American Sign Language
Are deaf or hard of hearing people more susceptible to mental illnesses?
The ability to communicate is at the heart of good mental health. Within any large group of people, one may expect to find a smaller group with mental health issues. However, in addition to conquering the difficulties associated with the inability to effectively communicate, individuals in the deaf community must also attempt to find mental health facilities that can accommodate their special circumstances. With all the challenges that face these individuals, it would come to no surprise to learn whether they are more prone to mental health problems than hearing individuals.
First, any diagnoses of any mental health issue in the United States comes from one book, the DSM IV- the Diagnostic and Statistical Manual of Mental Disorders, Version IV. This bible of the mental health field is separated into five sections, though the first two are most prevalent in the studies to follow. The first section is Axis I, listing and describing the Clinical disorders including major mental disorders and learning disorders, such as depression, schizophrenia, ADHD, and bipolar disorder. Axis II lists Personality disorders such as paranoid personality disorder and dependent personality disorder, and mental retardation.
In diagnosing children with sensory problems it is important to remember that early onset of significant hearing impairment can have a profound effect on the child’s development, with adverse consequences for mental health, both in childhood and adult life. 90% of deaf children born to hearing parents risk developmental delays in language and vocabulary, resulting in consequences in emotional, psychological, and educational growth (du Feu, 2003). In the past, these consequences manifested themselves in lower expectations for deaf children, and difficulties in teaching them led to the absence of correctly diagnosing mild learning disabilities, attention deficit disorder, and even autism. The children’s behaviors were instead attributed to their deafness. As a result, deaf children have an increased prevalence of mental health problems, 45-50% versus an average of 25% for the general population. Interestingly enough, deaf children from deaf families do not show this increased level of mental health problems (du Feu, 2003).
Because hearing loss so readily interferes with the acquisition of vocabulary, the mean English literacy of deaf high school graduates is at the 4.5 grade level. (Reed, 2006) To compound this problem, a great many deaf people are not fluent in American Sign Language either, leaving the individual with a gross inability to communicate in general. Or, assuming the deaf person knows at least some ASL, written sentences may be choppy, incomplete, written in ASL syntax versus English grammar, and therefore may be misleading to the physician. Many mental help providers mistake normal language and communication issues for developmental delays, mental illness or mental retardation. However, misdiagnosing a non-fluent deaf person as psychotic is just as prevalent as mistaking psychosis as merely poor communication.
The fear of being misdiagnosed due to language and cultural differences is one reason why deaf people may be reluctant to seek treatment for a mental health problem. Early studies found that schizophrenia was more common in deaf individuals than hearing people; however, the redirection of diagnoses from schizophrenia to adjustment disorders and organic problems occurred as the diagnostic process became more accurate and clearly defined (Black, 2006). In addition, deaf people are far less likely to be diagnosed with psychotic diagnoses if they are served in a deaf psychiatric program versus the mainstream population; understandably, those specific deaf psychiatric programs are not always readily available in the individual’s vicinity.
Another reason deaf people may hesitate to...
Bibliography: Advances in Psychiatric Treatment, Margaret du Feu, 2003, volume 9, pp95-103
Deaf People: Mental Illness; Mental Illness in the Deaf Community: Increasing Awareness and Identifying Needs, Sandra Mueller, 2006, www.lifeprint.com
Serving and Assessing Deaf Patients; Implications for Psychiatry, B. Haskins, Psychiatric Times, December 2000, volume XVII, Issue 12
Demographics, Psychiatric Diagnoses, and Other Characteristics of North American Deaf and Hard of Hearing Inpatients, Patricia Black, Riverview Psychiatric Center, jdsde.oxfordjournals.org
Interview with Robert Pollard, Ph. D., Professor of Psychiatry at University of Rochester and director of Deaf Wellness Center, 2010, www.healthbridges.info
Mental Health Issues in the Deaf Community, Kimberly Reed, About.com guide 2006 bipolar.about.com/od/socialissues/a/000425_deaf.htm
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