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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 1 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 2 Herbert Klein 10 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. 3 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 4 Herbert Klein 10 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 5 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 [email protected] 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 6 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. 7 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 8 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. 9 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. 10 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. This page was last modified on 13 February 2008, All text is available under the terms of the GNU Free Documentation License. (See Copyrights for details.) Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc., a U.S. registered 501(c)(3) tax-deductible nonprofit charity. 12 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. 13 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. 14 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 15 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. 16 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 17 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. 18 Herbert Klein 10 Deaf Organisations 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 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 19 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: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] www.bris.ac.uk/deaf/english/postgraduate/msc/units.html 20 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: [email protected] 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 21 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. 22 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 23 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. 24 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 25 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. 26 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. 27 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". 28 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. 29 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. 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. 30 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. 31 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 32 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 33 Herbert Klein 10 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. 34 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 . 35 Herbert Klein 10 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: [email protected] 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: [email protected] 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 [email protected] Provides a comprehensive mental health service to Deaf people, throughout the UK. Inpatient, day-patient, out-patient and community based services. 36 Herbert Klein 10 Whitepost Healthcare Group Inpatient Hospital Unit Lavender Place Whitepost Hill, Redhill, Surrey. RH1 6YY Tel: 01737 764664 Fax: 01737 780710 Email : [email protected] 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 [email protected] 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: [email protected] 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. 37 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: [email protected] www.commlinks.co.uk Deaf Mental Health Team, Bristol Brookland Hall, Conduit Place, St Werburgh's, Bristol Tel: 0117 9556098 Fax: 0117 9541954 Email: [email protected] 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. 38 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: [email protected] [email protected] 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: [email protected] 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: [email protected] Email: susano'[email protected] 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: [email protected] 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. 39 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: [email protected] 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 [email protected] 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: [email protected] www.westkentpct.nhs.uk 40 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: [email protected] 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: [email protected] 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: [email protected] 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 [email protected] 41 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: [email protected] www.sompar.nhs.uk/Children_and_Young_People.aspx 42 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; [email protected] www.viridianhousing.org.uk Sign Health Head office 5 Baring Road Beaconsfield Road Bucks, HP9 2NB Tel: 01494 687600 Fax: 01494 687622 Email: [email protected] 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: [email protected] 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: [email protected] 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: [email protected] www.sense.org.uk 43 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: [email protected] 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: [email protected] www.deafhampshire.org Doncaster Deaf Trust Leger Way Doncaster, DN2 6AY Tel: 01302 386700 Fax: 01302 361808 Email: [email protected] 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. 44 Herbert Klein 10