Visit our publications page to download this position statement as a pdf.

One of the problems facing mental health services is that of communicating effectively essential information concerning their services and care plans with deaf people. Planners and providers of mental health services need to recognise their responsibilities and the rights of deaf people to have full information and access to services available to the community as a whole.

Under the Disability Discrimination Act 1995 (DDA), it is unlawful for a service provider to discriminate by offering a lower standard of service or providing a service in a worse manner to deaf people.

SCoD is also concerned that deaf people with mental illness should receive the same standards of health promotion, assessment, treatment, care and rehabilitation as hearing people and, therefore, that the health service makes provision for the special needs of those with hearing loss.

There are currently no reliable statistics on the incidence of mental health associated with sensory loss - this warrants further research.

While it is generally known that deaf people have the same range of mental health problems as hearing people, the incidence of mental illness amongst deaf people is estimated to be about 4 times greater than in the general population.

It is also important to recognise that deafness may present special problems in the diagnosis and treatment of mental illness; because of poor communication mental illness may go unrecognised in deaf people or mental impairment may remain undiagnosed.

The Scottish Council on Deafness therefore recommends that the following good practice be implemented:

1. The National Health Service in Scotland should provide good quality services and facilities (see below) which are appropriate for the treatment of deaf people with mental illness, both in the settings of primary and secondary care.
   
   
2. The health services should give consideration to improving the accessibility of the services to deaf people, particularly with regard to telecommunication for making appointments, enquiries, etc. and vice versa.
   
   
3. The health services should consider the needs of deaf people who are outpatients, e.g. in the waiting areas, (loop systems, visual systems, amplified payphones, textphones, etc).
   
   
4. The health services should consider the needs of deaf people who are in-patients, e.g. in the wards (amplified payphones, textphones, televisions with teletext/captioning facility, etc.)
   
   
5. The health services should be responsible for the provision of and payment for appropriately trained and registered communication service providers in hospitals and in primary care, e.g. Sign Language Interpreters, Lipspeakers, Notetakers, Deafblind Communicators, etc. (see point 10 below)
   
   
6. The health services should consider the use of videophone technology which should enable Deaf sign language users to have access to a Sign Language Interpreter at all times when in contact with the health services.
   
   
7. Health services personnel should receive deaf and deafblind awareness training; this should be provided both in pre-service training, and in in-service training on an ongoing basis.
   
   
8. Information on mental health and related subjects should be developed in appropriate languages and with illustration, taking into account the culture, identity and language of deaf people.
   
   
9. Professionals in the field of mental illness should be aware of deaf people's communication needs and of their own need to improve communication and understanding.
   
   
10. Where external communication support services are used the communication service provider should have the necessary training for working in the field of mental health & deafness.
    
    
11. Each health board should have full-time staff (such as CPNs) who have knowledge and experience of working with deaf people, i.e. people who have a thorough understanding of deaf issues and who are trained to communicate with deaf people.
    
    
12. Health service personnel should be fully aware of the Disability Discrimination Act and other relevant legislation.
    
    
13. Deaf people should have full and real involvement in the planning, setting priorities, provision and monitoring of mental health services.
    
    
14. Mental health services should encourage the employment of deaf people to facilitate service use by deaf people.
    
    
15. All staff in the mental health services should also be fully aware of the Scottish Council on Deafness's position statement on health services and which should be read in conjunction with this document.

Selected Bibliography

Mental Health Services for Deaf People: Are they appropriate, Sign, 1998.

Mental Health Services: forging new channels, British Society for Mental Health & Deafness, 1998.

Denmark, John C., Deafness and Mental Health, Jessica Kingsley Publ., 1994

Heath, Ian, Tinnitus and Health Anxiety, British Journal of Nursing, Vol. 3, No. 10, 502-505, 1994.

Hindley, Peter, Psychiatric Aspects of Hearing Impairments, Journal of Child Psychology and Psychiatry, Vol. 1, 101-117, 1997.

Hindley, Peter & Kitson, Nick, Mental Health and Deafness, Whurr Publ., 2000.

Iqbal, Z. and Hall, R., Mental Health Services for Deaf People: A Need Identified, Public Health, Vol. 105, 467-473, 1991.

Ridgeway, Sharon, Deaf People and Psychological Health - Some Preliminary Findings, Deaf Worlds, Vol. 13 (1), 9-18, 1997.

Stewart, George, Deafness and Mental Health, MIND, December 1998.