along.
[Several CBMHC's] will accept Medicaid and will
provide interpreters [however] Dr. Logan has proven
to be a great resource as he accepts Medicaid and is not
county-specific.
Receiving services directiy from a deaf professional quickly benefitted
the deaf community, as Dr. Logan became the person-to-call for providers
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in need of culturally and linguistically sensitive mental health services.
Participants agreed that structured funding streams, not bound by county,
are needed in order to create high quality, deaf-focused mental health
services in the region.
Facilitators to Effective MentalHealth Servicesfor the Deaf
Facilitators often reflected the simple inverse of obstacles. However,
substantial discussion of several core facilitators reflected issues of high
value to the deafcommunity.
Culturally competent mental health professionals.Participants indicated
that ASL-fluent therapists are perhaps best equipped to effect change in
their deafclients. Rather than relying on an interpreter,signing practitioners
were preferred. A deafsocial worker stated that"[Deafpeople] would prefer
to see a professional who can communicate with them rather than pulling
someone else in."Another mental health consumer stated:
A third person in the room changes the dynamic.With
direct communication there would be more time spent
addressing real issues.
Some participants believed that social workers, psychologists, and
counselors should be educated about deaf culture and norms. For example,
one participant stated "[I]n my experience as an interpreter, I often need
to educate the therapist about deaf culture and norms [before therapy can
begin]."
Notably, there was one deaf mental health consumer who was "very
comfortable"with the use of an interpreter in therapeutic settings.The triad
created by a hearing therapist, hearing ASL interpreter, and deaf consumer
was perceived as supportive;indeed,the particular deaf participant had never
received services (directiy) from someone who signed. The focus groups
small sample of deaf community members thus reflected the heterogeneity
of the larger deaf community; the use of interpreters is an acceptable, even
preferred, way to receive mental health services for at least some portion of
the population, while other deaf persons would prefer ASL-fluent mental
health practitioners. Notably, most focus group participants were well-aware
oflegislation arising fromTugg v.Towey(1994)stating that services provided
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through a sign language interpreter are not equivalent to the sendees hearing
people receive and thus violates ADA.
Technology. Participants considered the use of technology, such as
videophones(VP),to be an important part ofincreasing accessibility in the
region.Two family members described a creative solution to a typical barrier:
"We prefer not to participate in [counseling] with an interpreter,[so] we
would consider [driving 3 hours] to meet a signing therapist and then do all
other sessions from the comfort ofour home [via] VP."
Technology as a means to increase mental health literacy among deaf
people was also discussed. An on-line community, as a means to share
information and provide social support,could be made available via a website
with videos in ASL.Linking to web pages originating in near-by cities with
large deaf populations would allow members to exchange information and
resources related to a variety of cultural and social opportunities, including
those related to mental health.
Action Suggestionsfor New Yorks CapitalRegion
The final theme,emerging toward the end ofthe focus group,centered on
potential action steps the group could take to effect change in the region.It is
noteworthy that a sense ofunity amongst focus group members was apparent
during this phase ofthe meeting and appeared to motivate creative thinking.
Initialaction suggestions.Increased funding for interpreters was reiterated
as a priority even though relying on interpreters was not the preferred mode
ofcommunication for the majority ofparticipants.One participant explained:
Myconcerns are around accessibilityfordeafindividuals.
HopefliUy we can influence systems that address the
affordability of interpreting services for mental health
providers.
A seasoned interpreter stated:"[I]t may help to provide public education
for mental health professionals [regarding the idea] that a deaf person is not
just a hearing person who doesht hear."A sub-theme of this discussion was
the participants' desire to attract more culturally competent mental health
practitioners and deaf professionals to the region.
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When distilled, mental health funding issues revolved around two
related state of affairs. First, ADA legislation does not apply to agencies or
businesses for which accommodations would prove a financial burden (e.g.,
employers with less than 100 employees).Therefore ADA compUance is not
required of many CBMHCs in the region. Second,agencies willing to hire
interpreters are limited to serving those who reside in the same county as
the agency—further restricting access to a fuU menu ofservices.It was clear,
at least to the group of deaf community members interviewed herein, that
there is Httle recourse when faced with a county with few signing clinicians
and/or providers who are excused from ADA compliance. In general, the
participants felt that the cost ofbeing accessible dictates level ofcompliance
with ADA legislation.
Task force development. A deaf participant described the core action
suggestion, as follows:
I think that this group here is a great start for a task
force or an advisory board ofsorts.We[could]formally
set up a group and meet on a regular basis with goals
and timelines...along with someone to chair the group.
As of now, it is too loose and may fall apart. That is
my recommendation; establish a task force with an
official name and a mission.This way you will get the
recognition needed.
The idea was supported and related actions were elaborated.For example,
data collection efforts that determine the prevalence of deaf people with
mental illness in the Albany area and attendance would be useful, as would
sending representation to local meetings administered by New York's Office
of Mental Health and the Albany County Department of Mental Health.
Developing potential aUies was considered an important part ofimproving
access to services.
Finally, it was re-emphasized that the fuU set of treatment options for
the deaf were lacking in the region. At the minimum, stakeholders will
need to advocate for the most basic of mental health services: Assessment,
individuahzed treatment plans,individual/group/family therapy, medication
therapy, symptom management, crisis intervention, case management, and
ongoing clinical support. Ideally, services would be delivered by fluently
signing psychiatrists,therapists,nurses,and case managers(deafand hearing).
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Study Limitations
There are several limitations to the study that may be outweighed by
mental health disparities influencing the deaf. The use of a convenient
sample means that results can only be generalized to a limited segment of
the general population. Namely, deaf people residing in mid-sized cites in
the U.S. However,even people residing in cites with similar concentrations
of deaf and hearing people may differ from the study sample because of
factors unique to New York or the Northeast. While generalizability is
limited, it is likely that deaf mental health consumers in other U.S. regions
face some of the sam?" challenges as those reported herein. A summary of
the major findings is presented in Figure 1.
Figure 1. Major Themes Derived from Focus Group.
Barriers to effective mental health services for the deaf
Lack of deaf-friendly mental health services
Qualified mental health interpreters
Insurance-related barriers
County-based services
Facilitators to effective mental health services for the deaf
Culturally competent mental health professionals
Technology
Action suggestions
Increased funding for interpreters
Task force development
Conclusion
We investigated mental health services for the deafin the Capital Region
of New York. Placed between two of the largest deaf centers in the world
(Rochester and New York City), the Albany area deaf community it is not
only much smaller, but is geographically widespread relative to the larger
cities. Specialists in deafness and mental health reside in the Capital Region
yet coordinated efforts are needed to advance the cause of gaining levels of
accessibility the general(hearing) population enjoys.
The data replicated several previous findings: a) there exist inequalities in
terms ofaccess to mental health services for the deaf; b)deafpeople generally
prefer direct communication with culturally sensitive,signing mental health
professionals; and c) interpreters are highly valued by the deaf community
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Horton et al.: Mental Health Services for the Deaf: A Focus Group Study in New Y
and are seen as necessary to improving accessibility in the region. Preparing
the manuscript for publication has contributed to post-focus group activities
including soliciting feedback from participants on the initial report and
planning development of a task force (underway at this writing).
The data collected reflected socially relevant and empirically valid
information about mental health services for the deaf. The desire for
specialized care is based on a century of research, from various empirical
perspectives, describing the populations unique cultural and linguistic
heritage. Deaf-centered treatment is based on the straightforward notion
that communicating freely, 24 hours per day with clinicians, receptionists,
support staff, and perhaps most importantly other consumers, is invaluable
to basic mental health.
ContactInformation
Heather K. Norton
School of Social Welfare
Richardson Hall 215
135 Western Avenue
Albany, NY, 12203
(518)442-5331
(518)442-5380 Fax
hhorton@albany.edu
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