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Induction Pack for new Staff and Students Mental Health and Deafness
Information on Deaf Issues
Types and levels of deafness
Types of language and communication
Communication Tips
Communication Support
Sign Language Interpreting Service
Interpreting Policy
Signing Policy and BSL Classes
Deaf Community
Deaf Organisations
Equipment and Technology, On-line BSL interpreter
Mental Health by Jim Cromwell
Mental Health and Deafness Tips
Deaf Ethnicity in Mental Health
Towards Equity and Access report 2005
References
Mental Health and Deafness Contact
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Herbert Klein 10
Types of Deafness
Some children are born deaf and others become deaf later (are deafened),
due to illness or medication they may have been given. Few children are
profoundly deaf. Most have some hearing on some frequencies at certain
volumes.
There are three types of deafness, these are described below:
Conductive deafness
This is the most common type of deafness. It occurs when sounds cannot
pass through the outer and middle ear to the inner ear, (which includes the
cochlea). This is often caused by blockages such as wax in the ear canal or
fluid in the middle ear.
Sensori-neural deafness (or ‘nerve deafness’)
As sound passes through the outer and middle ear, tiny hair cells in the
cochlea convert sound waves into electrical signals. These signals travel
along the auditory nerve to the brain. Most cases of sensori-neural deafness
are caused by loss of, or damage to the hair cells in the cochlea.
This damage can be caused by infectious diseases such as rubella, mumps,
measles or meningitis. Children may be deaf because of a shortage of
oxygen in the bloodstream at birth or could be a result from another trauma
during pregnancy or childbirth.
Mixed Deafness
This is a mixture of conductive and sensori-neural deafness.
Levels of Deafness
There are different levels of deafness and these are most often classified as
mild, moderate, severe or profound.
Mild Deafness
A child with mild deafness may be able to hear sounds ranging between 24
and 40 decibels (dB) on average in their better ear. Children with a mild level
of deafness may find it difficult to follow speech in situations where there is a
lot of background noise.
Moderate Deafness
A child with a moderate level of deafness may hear sounds between 40 and
70 decibels on average in their better ear. Children with moderate deafness
find it difficult to follow speech without a hearing aid or other technology to
amplify the sound.
Severe Deafness
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A child with a severe level of deafness may hear sounds between 70 and 95
decibels on average in their better ear. Children with a severe level of
deafness may rely heavily on lip-reading or may use sign language as a
communication method. They may also use technology such as a text phone.
Profound Deafness
A child with a profound level of deafness can hear sounds of around 95
decibels or more on average in their better ear. Profoundly deaf children may
lip-read and/or use sign language and use a text phone.
The commonest cause of acquired hearing loss is ageing. Some illnesses,
such as mumps, measles and meningitis, and severe head injuries may also
cause deafness. Exposure to extreme noise, for example, explosions or
repeated exposure to loud music or machinery, may also cause hearing loss.
There are other reasons for deafness. One or two children per thousand are
born with significant, permanent deafness. Of these, an estimated 50% have
a moderate hearing loss, and 50% are severely or profoundly deaf. There are
many reasons why a child may be born with a hearing loss – over 90% of deaf
children are born into families where both parents are hearing.
Hearing Aids and Cochlear Implants
Hearing Aids
Most hearing aids have a common purpose – to amplify sound signals. They
come in various shapes and types and may be worn on the body, behind the
ear, or in the ear. Some, like cochlear implants, have parts that are surgically
implanted. Most have audiological settings so they can be adjusted to suit the
users’ specific needs. A range of digital hearing aids are available which offer
much more precise control of these settings. Hearing aids enable people to
utilise their residual hearing. It is important to remember all noise including
background noise is amplified making communication difficult in noisy
environments.
Cochlear Implants
Most sensory neural deafness is caused by loss or damage to the tiny hair
cells in the cochlea. Where enough functioning hair cells remain,
conventional hearing aids may help. If a child has a severe to profound
deafness, there may not be sufficient functioning hair cells for hearing aids to
be effective. For these children a cochlear implant may help.
The implant is a sophisticated hearing aid, which works by stimulating the
auditory nerve and bypassing the damaged hair cells in the cochlea to provide
a sensation of hearing. Like hearing aids, cochlear implants do not restore
typical hearing levels. The implant system has two parts; the external part
consists of the speech processor, a lead, transmitter coil and microphone.
The internal part is surgically implanted under the skin behind the ear. It
includes a number of electrodes that directly stimulate the auditory nerve.
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Herbert Klein 10
Types of Language and Communication
How deaf people communicate depends on their hearing loss and their
preference.
People with mild hearing loss (25-40dBHL) may have some difficulty in
following what is said, mainly in groups or noisy situations. Some wear
hearing aids and find lip-reading helpful in certain situations.
A moderate hearing loss (40-70dBHL) means people have difficulty in
following what is said without a hearing aid, particularly somewhere noisy.
They will probably use a voice telephone if it has an adjustable volume or is
designed to work with hearing aids.
People with a severe hearing loss (70-95dBHL) may have difficulty following
what is being said even with use of a hearing aid. Many rely on lip-reading
and some use British Sign Language (BSL). Most deaf find it hard to use a
voice telephone, even if it is amplified, and the majority choose to use a text
phone.
Hearing aids may be of little or no benefit to people with profound hearing loss
(95+dBHL). They may use British Sign Language (BSL) or lip-read, or both.
They will probably use a text phone. Some may have a cochlear implant.
British Sign Language (BSL)
BSL is the language used by 50,000 – 70,000 people within the British Deaf
community (RNID). BSL is a complex visual-spatial language with its own
vocabulary, structure and grammar, which is different from spoken English.
BSL uses both hand shapes and non-manual features including facial
expressions, lip shapes and body movement. As spoken languages have
different dialects, sign language has regional variations. Also, as with spoken
languages, sign language is different in different countries. BSL is a language
in its own right. BSL is officially recognised by the UK government to be a
language. Recognition was achieved in March 2003. Finger spelling is a way
of spelling out words, usually for names and places, using your hands to show
each letter. In Britain most people use a two-handed alphabet. Some
countries (for example North America) use a one-handed alphabet.
Auralism/Oralism
An umbrella term covering aural/oral approaches to communication and
education that concentrates on developing listening skills and spoken
language.
Lip-reading/speech reading
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Lip-reading/speech reading is used by some deaf people to follow speech.
When people speak, their lips make patterns. Lip-reading is the ability to read
these patterns. It is not possible to distinguish all the parts of speech from lipreading alone, as only a third of words can be understood by lip-reading.
Knowledge of spoken language is extremely important for successful lipreading.
Sign Supported English (SSE)
Sign Supported English uses BSL (signs and finger spelling) and follows
English word order but it does not require every word to be signed.
Signed (Exact) English (SEE)
Signed (exact) English uses BSL (signs and finger spelling) and other
specifically developed signs to give an exact manual representation of spoken
English. Each spoken word is represented with a sign and it is designed to be
used at the same time as spoken English.
Total Communication
Total communication is a philosophy, which involves selecting the
communication method that is the most appropriate for the individual at any
given time. Total communication may involve the use of aural/oral support
and/or the use of a sign system.
Bilingualism
Bilingualism is the ability to use two languages fluently. Usually for deaf
people in England these are English and British Sign Language.
Cued Speech
Some words which sound different when verbalised can look very similar
when they are lip-read by deaf people (e.g. pat and bat). Cued speech uses
one hand placed near the mouth and a variety of hand shapes to highlight the
differences between spoken words.
Makaton
Makaton is a basic system of a few hundred signs, which is mainly used by
children and adults who have learning disabilities. Although it is separate
from BSL, it is used by some deaf children and adults with additional needs.
It consists of vocabulary, (influenced by BSL) which allows the child to
express basic needs.
Deaf blindness
About 23,000 people in the UK have a combined sight and hearing loss
(RNID). They need additional support for communication, accessing
information and mobility.
Degrees of deafness
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Herbert Klein 10
Hearing loss is measured in decibels, as dBHL (hearing level). It is often
greater at some pitches than others. Many people have less hearing at high
pitches than at low pitches. They may be able to hear you speak but not
make out the words because they cannot tell the difference between some
consonants, particularly the higher pitched ones like ‘s’, ‘sh’, ‘f’, ‘p’, ‘t’ and ‘k’.
Statistics on the incidence of deafness within the UK Population.
Description of
hearing loss
Average dBHL
(better ear)
Number of
people
% of total UK
population
Mild
25-40
4,645,000
7.9%
Moderate
40-70
3,335,000
5.7%
Severe
70-95
537,000
0.9%
Profound
95+
146,000
0.2%
8,663,000
14.7%
Total
Estimates are based in National Study of Hearing (see A Davis, Hearing in
Adults, Whurr 1995) and current general population estimates.
Statistics relating to deafness are regularly published on the RNID website:
See www.rnid.org.uk
RNID Tinnitus
Tinnitus helpline
0808 808 6666 voice
0808 808 00007 text
020 7296 8199 fax
tinnitushelpline@rnid.org.uk
For further details on oral education please refer to the following websites:
www.dex.org.uk
www.deafeducation.org.uk
www.batod.org.uk
www.lipspeaking.co.uk and www.lipreading.org.uk
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Herbert Klein 10
History of Sign Language
Juan Pablo Bonet, Reducción de las letras y arte para enseñar a hablar a los
mudos (Madrid, 1620).
The written history of sign language began in the 17th century in Spain. In
1620, Juan Pablo Bonet published Reducción de las letras y arte para
enseñar a hablar a los mudos (‘Reduction of letters and art for teaching mute
people to speak’) in Madrid. It is considered the first modern treaty of
Phonetics and Logopedia, setting out a method of oral education for the deaf
people by means of the use of manual signs, in form of a manual alphabet to
improve the communication of the dumb or deaf people.
From the language of signs of Bonet, Charles-Michel de l'Épée published his
alphabet in the 18th century, which has arrived basically unchanged until the
present time.
In 1755, Abbé de l'Épée founded the first public school for deaf children in
Paris; Laurent Clerc was arguably its most famous graduate. He went to the
United States with Thomas Hopkins Gallaudet to found the American School
for the Deaf in Hartford, Connecticut.[1] Gallaudet's son, Edward Miner
Gallaudet founded the first college for the deaf in 1857, which in 1864 became
Gallaudet University in Washington, DC, the only liberal arts university for the
deaf in the world.
Generally, each spoken language has a sign language counterpart in as much
as each linguistic population will contain Deaf members who will generate a
sign language. In much the same way that geographical or cultural forces will
isolate populations and lead to the generation of different and distinct spoken
languages, the same forces operate on signed languages and so they tend to
maintain their identities through time in roughly the same areas of influence as
the local spoken languages. This occurs even though sign languages have no
relation to the spoken languages of the lands in which they arise. There are
notable exceptions to this pattern, however, as some geographic regions
sharing a spoken language have multiple, unrelated signed languages.
Variations within a 'national' sign language can usually be correlated to the
geographic location of residential schools for the deaf.
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Herbert Klein 10
International Sign, formerly known as Gestuno
It is used mainly at international Deaf events such as the Deaflympics and
meetings of the World Federation of the Deaf. Recent studies claim that while
International Sign is a kind of a pidgin, they conclude that it is more complex
than a typical pidgin and indeed is more like a full signed language.
Engravings of Reducción de las letras y arte para enseñar a hablar a los
mudos (Bonet, 1620)
A.
B, C, D.
E, F, G.
H, I, L.
M, N.
O, P, Q.
R, S, T.
V, X, Y, Z.
Linguistics of Sign
In linguistic terms, sign languages are as rich and complex as any oral
language, despite the common misconception that they are not "real
languages". Professional linguists have studied many sign languages and
found them to have every linguistic component required to be classed as true
languages.
Sign languages are not pantomime - in other words, signs are largely arbitrary
and have no necessary visual relationship to their referent, much as most
spoken language is not onomatopoetic. Nor are they a visual rendition of an
oral language. They have complex grammars of their own, and can be used to
discuss any topic, from the simple and concrete to the lofty and abstract.
Sign languages, like oral languages, organise elementary, meaningless units
(phonemes; once called cheremes in the case of sign languages) into
meaningful semantic units. The elements of a sign are Handshape (or
Handform), Orientation (or Palm Orientation), Location (or Place of
Articulation), Movement, and Non-manual markers (or Facial Expression),
summarised in the acronym HOLME.
Common linguistic features of deaf sign languages are extensive use of
classifiers, a high degree of inflection, and a topic-comment syntax. Many
unique linguistic features emerge from sign languages' ability to produce
meaning in different parts of the visual field simultaneously. For example, the
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Herbert Klein 10
recipient of a signed message can read meanings carried by the hands, the
facial expression and the body posture in the same moment. This is in
contrast to oral languages, where the sounds that comprise words are mostly
sequential (tone being an exception).
Sign languages' relationships with oral languages
A common misconception is that sign languages are somehow dependent on
oral languages, that is, that they are oral language spelled out in gesture, or
that they were invented by hearing people. Hearing teachers of deaf schools,
such as Thomas Hopkins Gallaudet, are often incorrectly referred to as
inventors of sign language.
The manual alphabet is used in sign languages, mostly for proper names and
technical or specialised vocabulary. The use of fingerspelling was once taken
as evidence that sign languages are simplified versions of oral languages, but
in fact it is merely one tool among many. Fingerspelling can sometimes be a
source of new signs, which are called lexicalised signs.
On the whole, deaf sign languages are independent of oral languages and
follow their own paths of development. For example, British Sign Language
and American Sign Language are quite different and mutually unintelligible,
even though the hearing people of Britain and America share the same oral
language.
Similarly, countries which use a single oral language throughout may have
two or more sign languages; whereas an area that contains more than one
oral language might use only one sign language. South Africa, which has 11
official oral languages and a similar number of other widely used oral
languages is a good example of this. It has only one sign language with two
variants due to two major educational institutions for the deaf which serve
different geographic areas of the country.
Use of Signs in Hearing Communities
Gesture is a typical component of spoken languages. More elaborate systems
of manual communication have developed in situations where speech is not
practical or permitted, such as cloistered religious communities, scuba diving,
television recording studios, loud workplaces, stock exchanges, in baseball,
while hunting (by groups such as the Kalahari bushmen), or in the game
Charades. In Rugby Union the Referee uses a limited but defined set of signs
to communicate his/her decisions to the spectators. Recently, there has been
a movement to teach and encourage the use of sign language with toddlers
before they learn to talk and with non-deaf or hard-of-hearing children with
other causes of speech impairment or delay. This is typically referred to as
Baby Sign.
On occasion, where the prevalence of deaf people is high enough, a deaf sign
language has been taken up by an entire local community. Famous examples
of this include Martha's Vineyard Sign Language in the USA, Kata Kolok in a
village in Bali, Adamorobe Sign Language in Ghana and Yucatec Maya sign
language in Mexico. In such communities deaf people are not socially
disadvantaged.
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Herbert Klein 10
Many Aboriginal sign languages arose in a context of extensive speech
taboos, such as during mourning and initiation rites. They are or were
especially highly developed among the Warlpiri, Warumungu, Dieri, Kaytetye,
Arrernte, Warlmanpa, and are based on their respective spoken languages.
A pidgin sign language arose among tribes of American Indians in the Great
Plains region of North America (see Plains Indian Sign Language). It was
used to communicate among tribes with different spoken languages. There
are especially users today among the Crow, Cheyenne, and Arapaho. Unlike
other sign languages developed by hearing people, it shares the spatial
grammar of deaf sign languages.
Spatial grammar and simultaneity
Sign languages exploit the unique features of the visual medium. Oral
language is linear. Only one sound can be made or received at a time. Sign
language, on the other hand, is visual; hence a whole scene can be taken in
at once. Information can be loaded into several channels and expressed
simultaneously. As an illustration, in English one could utter the phrase, "I
drove here". To add information about the drive, one would have to make a
longer phrase or even add a second, such as, "I drove here along a winding
road," or "I drove here. It was a nice drive." However, in American Sign
Language, information about the shape of the road or the pleasing nature of
the drive can be conveyed simultaneously with the verb 'drive' by inflecting the
motion of the hand, or by taking advantage of non-manual signals such as
body posture and facial expression, at the same time that the verb 'drive' is
being signed. Therefore, whereas in English the phrase "I drove here and it
was very pleasant" is longer than "I drove here," in American Sign Language
the two may be the same length.
In fact, in terms of syntax, ASL shares more with spoken Japanese than it
does with English.(Karen Nakamura,1995)
Written forms of Sign Languages
Sign language differs from oral language in its relation to writing. The
phonemic systems of oral languages are primarily sequential: that is, the
majority of phonemes are produced in a sequence one after another, although
many languages also have non-sequential aspects such as tone. As a
consequence, traditional phonemic writing systems are also sequential, with
at best diacritics for non-sequential aspects such as stress and tone.
Sign languages have a higher non-sequential component, with many
"phonemes" produced simultaneously. For example, signs may involve
fingers, hands, and face moving simultaneously, or the two hands moving in
different directions. Traditional writing systems are not designed to deal with
this level of complexity.
Partially because of this, sign languages are not often written. Most deaf
signers read and write the oral language of their country. However, there have
been several attempts at developing scripts for sign language. These have
included both "phonetic" systems, such as HamNoSys (the Hamburg
Notational System) and SignWriting, which can be used for any sign
language, and "phonemic" systems such as the one used by William Stokoe
in his 1965 Dictionary of American Sign Language, which are designed for a
specific language.
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Herbert Klein 10
These systems are based on iconic symbols. Some, such as SignWriting and
HamNoSys, are pictographic, being conventionalized pictures of the hands,
face, and body; others, such as the Stokoe notation, are more iconic. Stokoe
used letters of the Latin alphabet and Arabic numerals to indicate the
handshapes used in fingerspelling, such as 'A' for a closed fist, 'B' for a flat
hand, and '5' for a spread hand; but non-alphabetic symbols for location and
movement, such as '[]' for the trunk of the body, '×' for contact, and '^' for an
upward movement. David J. Peterson has attempted to create a phonetic
transcription system for signing that is ASCII-friendly known as the Sign
Language International Phonetic Alphabet (SLIPA).
Sign Writing, being pictographic, is able to represent simultaneous elements
in a single sign. The Stokoe notation, on the other hand, is sequential, with a
conventionalized order of a symbol for the location of the sign, then one for
the hand shape, and finally one (or more) for the movement. The orientation
of the hand is indicated with an optional diacritic before the hand shape.
When two movements occur simultaneously, they are written one atop the
other; when sequential, they are written one after the other.
Neither the Stokoe nor HamNoSys scripts are designed to represent facial
expressions or non-manual movements, both of which Sign Writing
accommodates easily, although this is being gradually corrected in
HamNoSys.
Further Reading
Branson, J., D. Miller, & I G. Marsaja. (1996). "Everyone here speaks sign
language, too: a deaf village in Bali, Indonesia." In: C. Lucas (ed.):
Multicultural aspects of sociolinguistics in deaf communities. Washington,
Gallaudet University Press, pp. 39-5
Emmorey, Karen; & Lane, Harlan L. (Eds.). (2000). The signs of language
revisited: An anthology to honor Ursula Bellugi and Edward Klima. Mahwah,
NJ: Lawrence Erlbaum Associates. ISBN 0-8058-3246-7.
Groce, Nora E. (1988). Everyone here spoke sign language: Hereditary
deafness on Martha's Vineyard. Cambridge, MA: Harvard University Press.
ISBN 0-674-27041-X.
Kendon, Adam. (1988). Sign Languages of Aboriginal Australia: Cultural,
Semiotic and Communicative Perspectives. Cambridge: Cambridge University
Press.
Klima, Edward S.; & Bellugi, Ursula. (1979). The signs of language.
Cambridge, MA: Harvard University Press. ISBN 0-674-80795-2.
Krzywkowska, Grazyna (2006). "Przede wszystkim komunikacja", an article
about a dictionary of Hungarian sign language on the internet (Polish).
11
Herbert Klein 10
Lane, Harlan L. (Ed.). (1984). The Deaf experience: Classics in language and
education. Cambridge, MA: Harvard University Press. ISBN 0-674-19460-8.
Lane, Harlan L. (1984). When the mind hears: A history of the deaf. New
York: Random House. ISBN 0-394-50878-5.
Padden, Carol; & Humphries, Tom. (1988). Deaf in America: Voices from a
culture. Cambridge, MA: Harvard University Press. ISBN 0-674-19423-3.
Poizner, Howard; Klima, Edward S.; & Bellugi, Ursula. (1987). What the hands
reveal about the brain. Cambridge, MA: MIT Press.
Sacks, Oliver W. (1989). Seeing voices: A journey into the land of the deaf.
Berkeley: University of California Press. ISBN 0-520-06083-0.
Sandler, Wendy; & Lillo-Martin, Diane. (2001). Natural sign languages. In
M. Aronoff & J. Rees-Miller (Eds.), Handbook of linguistics (pp. 533-562).
Malden, MA: Blackwell Publishers. ISBN 0-631-20497-0.
Stiles-Davis, Joan; Kritchevsky, Mark; & Bellugi, Ursula (Eds.). (1988). Spatial
cognition: Brain bases and development. Hillsdale, NJ: L. Erlbaum
Associates. ISBN 0-8058-0046-8; ISBN 0-8058-0078-6.
Stokoe, William C. (1960). Sign language structure: An outline of the visual
communication systems of the American deaf. Studies in linguistics:
Occasional papers (No. 8). Buffalo: Dept. of Anthropology and Linguistics,
University of Buffalo.
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Herbert Klein 10
Communication Tips/Deaf Awareness
Before you start communicating with a deaf person you need to get their
attention. You should try and establish eye contact first, and then the deaf
person will know that you want to talk to them. If you are unable to do this,
(maybe the person you want to talk to is on the other side if the room or has
their back to you) get their attention by tapping them lightly on the arm or
shoulder, flash the light on and off, stamp on the floor or if you are at a
distance, wave.
Eye contact is very important. You should sit in front of and on the same
level as the person. Be aware that glasses and sunglasses can make it
difficult to maintain eye contact.
Make sure you are facing the light and not sitting/standing in front of a
window as this creates a shadow and makes it difficult to see facial features.
Try and keep background noise to a minimum, as it is difficult for a person
who uses hearing aids to cut out this noise.
Do not shout as mouth patterns become distorted and make it harder for the
person to understand what is being said. Also, if you are shouting your
expression will be angry and what you are saying could be misunderstood.
Speak clearly and with a normal rhythm of speech. It is not helpful to speak
very slowly or too fast or to use exaggerated mouth patterns.
Be aware of using unusual words and keep asking and checking with the
person that they have understood you.
When having a conversation with a deaf person they will nod to acknowledge
the other person is speaking to them. Also you need to be aware that just
because a deaf person is nodding in response to your conversation, it does
not mean that they have understood – they could be nodding because they
are anxious or they want to please. Say at the beginning of the conversation
if there is anything they want to clarify – just say so.
Some words are difficult to lip-read. If a word is not understood use a
different word with the same meaning. 70% is guesswork and many words
look the same.
If you have a beard or moustache try to keep it trimmed, especially around
the mouth. Also do not smoke or eat (including chewing gum) whilst
communicating and do not cover your mouth or face.
Try to use appropriate facial expressions to show questions, anger, joy,
disappointment, upset, etc.
Gestures and mime are helpful, as a deaf person will rely on visual clues to
help them understand what is being said.
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Herbert Klein 10
Be responsive; nod to show you have understood. Don’t pretend to
understand if you haven’t, ask for the information again.
Don’t look away when talking.
Finally do not give up trying to communicate – You can always write things
down.
Be patient, if you have been asked to repeat something – try changing the
sentence slightly, as this may make it easier to understand.
Useful Websites for learning about British Sign Language and Deaf
culture
www.signpostbsl.com
www.deafstation.org
www.signonline.org.uk
www.british-sign.co.uk
www.deafclub.co.uk
www.british-sign.co.uk
www.deafsign.com
Deaf Issues in Mental Health with BSL video clips:
www.deafinfo.org.uk gives you information about Deaf website, contacts,
research, counselling, youth and faiths.
www.deaf247.co.uk has very good information about everything included
Deaf mental health issues.
www.sign-tube.com is an excellent way for the Deaf community to find out
about news and gossip.
www.mentalhealthsleeds.org.uk
issues.
www.samh.org.uk
there are BSL clips about Mental Health
there are BSL clips about Mental Health issues.
www.rcpsych.ac.uk is useful for psychiatry BSL clips.
www.bsltranslations.org.uk is a resource for mental health in sign language.
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Herbert Klein 10
Communication support
BSL/English Interpreter – Communication Support Worker (CSW)
A BSL/English Interpreter is used for communication between Deaf and
hearing people. They are usually used in meetings, but can also be used by
Deaf people to attend daily appointments e.g. doctors, dentists, banks and in
office environments. Some Deaf professionals also use CSWs to assist them
with office duties.
BSL/English Interpreters hold professional qualifications and are registered
with the National Registers of Communication Professionals Working with
Deaf and Deafblind People (NRCPD) www.nrcpd.org.uk managed by
Signature www.signature.org.uk
Interpreters follow a code of practice, which binds them to confidentiality. The
code of practice used by interpreters working in mental health can be found at
http://www.asli.org.uk/asli-s-policies-p35.aspx
You can book an interpreter through interpreting agencies by logging in sign
language interpreting. Alternatively you can book free-lancers direct by
looking at the NRCPD directory (which can be found on their website) or the
ASLI website (www.asli.org.uk) for interpreters in your area.
For a website containing a wealth of information on interpreting issues
and Deaf cultures and Sign Languages of the World
www.theinterpretersfriend.org
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Herbert Klein 10
There are different types of BSL/English Interpreters, which depend on
completion of qualifications. It is imperative that in Mental Health, only
Qualified Interpreters are used. Descriptions of the various levels of
qualifications are listed below:
Qualified Interpreter
 Have completed interpreter training and assessment equivalent to NVQ
Level 6
 Are trained to interpret from English to BSL and vice versa
 Are registered with Signature,
 Holds an enhanced CRB that is no more than three years old.
Trainee Interpreter
 Have completed the NVQ Level 6 Language units and are still gaining
experience
 Are undergoing a recognised interpreter training programme
 Holds an enhanced CRB that is no more than three years old
Junior Trainee Interpreter
 Have completed the NVQ Level 6 Language units and are still gaining
experience
 Are working through a recognised interpreter programme
 Holds an enhanced CRB that is no more than three years old
Communication Support Worker
 Have BSL skills to NVQ level 3
 Holds an enhanced CRB that is no more than three years old
There are also Relay Interpreters, who are Deaf and work alongside
BSL/English Interpreters. They would work with a Deaf person who had
minimal language skills or maybe used International Sign Language. They
would relay the information to a BSL/Interpreter, who would then interpret the
information into English and vice versa.
If a Deaf person comes from a foreign country, the person booking the
Interpreter should endeavour to book an Interpreter to cater for the individuals
need.
Some Deaf people prefer different forms of communication support such as
Lipspeakers (follows the spoken English grammar), Notetakers (writes down
what is being spoken about), Speedtext (spoken work is transcribed/typed
onto a computer or other technological device), SSE (Sign Supported
English), SEE (Signed Exact English) and so on.
More information on these methods can be found at the Signature website
as mentioned above.
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Herbert Klein 10
BSL Classes
This is for BSL NVQ Level 1, Level 2, Level 3 and Level 6.
Day and evening BSL classes are also to be found in your Local Adult/Further
Education Institutes. See your local education authority website.
Other agencies offering sign language classes are as follows:
BSLworks
www.bslworks.com
Signamic
www.signamic.co.uk
Remark!
www.remark.uk.com
Dorothy Miles Cultural Centre
www.dorothymilescc.org
Positive Signs
www.positivesignslondon.com
Learndirect
www.learndirect-advice.co.uk/findacourse
Actual Signs
www.actualsigns.com
Andrea of School
www.andreaschoolofbsl.com
City Lit
www.citylit.ac.uk
Deafworks
www.deafworks.co.uk
RNID
www.rnid.org.uk/information_resources/communicating_better
National Local Education in UK
http://www.hotcourses.com/pls/cgibin/hc2_search.adv_col_do?x=16180339&y=&search_what=Z&search_ho
w=R&search_range=10&ref_id=&lucky=&crs_search=search&search_cate
gory=&phrase_search=BSL&which_search=allcourse&study_mode=&quali
fication=Any&a=0&area=&postcode=+Enter+town+%2F+postcode+%2F
+region
HearFirst
www.hearfirst.org.uk
RAD
www.royaldeaf.org.uk
BDA
www.bda.org.uk
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Herbert Klein 10
Deaf Community
Deaf Media
There are programmes that are directed and produced by Deaf people and
include Deaf actors and presenters. Programmes with In-vision Interpreters
are available – check TV guide. There are also subtitles (select page 888) on
many TV programmes and now cinemas have a certain percentage of
subtitles performances on recent films that they advertise through
www.yourlocalcinema.com
Deaf Events
In addition to Deaf Media, there are also Signed Performances in Theatre
www.spit.org.uk which is a website that has information on theatre shows that
have a BSL/English Interpreter for the show and are therefore accessible for
Deaf people. There are also museums and galleries that do the same with
their guided tours.
You can access a comprehensive listing from www.bda.org.uk under events
or www.magicdeaf.org.uk.
Deaf Information
If you want more information on Deaf issues or the Deaf community, you can
purchase materials, books and CD ROMs from the Forest Bookshop
www.forestbooks.com. www.deafbooks.co.uk
Royal National Institute for Deaf People Library
RNID Library, Institute of Laryngology and Otology, 330-336 Grays Inn Rd,
London, WC1X 8EE Tel / Minicom: 020 7915 1553
Fax: 020 7915 1443
Location
The RNID Library is located in the Royal National Throat Nose and Ear
[RNTNE] Hospital. The RNTNE Hospital itself is situated at the King's Cross
end of Gray's Inn Road, close to the junction with Euston Road, and to the
Kings Cross and St. Pancras railway stations. The entrance to the Hospital is
on Gray's Inn Road between Britannia Street and Swinton Street. External
visitors should report to the reception desk in the foyer. Once in the Hospital
make your way to the outpatients department; the door leading to the stairs up
to the libraries is opposite the outpatients reception desk. The RNID Library is
on the second floor above the ILO Library.
The RNID Library is open to everyone - whether you are an academic looking
for the latest research paper in your field, a student writing an essay, or
someone with a general interest in deaf issues. Please note that the books
cannot be taken out of the library.
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Herbert Klein 10
Deaf Organisations
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British Deaf Association www.bda.org.uk
Royal National Institute for Deaf People www.rnid.org.uk
National Deaf Children’s Society www.ndcs.org.uk
Action on Hearing Loss www.royaldeaf.org.uk
deafPLUS – www.deafplus.org
London Ethnic Minorities Deaf Association www.lemda.org.uk
DeafBlind UK www.deafblind.org.uk
Sense www.sense.org.uk
City Lit Institute for the Deaf www.citylit.ac.uk
Deaf Connections www.deafconnection.org.uk
Deaf Clubs – www.deafclub.co.uk
Deaf Sport – www.ukdeafsport.org.uk
Signature www.signanature.org.uk
Hearing Concern LINK www.hearingconcernlink.org
Jewish Deaf Association www.jda.org.uk
Christian Deaf - www.DeafChristian.org.uk
European and Worldwide Deaf organisations
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WFD – World Federation of the Deaf www.wfd.org
EUD –
European Union of the Deaf www.eudnet.org
ESMHD – European Society Mental Health www.esmhd.org
United Kingdom Council of Deafness has a members directory at
www.deafcouncil.org.uk/memdir.htm which lists the up to date details of the
100’s of different deaf organisations in the UK.
Government Information for Disabled People
directgov is the website to visit for the latest information and services from
government.
Information for disabled people, home, housing, financial support, disability
rights, health & support, employment
www.direct.gov.uk/disability
National Equality Partnership
www.changepeople.co.uk
www.improvingsupport.org.uk
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Herbert Klein 10
Deaf University for Deaf Mental Health
Salford University Nursing College for Deaf people
The School has launched Europe's first course for deaf students within the
new Peach programme. Four students began the course in September. The
students will have the support of British Sign Language Interpreters and they
have all been issued with the latest laptop computers to help with their
studies. When the students qualify they will go onto the Mental Health register
to take up careers in their chosen field. For further information contact:
Voice: 0161-295 2780
Email: n.sharples@salford.ac.uk
Website: www.salford.ac.uk
Northumbria University for D/deaf People’s Mental Health:
Training for Mainstream Mental Health Professionals
Angela Ridley,
Mental Health and Deafness Project
Room G208
Coach Lane Campus
Northumbria University
Coach Lane Campus
Newcastle upon Tyne
NE7 7XA
Tel:
01919 215 6312
Email: a.ridley@northumbia.ac.uk
www.mentalhealth-deafpeople.co.uk
Birmingham University for Mental Health and Deafness
Guy Wishart
Lecturer/Assistant Director of Community Mental Health Programmes
Institute of Applied Social Studies
University of Birmingham
Edgbaston
Birmingham
B15 2TT
Tel: 0121 414 7910
Email: G.D.Wishart.1@bham.ac.uk
www.ceimh.bham.ac.uk/newsandevents/mhdeafness.shtml
Bristol University
University of Bristol,
Centre for Deaf Studies,
8 Woodland Road,
Clifton,
Bristol BS8 1TN, UK
Tel: 0117 954 6900
Text: 0117 954 6920
Fax 0117 954 6921
Email: enquiries-cds@bristol.ac.uk
www.bris.ac.uk/deaf/english/postgraduate/msc/units.html
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Herbert Klein 10
British Society for Mental Health and Deafness - BSMHD
The British Society for Mental Health and Deafness was established in 1991
in order to promote the relief of mental health problems and educate
professionals about mental health issues within the Deaf community. It now
continues as a constituted, membership organisation, which provides a forum
for professionals, organisations, service providers and other practitioners
involved with, or having an interest in, the provision of mental health services
to deaf people in the UK.
Website: www.bsmhd.org.uk
European Society for Mental Health and Deafness – ESMHD
ESMHD is an international Non-Government Organisation for the promotion of
the positive mental health of deaf people in Europe.
Mental health includes healthy emotional, psychological and social
development, the prevention and treatment of mental illness and other
disorders. ESMHD focuses on people, who were born deaf or deafness
occurred in early childhood and whose first or preferred language is sign
language. Additionally ESMHD is interested in the mental health of all deaf
people, whatever the age of onset or degree of deafness
Website: www.esmhd.org
Healthy Deaf Minds – HDM
The meeting of the Healthy Deaf Minds London Group will be at the Small
Meeting Room, Friends Meeting House, Euston Road, London (opposite
Euston Station).
In order to receive automatic emails you can subscribe at:
info@bsmhd.org.uk
All meetings are on a Wednesday at Friends Meeting House, Euston. Starting
at 6.30pm and finishing at 9.00pm.
Full communication support, tea & coffee are available.
Health Professionals for Hearing Loss
www.amphl.org Health Professionals for Hearing Loss in USA
www.exceptionalnurse.com for Health Professionals for Disability
www.hphl.org.uk Health Professionals for Hearing Loss in UK
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Herbert Klein 10
Equipment and Technology
There are various pieces of equipment that Deaf people use everyday and
also technology that one can use to communicate with Deaf people.
Information about equipment and assistive devices, such as pagers to alert
deaf people to fire alarms can be found at:
Free hearing test, free eye tests, free demonstrations for wheelchairs, mobility
scooters. www.mouseability.co.uk
www.deafequipment.co.uk
www.rnid.org.uk/shop
www.connevans.com
www.bellman.com
www.siemens.co.uk/hearing
www.phonak.co.uk
www.bioacoustics.com
www.coversorproducts.com
www.hear4you.com
If you have difficulty getting up in the morning because you
cannot hear your alarm clock, then help is at hand. Special
alarm clocks are available which wake you with a flashing
light or with a vibrating pad, which you place under your
pillow. Wristwatches are also available with a vibrating alarm
function but tend to be on the chunky side.
If you have some hearing and are able to hear your doorbell
when you are right beside it, then you may benefit from a
portable doorbell that you carry around the house with you.
For people with a higher degree of hearing loss, there are
doorbells, which alert you with flashing lights and vibrating
pagers.
Smoke detector alarms are very loud and many hearing aid
users are able to hear and respond to them during the day.
However, if you have a high degree of hearing loss or you take
your hearing aids out at night you may need an alternative
system to alert you to the danger of fire. Again, smoke/fire
detection systems with vibrating pads and bright strobe lights
are available to keep you safe and some can be wired in to the
lighting circuit in your home.
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Herbert Klein 10
Enhanced Volume telephones
If you have enough hearing to use a voice telephone, you may benefit from
adaptations, which make the sound louder and clearer. Telephones are
available which can not only amplify sound but have an inductive coupler
which works with the "T" setting on a hearing aid to help you hear more
clearly and cut down background noise. Portable inductive couplers, which
simply attach to the handset earpiece with a stretchy strap, can make any
telephone "hearing aid friendly". Some telephones such as the "Clearsound
Megaphone" by-pass the ear completely and conduct sound directly through
your bones!
A text phone (Minicom) is another method of communication. However, like
mobile phones and internet, both users must have a Minicom to communicate
using this technology. The Minicom is accessed via a mainline telephone line.
Messages are typed on a keyboard and transmitted down the phone line
where they appear as a text message on the screen of the text phone at the
other end. Text phones are available with a range of features, from small
portable machines to larger
To use a Minicom or Textphone someone has to answer the call.
Once that has been done, each person must type GA for Go Ahead once they
have finished their entry.
When someone wants to finish the conversation, they type BI BI or BYE BYE
and SK SK for Stop Keying. All Minicom users use this code.
emergencySMS
SMS to the emergency services
Welcome to the emergencySMS
We are trialing a service that lets deaf, hard of hearing and speech-impaired people in
the UK send an SMS text message to the UK 999 service where it will be passed to the
police, ambulance, fire rescue, or coastguard. Simply by sending an SMS message to
999 you can call for help and the emergency services will be able to reply to you.
You will need to register your mobile phone before using the trial emergencySMS
www.emergencysms.org.uk
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Herbert Klein 10
Text Relay
TextRelay is a text – based telephone interpreting service.
A Deaf person dials 18001 and then the telephone number of the hearing
person. This attaches an operator to the call. The Deaf person will type on
the Minicom or text-phone and the operator would speak the information to
the hearing person on the other end of the phone line. When the hearing
person replies, they speak their reply and the operator types the information
to the Deaf person.
If a hearing person wants to contact a Deaf person, they must dial 18002
before the Textphone number.
If a Deaf person wants to contact the emergency services, using a Mincom
instead of dialling 999, they will dial 18000.
Their website address is www.textrelay.org
Mobilephone
One of the most popular ways of communicating with Deaf people is via text
messaging on mobile phone, SMS messaging services and emailing.
However it is important to remember that for many Deaf people English is not
their preferred method of communication, so it is wise to find out which of the
above methods would suit them best. Deaf people now have access to
emergency services via text.
Fax
Many elderly deaf may prefer to use a fax machine.
Internet Communication
Many younger deaf now also use email and Facebook and other social
networking sites to access information and to communicate with a wide
variety of services and organisations.
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Herbert Klein 10
Communication and Technology
On-line BSL Interpreter Services
SignVideo provides instant and high quality sign language interpreting via the
videophone. This service is provided via web cam and other video phone
technology. This is a modern service which allows Deaf people to access to
interpreting services, with no waiting times. To find out more about this
company, see www.signvideo.org.uk
In addition to the sign video service, mentioned above, there are alternate
video-based communication methods, such as web cam, on the internet and
video phones on G3 phones. As visual communication is most preferred by
Deaf people of all varieties of Deafness, these options are well worth
exploring.
SignTranslate provide instant help to medical staff when communicating with
Deaf patients.
Our video conferencing or On-Line Interpreting service enables immediate
access to qualified British Sign Language (BSL) interpreters provided by our
partner interpreting organisations around the country.
Clear, precise communication is an absolute necessity in so many situations,
particularly GP visits, hospital A & E departments, maternity units, any
situation where it's impossible to book a face to face interpreter at shortnotice.
Deaf people have a right to communication support and SignTranslate can
help. www.signtranslate.com
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Herbert Klein 10
Mental Health by Jim Cromwell
http://www.jimcromwell.com/brain/index.html
We are all "mental". This means that we all are able to think about the world
and about the things we do. We are also all emotional. This means that we all
feel happy or sad, excited or bored, stressed or relaxed, and so on.
There is more to us than blood to keep us alive, muscles to move us about,
and bones to hold us up. Those are the physical parts of us. We also have
ideas, beliefs, fears, wishes, dreams, worries, relationships and so on. They
are not physical, so to make it easy to talk about them we call them all
"mental".
Sometimes our ideas, beliefs, and feelings can start to make life difficult for
us. When that happens we have problems - but they are not physical
problems. They are problems with the mental parts of our lives.
You might call them "mental health problems"…
What is mental health? Well… what is physical health?
We are mentally healthy when we are
We are physically healthy when
coping with life, feeling OK about
we are not ill and when we feel
ourselves, and relating well to other
good and fit.
people.
We can get unwell or unfit in
many different ways - physical
health problems can be just a
small problem like a cold, or a big
problem like cancer.
We can get mentally unwell or unfit too mental health problems can be just a
small problem like being frightened of
spiders, or a big problem like believing
wrongly that people want to kill you.
They can be simple like a broken
They can be simple like a phobia or
leg or complicated like kidney
complicated like schizophrenia.
failure.
Probably nobody is 100% physically healthy. Some people are weaker than
others; some people get out of breath quickly; some people always have a
cough. Probably nobody is 100% mentally healthy either. Some people get
stressed easily; some people worry all the time; some people don't go out
much because they are frightened that something will happen. We are all
physically healthy in some ways and physically unhealthy in others. We are
also all mentally healthy in some ways and mentally unhealthy in others.
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Herbert Klein 10
People worry about being labelled "mentally ill" - but what does
this mean? Most people we see who we think are "mentally ill"
are on the news. Also, they are on the news because they
have done something terrible. We do not see people on the
news who have not done anything wrong. So nearly all the
people we see who we think are "mentally ill" are on the news
and all those people have done something terrible. That's why
they are on the news. So people think that all people with
mental health problems are dangerous or out of control - but
that's wrong.
Also most people with mental health problems we see on TV
have schizophrenia. But most mental health problems are
simple - like stress, feeling depressed, or being scared of
something harmless.
Having a problem with your mental health is nothing to be ashamed of - just
like having something wrong with you physically is just a part of life
It is a shame that people do not ask for help with mental health problems
because they are worried about what other people will think of them. If people
talked about their problems more, they would find out that other people have
them too and that difficulties with emotions, thoughts and beliefs ("mental
health problems") are just a part of life. We all have them and there is nothing
to be ashamed of.
Nobody can do everything. If you have a leaking
water pipe, a plumber can help you. If you are
confused about your money then your bank
manager can help you. If you cannot make
shelves then a carpenter can help you. If you find
it difficult to feel happy, or to stop feeling stressed,
or to stop feeling frightened then therapy can help
you.
Some people can fix their own pipes, and some people can sort out their
feelings - but there is nothing wrong with asking for help. ("Therapy" means
talking to a counsellor, or taking medicine, or joining a group.)
Plumbing problems are about leaking and not leaking.
Mental health problems are about coping and not coping.
We can have problems coping with stress, with our
emotions, with our fears, or with our worries. BUT a leak is
easy to see. It is not easy to notice when we are not coping
very well.
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Herbert Klein 10
Emotions, thoughts, beliefs and worries, are all invisible so it is hard to notice when we are not coping well, and it
means we do not really see other people with similar
problems either. If your problems upset you, or if they
stop you from getting on with life, then it makes sense to
ask for help from somebody who understands emotions,
beliefs, thoughts, and worries.
That could be a counsellor, a psychologist, a psychiatrist, a
psychotherapist… and so on. They mostly help by talking
about the problem, because talking makes us think and
thinking about the problem helps us to understand. When
we understand the problem we can cope better, and when
we can cope with it, the problem goes away. Sometimes
our GP or a psychiatrist will give us medicine to help us
cope. That can help too because medicines can help to
calm us down if we are too wound up, or to cheer us up if
we are feeling depressed.
Doctors usually mean these complicated problems when they say somebody
has a "mental illness". Sometimes those problems make it impossible for us to
think clearly enough to make decisions for ourselves. Usually we decide when
to ask for help and who to ask for it, but if we have a very complicated and
serious problem that stops us from being able to decide for ourselves, then
certain doctors are allowed to make that decision for us. Even then, they need
a social worker and a second doctor to agree with the decision.
Sometimes it is useful to think about a mental health problem as an illness
and sometimes it is not. Thinking in this way can be a bit black and white, but
that means we can be clear what we are talking about.
Here, we say the people on the right are "ill" and the people on the left are
"well".
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Herbert Klein 10
For physical health and illness this is a good way to think about it.
Sometimes with mental health it is useful as well.
More often it is useful to think about a mental health problem as being normal
but that has started to make your life difficult or unhappy. For example if you
are frightened of going out in public that can be normal anxiety, but if it means
you never leave your house then it might be a bigger problem.
Here, we don't say anybody is ill or well. We say people have problems that
can be small or big. If a person's problem gets so big that they suffer from it,
then they can get help. That decision is theirs unless they have very serious
problems, which mean they are not able to make decisions for themselves.
For most mental health problems it is usually not very helpful to think, "Am I ill
or well?" It usually makes more helpful to think, "Do I think that I am coping
with my life well, or am I having some problems with it?" If you feel like life is
sometimes too much, it makes sense to ask somebody to help you cope.
People are scared of these "mental illnesses" because of what they see on
the news - but we know that the news does not give us the full picture. Nearly
all people with mental health problems have normal, simpler problems and
therapy can help them to sort them out.
BUT
many people decide not to ask for therapy because they are frightened of
what other people will think. But really that doesn't make sense - it is like not
going to hospital with a broken leg just because other people in the same
hospital have scary problems like cancer.
A mental health problem can be any problem to do with thoughts, beliefs or
emotions - that's what "mental" means - and we should always ask for help if
we couldn’t cope alone.
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Herbert Klein 10
Mental Health and Deafness Tips
When you are communicating with Deaf people with a mental illness, you
have to make sure that you are doing so more sensitively. Therefore this
section of the Induction pack must be recognised as very different from the
Communication Tips section.
All patients have differing levels of language, so to ensure that you are
matching someone’s level, try to use BSL, gesture, drawing, pictures, toys or
any other way that you feel that patient would benefit from.
This could be because they are uneducated, possibly from another country,
had an oral-education upbringing and do not use BSL, come from a different
part of the country and use many regional signs, have an illness or on the
other hand they could have had a clear education and are able to read
English as well as using BSL.
There are ways for hearing people to be aware of Deaf people and learning
how to communicate without the use of BSL.
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If you are trying to get the attention of a Deaf person, then touch them
on the shoulder – if it is a patient then try to get in their view
Write things down or draw what you mean
Show things by pointing
Make sure that you maintain eye contact
Have friendly facial expressions
Hold good body language
Have patience and concentration and show you are interested
If you are using BSL, then remember that the speed of the persons’ language
is relevant. If a person is slow, this could mean they are depressed, upset
and withdrawn. If they are using fast language, this could mean that they are
excited, highly-strung or angry. If they are using normal speed of language,
this could mean they are stable and in a good mood.
If the signer is talking a lot, this could be due to being lonely or that they are
hungry for information.
If the signer is in a bad mood, they may just sit there and to have someone
sitting in front of them would feel safe like music is like a safety blanket for
hearing people.
Hearing people may watch the TV until 11pm and then listen to music, but
Deaf people would watch TV after 11pm as a visual stimulus, which acts as a
relaxant.
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Herbert Klein 10
Deaf people like to see visual space like outside a window or to actually
physically move around a space.
Mental illnesses are complex and signing can be confusing, so it is important
to use visuals aids e.g pictures and drawings.
Poor or distracted eye contact, or signs of not being able to write things down
or draw, could mean that they are not well or are suffering hallucinations. Deaf
people can see and interact through sign with visual hallucinations, and ‘hear
voices’ too. Talk to him/her with BSL or try to communicate to make them feel
safe.
With Deaf patients that are suffering a mental illness, more sensitive
communication is needed – you need to ensure that you do not apply too
much pressure.
Deaf people with mental illnesses need to be clear on the meaning of TV,
movies and media information. It needs to be pointed out what is wrong and
what is right e.g. that the patient cannot copy sexual activities or violence from
a film or a TV programme.
It is important that Deaf people receive short and precise pieces of
information.
Deaf people experiencing mental health problems frequently find it difficult to
gain access to services, and when they do, many have experienced problems
around assessment and diagnosis of their condition. This has resulted in a
gross over-representation of deaf people in psychiatric hospitals.
A study by Timmermans in 1989 identified that whereas hearing patients had
remained in psychiatric hospitals for an average of 148 days, deaf patients’
average stay was 19.5 years.
Deaf people are frequently misdiagnosed, often labelled as having learning
disabilities, having been assessed by people with whom they are unable to
communicate effectively with.
Deaf people experiencing mental health problems need assessment and care
from professionals with specialist skills, who can communicate fluently in
British Sign Language (BSL) or any form of modified Sign and who
understand the complexities of deaf culture.
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Herbert Klein 10
Deaf people from Minority Ethnic groups
There are particular difficulties that many deaf people from minority ethnic
groups have to face. Profoundly deaf young people, particularly those who
communicate with British Sign Language, often have limited access to family
languages, customs, culture and religion. Many parents have relatively poor
communication with their deaf children which hampers the children’s full
participation in family life. Often, deaf children have been better integrated into
deaf culture than the culture to which their family may belong, leading to
feelings of ambivalence towards deaf culture from some families who may see
deaf culture as an extension of white culture.
Recent research has studied initiatives with minority ethnic deaf people Deaf
people and their families have often lacked a common language in which to
communicate, so a number of initiatives have focussed on teaching sign
language to parents of deaf children. Access to information and services had
often been hampered by poor provision of both community spoken language
and sign language interpreters. A common problem is that community spoken
language interpreters often lack specific knowledge about deafness and deaf
education or mental health services, while sign language interpreters often
lack knowledge about specific cultural practices. The provision of spoken
language interpreters and BSL interpreters is now improving.
A recent development has been the emergence of cultural and social groups
led by minority ethnic deaf people. (See the useful organisations section.)
These have highlighted issues around the importance of religious and cultural
identity to deaf people many of whom have felt marginalised within their ethnic
communities and have experienced racism from white deaf people.
National Deaf Services Child and Family Team will provide spoken language
interpreters for those requiring it, as well as Deaf relay interpreters where
needed.
External support for Deaf asylum seekers, refugees or simply Deaf people
isolated due to membership of an ethnic minority group, can be found at the
following organisations: Jewish Deaf Association, LEMDA, deafPLUS and
RAD. (website addresses can be found on page 15.)
www.royaldeaf.org.uk
www.lemda.org.uk
www.deafplus.org
www.jda.org.uk
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Herbert Klein 10
TEA Report (Towards Equity and Access)
Following the Daniel Joseph Enquiry in 2001, the government instigated an
investigation into the effectiveness of communication between health
professionals and the Deaf community. They discovered that many health
professionals (GP’s, hospital doctors, etc) could not communicate with Deaf
people and many hospitals were not providing access to interpreters. Added
to this, they discovered that a significant number of Deaf people were unable
to read or write to a high level of English. As a result, many Deaf people did
not understand when they were diagnosed with a serious health problem.
The government realised that they had a duty to improve access to health
services for Deaf people but they were aware that they had not received any
complaints from the Deaf community and were concerned about this as it
indicated a breakdown in communication. To this end, in 2004 the
Government awarded a large sum of money to PCTs to improve access.
In total £2.5 million was allocated in 2005, which amounts to approximately
£10,000 for each of the 303 PCTs in England (these have subsequently been
merged to 152). PCTs are responsible for money for primary health services
in the local community, such as GPs, dentist, pharmacists, opticians, etc.
In March 2005, the TEA (Towards Equity and Access) report was published
by the DoH outlining recommendations as to how Primary Care Trusts should
use this money, e.g. to provide new health worker posts to serve the Deaf
community, Deaf awareness training for Health Professionals and improving
access for deaf or deafblind people. The TEA money is issued by the DoH on
an annual basis. To find out what is happening in your area, contact your local
PCT Disability Equality Officer.
You can find a copy of the full report on the DoH website.
http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsPolic
yAndGuidance/PublicationsPolicyAndGuidanceArticle/fs/en?CONTENT_ID=4
103995&chk=wTIJBz
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History of the TEA report
2000 – Daniel Joseph Enquiry. An investigation carried out by the NDS,
Maudsley NHS Trust and Lambeth Social Services in London. New guidelines
and recommendations were implemented.
2001 - The London Consortium was set up. This was a consortium of all 32
PCTs in London who pooled together their money to pay for referral and
access to the National Deaf Services for adults and children in their area.
They established new guidelines for the care of Deaf Patients following
discharge from hospital to care in the community, which is called the Pathway
procedure, as well as additional responsibilities for local Key Workers.
2001 - Deaf Enhanced Support Team (DEST) established as an outreach
team within National Deaf Services. DEST was to provide ongoing care of
Deaf people in the London Community only. This service is similar to the
mainstream service called Assertive Outreach Team (AOT)
2002 - Sign of the Times consultation process
 Consultation with the Deaf Community, organisations for the Deaf and
the Specialist services for Deafness and Mental Health. Bi-annual
meetings of the five Specialist Clinical Governance Services for the
Deaf in England.
 BSMHD and UKCoD involved in advising the Department of Health –
conducting on-going research/campaigns and raising awareness of
Mental Health Issues
 30,000 Sign of the Times Documents distributed throughout the
National Health Service.
2003 - workshops/training and the Healthy Deaf Minds Public Meetings, as
part of the on-going consultation process with the Deaf Community
2003 - The Sign of the Times report was held up due to a second enquiry into
an incident in Nottingham, The Sarwat Al-Assaf Enquiry.
2004 - DOH awarded PCTs an extra 1.5 million pounds to improve access to
Health Services for the Deaf
2005 – Towards Equity and Access
 Following both enquiries and the consultation process initiated by the
Sign of the Times, a final report was published with new guidelines and
recommendations for PCTs and NHS Trusts throughout England.
 This is called The Towards Equity and Access Report (TEA)
 An additional 2.5 million pounds is allocated annually to PCTs in order
to implement practices and procedures, as outlined by the TEA report.
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Herbert Klein 10
References
Printed Resources
Why do you keep missing me? Reported by Signhealth 2009
www.signhealth.org.uk/documents/Why_report.pdf
The GP Patient Survey asks lots of people about their experience of seeing
their GP. SignHealth looked at the responses of deaf people. Read these
reports, to see why we think Deaf people are less healthy and get poorer
access to services
A Simple Cure 2007, produced by Royal National Institute of the Deaf (RNID)
Towards Equality and Access Report 2005 (267206), produced by DoH
The Code of Practice for Sign Language Interpreters Working in Mental
Health 2005, E Thomas, published by Association of Sign Language
Interpreters (ASLI)
Working Psychologically with Deaf People Across the Lifespan, S Austin and
S Crocker, 2004 (ISBN 186156404)
Access to Primary Care and Accident & Emergency Services for Deaf People
in the North West 2003, David Reeves A report for the NHS Executive North
West Research and Development Directorate
A Sign of the Times consultation document 2002 (27966), produced by
Department of Health (DoH)
Mental Health Services for Deaf People, A worldwide perspective, Part 1 and
2. Of the 5th European and 2nd World Conference on Mental Health and
Deafness 2001, produced by European Society for Mental Health and
Deafness
Sign Language in Mental Health 2000 (ISBN 0 9525987 1 X), Deaf
Professionals in Mental Health Group
Mental Health and Deafness, N Kitson and P.Hindley 2000 (ISBN: 1
897635397)
Mental Health Services for Deaf People: Are they Appropriate? (1998) Sign
Equality before the law 1997 (ISBN0 946252 41 6), M Brennan and R Brown
Progess through equality 1996 (ISBN 0 9525987 0 1), C Laurenzi and S
Ridgeway
.
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Specialist Mental Health Services for Deaf People
The following services are available to Deaf people with mental health problems. The
specialist services have a mixture of hearing and Deaf staff with British Sign Language skills.
Clinical psychiatrists, psychologists, nurses, community psychiatric nurses (CPNs),
occupational therapists, speech and language therapists, social workers, community support
workers, counsellors and a multitude of other health professionals work together using
specialist qualified BSL interpreters in diagnosing, treating and rehabilitating
National Deaf Services, Adult Team
South West London & St George Mental Health NHS Trust
Old Church,
146a Bedford Hill,
London SW12 9HW
Tel:
020 8675 2100
Text: 020 8675 2200
Fax:
020 8675 2266
Email: oldchurch@swlstg-tr.nhs.uk
www.swlstg-tr.nhs.uk/nds
The NDS provides a comprehensive mental health service to adults, Including in-patient, day
patient, outpatient and community-based services. The service offer deaf people assessment
and management of psychiatric, behavioural, communication and social problems.
National Deaf Mental Health Services
Birmingham & Solihull Mental Health NHS Trust
The Barberry Centre
Jasmine Suite
25 Vincent Drive
Edgbaston,
Birmingham, B15 2FG
Tel:
0121 301 2002
Text: 0121 301 2496
Fax: 0121 301 2461
Email: a.cox@bsmhft.nhs.uk
www.bsmhft.nhs.uk
Provides a comprehensive mental health service for Deaf adults.
National Centre for Mental Health and Deafness
Greater Mancester West NHS Foundation Trust
The John Denmark Unit
Bury New Road,
Prestwich,
Manchester
M25 3BL
Tel:
Text:
Fax:
Email:
0161 772 3400
0161 772 3407
0161 772 3401
jdu@gmw.nhs.uk
Provides a comprehensive mental health service to Deaf people, throughout the UK. Inpatient, day-patient, out-patient and community based services.
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Whitepost Healthcare Group
Inpatient Hospital Unit
Lavender Place
Whitepost Hill,
Redhill,
Surrey.
RH1 6YY
Tel:
01737 764664
Fax:
01737 780710
Email : info@whiteposthealthcare.co.uk
www.whiteposthealthcare.co.uk
Lavender Place is a 7 bedded rehabilitation in patient unit, fully adapted for the needs of deaf
adults with severe and enduring mental health problems.
It also has a three bedded cottage and “step down” facility. The cottage is designed for those
moving from Lavender towards full community integration.
North East Community Mental Health and Deafness Service
Northumberland, Tyne & Wear NHS Trust
Walkergate Park
Benfeild Road
Newcastle Upon Tyne NE6 4QD
Tel
0191 287 5077
Text
0191 287 5078
Fax
0191 287 5250
Mobile 0777 1983569
Email joyce.pennington@ntw.nhs.uk
Clinical Nurse Specialist
Offer assessment and treatment to Deaf adults with mental health problems living in the North
East of England
Deaf Mental Health Services, Nottinghamshire
Emmanuel Chan
Nottinghamshire Healthcare NHS Trust
c/o Stonebridge Centre
Cardiff Street, Carlton Road,
Nottingham NG3 2FH
Tel:
0115 9483268
Fax:
0115 9859894
Text:
0115 8418826
Email:
AMHDeafServices@nottshc.nhs.uk
www.nottinghamshirehealthcare.nhs.uk/our-services/
A nurse-led, community-based, secondary service provides specialist care for deaf and hard
of hearing people with mental health needs in Nottinghamshire. Funded with 2 full time
community mental health nurses by the three PCTs in Nottinghamshire and based in
Nottingham and Mansfield.
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Herbert Klein 10
Deaf Mental Health Services, Leeds
Gerard Cooper
Community Links,
Suite 4
Bank House
150 Roundhey Road,
Leeds, LS8 5LJ
SMS: 07792 186 332
Email: gerard.cooper@commlinks.co.uk
www.commlinks.co.uk
Deaf Mental Health Team, Bristol
Brookland Hall,
Conduit Place,
St Werburgh's,
Bristol
Tel: 0117 9556098
Fax: 0117 9541954
Email: mary.griggs@awp.nhs.uk
www.bristol.gov.uk/item/bsl/?command=file&fid=40&gid=19
The team consists of a Team Leader/Clinical Psychologist and three part time Community
Care Workers and we are very keen to augment our skills mix with Occupational Therapy.
The team undertake assessments, deliver a range of interventions and provide support under
the CPA process for service users living in the Bristol area. The team has links with Bristol
Sensory Impairment Service as well as general community mental health services.
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Herbert Klein 10
Forensic Deaf Services
Mental Health Forensic Deaf Services
Nottingham Healthcare NHS Trust
Rampton Hospital
Retford
DN22 0PN
Tel:
01777 247811 or 247380
Text:
01777 247273
Fax:
01777 247594
Email: lisa.spencer@nottsch.nhs.uk
Rampton-DeafServices@nottshc.nhs.uk
www.nottinghamshirehealthcare.nhs.uk
Rampton Hospital is a high security psychiatric hospital and part of the NHS. Patients at
Rampton Hospital are kept securely due to acute Mental Health issues which can pose a risk
to themselves and the public.
Alpha Hospital (Private)
Bolton Road, off Buller Street ,
Bury,
Lancashire, BL8 2BS
Tel:
0161 762 7200
Text: 0161 762 7235
Fax: 0161 762 4747
Email: info@alphahospitals.co.uk
www.alphahospitals.co.uk
Alpha Hospitals is a Low to Medium Secure Unit for Deaf People who suffer from a Mental
Health Illness and/or personality disorders. Alpha Hospital has separate male and female
units.
St. George Healthcare Group (Private)
St Mary's Hospital
Floyd Drive
Warrington
WA2 8DB
Tel:
01925 423300
Fax: 01925 576752
Email: info@stgeorgehealthcaregroup.co.uk
Email: susano'rourke@stgeorgehealthcaregroup.co.uk
www.stgeorgehealthcaregroup.co.uk
www.youtube.com/watch?v=2VCXl8_Zxkg
Saint Mary’s Hospital is an Open Rehabilitation Ward, Low and Medium Secure Hospital. The
service provides specialist rehabilitative care and support for independent living enabling deaf
people to live in community settings whenever possible.
St. Andrew Healthcare Group (Private)
Billing Road
Northampton
NN1 5DG
Tel: 01604 616729
Fax:
Text: 01604 616161
SMS: 07827 304500
Email: sgibbon@standrew.co.uk
http://www.stah.org/services/deaf-service.aspx
Deaf medium security unit for Southern England, 17 beds for Deaf men who suffer from a
Mental Health disorder or illness.
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Herbert Klein 10
Deaf Children, Young People and Family Services
National Commissioning Group
England’s only psychiatric service that assesses treats and provides therapy
for Deaf children, young people of all ages and their families.
London Deaf Children, Young People and Family Services
(National Deaf CAMHS)
South West London & St George Mental Health NHS Trust
High Trees, Unit 16
Springfield University Hospital,
61 Glenburnie Road, Tooting
London SW17 7DJ
Tel:
020 8682 6925
Fax: 020 8682 6461
Text: 020 8682 6950
Mobile: 07879 420453
Email: cornerhouse@swlstg-tr.nhs.uk
www.swlstg-tr.nhs.uk/nds
NDS provides two separate services; Corner House, Children inpatient service which is
funded from the National Commission Group and is available across UK (excl. Wales).
Cambridge Deaf Children, Young People and Family Services
Heron Court
Ida Darwin Hospital,
Fulbourn,
Cambridge, CB21 5EE
Tel:
01223 885 715
Fax:
01223 885 716
Text: 01223 885 715
SMS: 07903 944 695
Email heroncourt@swlstg-tr.nhs.uk
www.cambridgeshirepct.nhs.uk
Maidstone Deaf Child, Young People and Family Services
Heathside House,
Heath Road,
Coxheath,
Maidstone
Kent ME17 4AH
Tel:
01622 741 881
Fax:
01622 746 762
Text:
01622 741 881
SMS: 07912 072 078
Email: heathside@swlstg-tr.nhs.uk
www.westkentpct.nhs.uk
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Herbert Klein 10
York Deaf Child, Young People and Family Services
Selby and York PCT
Limetrees
31 Shipton Road
York YO3 6RE
Tel : 01904 726926
Fax: 01904 632893
Text: 01904 724242
SMS: 07800 867911
Email: deafserviceyork@nyypct.nhs.uk
www.nyypct.nhs.uk/LocalServices/MentalHealth/CAMHS.htm
Newcastle Deaf Children, Young People and Family Services
North East Outreach Team
Benton House,
136 Sandyford Road,
Newcastle upon Tyne, NE2 1QE
Tel: 0191 210 6875
Fax: 0191 246 6930
Email: deafservicenewcastle@nyypct.nhs.uk
www.ntw.nhs.uk/sites.php?site=10
Manchester Deaf Children, Young People and Family Services
Royal Manchester Children’s Hospital
Harrington Building,
Oxford Road,
Manchester, M13 9WL
Tel: 0161 701 4519
Fax: 0161 701 1885
Text: 0161 701 4595
Email: deafservicemanchester@nyypct.nhs.uk
www.cmft.nhs.uk/media-news-detail.aspx?newsID=212.
Dudley Deaf Children, Young People and Family Services
Castlemill
Room 104N
Burnt Tree
Dudley
West Midlands, DY4 7UF
Tel:
Fax:
SMS:
Email:
0121 226 3616
0121 226 3615
07917 502 790
Nicola.hall@dwmh.nhs.uk
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Herbert Klein 10
Oxford Deaf Children, Young People and Family Services
CAMHS & Specialist Services
Boundary Brook House
Churchill Drive,
Headington, Oxford, OX3 7LQ
Tel: 0845 219 1467
Fax: 0845 219 1444
Email:
http://www.obmh.nhs.uk/services/a-z/name/oxford-deaf-child-young-people-and-familyservice-part-of-national-deaf-camhs-2/
Nottingham Deaf Children, Young People and Family Services
Thorneywood Child & Adolescent Mental Health Services
Porchester Road
Nottingham
NG3 6LF
Tel: 0115 844 0599
Fax: 0115 844 0597
Email:
http://www.nottinghamshirehealthcare.nhs.uk/our-services/local-services/child-andadolescent-mental-health-services/
Taunton Deaf Children, Young People and Family Services
Foundation House
Wellsprings Road
Taunton
Somerset, TA2 7PQ
Tel: 01823 368373
Fax: 01823 368 552
Text: 01823 368370
SMS: 07798 667966
Email: ndcamhstaunton@sompar.nhs.uk
www.sompar.nhs.uk/Children_and_Young_People.aspx
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Herbert Klein 10
Residential Care Homes for Deaf people with Mental Health Problems
Viridian Housing
Aura House
53 Oldbridge Road
Balham
London SW12 8PP
Tel 0208 333 6000
Fax 020 8333 6001
Email; outreachservice@viridianhousing.org.uk
www.viridianhousing.org.uk
Sign Health
Head office
5 Baring Road
Beaconsfield Road
Bucks, HP9 2NB
Tel: 01494 687600
Fax: 01494 687622
Email: info@signhealth.org.uk
www.signhealth.org.uk
RNID
Head office
19-23 Featherstone Street
London EC1Y 8SL
Tel: 0808 808 0123
Fax: 020 7296 8199
Text: 0808 808 9000
Email: Fiona.McClelland@rnid.org.uk
www.rnid.org.uk
BID
The Deaf Cultural Centre
Ladywood Road
Birmingham, B16 8SZ
Tel: 0121 246 6100
Fax : 0121 246 6125
Text: 01212 466 101
Email: info@bid.org.uk
www.bid.org.uk
SENSE
101 Pentonville Road,
Finsbury Park
London N1 9LG,
Tel.: 0845 127 0060,
Text 0845 127 0062,
Fax: 0845 127 0061
Email: info@sense.org.uk
www.sense.org.uk
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Herbert Klein 10
RAD
18 Westside Centre,
London Road,
Stanway,
Colchester, CO3 8PH
Tel: 0845 688 2525
Text: 0845 688 2527
SMS: 07851 423866
Email: info@royaldeaf.org.uk
www.royaldeaf.org.uk
Blackpool Fylde & Wyre Society Home for the Deaf
115 Newton Drive
Blackpool
Lancashire FY3 8LZ
Tel: 01253 392183
Fax: 01253 392183
www.ilancashire.co.uk/profile/83469/Blackpool/Blackpool-Fylde-and-Wyre-Society-For-TheDeaf/
Easthill Home for the Deaf
7 Pitt Street
Ryde,
Isle of Wight, PO33 3EB
Tel: 01983 564068
Text: 01983 564068
Fax: 01983 811 857
Email: k.melville@deafhampshire.org.uk
www.deafhampshire.org
Doncaster Deaf Trust
Leger Way
Doncaster, DN2 6AY
Tel: 01302 386700
Fax: 01302 361808
Email: enquiries@ddt-deaf.org.uk
www.deaf-college.com
www.deaf-school.com
Disclaimer:
The information in this document has been collaborated from public records.
Inclusion in this document is not an endorsement by Herbert Klein.
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Herbert Klein 10