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Deaf Individuals Face Challenges in Accessing Mental Health Services, Part 1

Seeking help for depression, an addiction or marital problems is intimidating enough. But imagine needing services for a mental illness or emotional problem and not being able to find anyone who speaks your language. This is a challenge that many deaf individuals face. There are only two licensed professional counselors who know sign language in Southwest Missouri. As part of our series this week on mental health, KSMU's Missy Shelton spoke with one of those counselors and files this report.

Shelton: Marcia Brewer works at Burrell Behavioral Health in Springfield. She's a hearing person who knows sign language. That enables her as a licensed professional counselor to work one-on-one with deaf people.

Brewer: "Very often, then they come into the office, here, in my office, it's the first time they've ever sat with somebody who is listening and giving them the opportunity to express what they need to express in their language."

Shelton: Brewer says that counselors who aren't used to working with deaf people sometimes misunderstand their clients. She says they may draw wrong conclusions from a deaf person's sign language and facial expressions, which are a normal part of how a deaf person communicates.

Brewer: "Very easily, I can misunderstand that and say, 'That person is having a hard time managing his mood. That person is probably a little bit drunk. That person sounds like he's mentally retarded or illiterate. I'm trying to write to him. He can't read. I think he has some mental dysfunction.'"

Shelton: To add to the communication problems, counselors who don't sign rely on an interpreter to tell them what the deaf person is saying. DeLinda Belanger is Care Coordinator for Deaf Services at Burrell. She is deaf herself and understands many of the issues her clients face in seeking mental health care. She says having an interpreter in the room during a counseling session can make a deaf person feel very uncomfortable. Marcia Brewer is interpreting for DeLinda Belanger.

Belanger: "This person's going to feel extremely awkward, like, 'I cannot truly open up and totally express everything freely because of this third person. And that interpreter is going to know everything about me.' And in the deaf community, here in the Springfield area, we have a very limited number of interpreters so we use the same interpreter for everything, for every appointment, every time we need an interpreter, that same person...they know everything about our lives. So, when you go to a counselor, it's very, very personal, very private, deep, intimate. 'I don't want anyone else to know. I don't want the interpreter to know because they're going to see me every week.'"

Shelton: Interpreters are bound by a strict code of ethics that requires them to maintain confidentiality...but DeLinda Belanger says that deaf people still wonder, in the back of their minds if that interpreter might tell someone else about their problems or judge the person for whom they're interpreting.

Besides communication, another barrier for deaf people who need mental health services is a lack of understanding of deaf culture. This is particularly challenging for deaf parents. Marcia Brewer again interprets for DeLinda Belanger.

Belanger: "Take for example, a deaf parent screaming at their child to get their attention or a deaf parent pounding the wall, stomping the floor, or pounding on a table to get their deaf child's attention. Within the hearing community, we tend to look at that and think, 'He's yelling. He's screaming. And we call that verbal abuse. Why are they screaming at that child?' Often, they'll call the hotline. That's actually happened, in fact more often than we would like to think. Children have been removed from the home because complained, 'I hear banging and yelling and screaming over there.' I often have to try to educate and say, 'That is not an abuse issue at all. That's simply a cultural issue. They can't call their name so they will bang the floor. They will pound their fist on a table. That's how they get someone's attention. That's a normal cultural thing but to the hearing, they're like 'That parent has a bad temper' or 'That parent's angry' or 'That parent's scaring the child.'"

Shelton: The need is great for mental health services that are culturally appropriate for the deaf. The same mental health disorders that exist in the general population also exist in the deaf community. Counselor Marcia Brewer says the lack of services contributes to problems among the deaf.

Brewer: "We have many adults in the community who are very unhappy. They use other ways to feel good. They use other ways to get what they want. They're often illegal but they're surviving. I'm not overstating it when I say that addiction is a foundational component of deaf culture."

Shelton: DeLinda Belanger agrees. She says when deaf people graduates from high school, they're almost at a breaking point because of the isolation they have felt for years. Again Marcia Brewer interprets for Belanger.

Belanger: "They feel very disconnected from society, from their peers, their high school hearing peers they never even knew the name of. They feel abandoned. They feel rejected. Nobody likes me. I've got problems I can't talk to anyone about. They've called me stupid, dumb. I'm an adult now and I'm longing for that sense of connection. I am desperate and I will do anything to get that sense of connection with someone so they see their friends, their neighbors drinking, using drugs. They're going to do it because that is the connection."

Shelton: And when a deaf person is ready to seek treatment for an addiction, ready to escape the very thing that has provided comfort and relationship, that person is back to the same problem...where to find a counselor who knows sign language and deaf culture, where to find a support group like Alcoholics Anonymous that will have accommodations for the deaf. And that's what makes the lack of mental health services so frustrating for many deaf individuals.