Experiences of current mental health care for Deaf adults
Research type
Research Study
Full title
An exploration of how Deaf service users, mental health practitioners and sign language interpreters experience current mental health care for Deaf adults; and how the linguistic and cultural differences between Deaf and hearing people might impact on the delivery of mental health care.
IRAS ID
230699
Contact name
Janet Fernando
Contact email
Sponsor organisation
Research Ethics and Governance, University of Exeter
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 5 months, 30 days
Research summary
Summary of Research
For the general population, mental health services in England are mainly commissioned by Clinical Commissioning Groups (CCGs). There are a small number of specialised services including Adult Deaf Mental Health Services that are commissioned directly by NHS England, for example, the Deaf Adult Community Team (DACT) that is based in an NHS Trust in South West London and serves Greater London, the Home Counties and East Anglia. Most service users identify as being culturally Deaf and communicate in British Sign Language (BSL). Service specifications and commissioning arrangements for Deaf mental health provision were set by NHS England in 2013. Services such as DACT are commissioned to support CMHTs and other mental health teams in delivering care to Deaf adults with enduring mental health problems.
The proposed study is interested in: how Deaf service users, mental health practitioners, and sign language interpreters experience current mental health care for Deaf adults; and how the linguistic and cultural differences between Deaf and hearing people might impact on the delivery of mental health care. The main research site is DACT. Other sites will be added. The research team will include a hearing Chief Investigator (CI) and three Deaf cultural brokers. The study will span an 18-month time frame. Service users, mental health practitioners, and sign language interpreters will be invited to participate in focus groups or individual interviews. Audio/visual recordings will be made of the interviews and qualitatively analysed using thematic analysis. Reflexive research diaries will describe and analyse personal experience and help to explore; how the hearing CI and Deaf cultural brokers relate to each other; and how linguistic and cultural differences might impact on the research process.Summary of Results
The aim was to investigate experiences of tertiary and secondary level mental health care for Deaf adults and examine factors influencing service delivery. Participants of the study are Deaf service users; Deaf and hearing mental health practitioners working in tertiary level care; hearing mental health practitioners working in secondary level services; and freelance sign language interpreters working in secondary and tertiary level settings.
A thematic analysis identified interrelated themes across the different participant groups. These themes are concerned with communication and equity of access. They are captured by an overarching theme: "It makes such a difference if the attitude is right".
The research shows that when Deaf service users are offered good, clinical secondary level services, it is experienced as exceptional, rather than a default position Deaf people should expect. Therefore, the findings of this study suggest that "audio centric privilege" and "audism" need to be brought into the mainstream discourse in the UK. It is argued that autism is analogous to racism and is examined through psychoanalytic and critical realist lenses.
The research contributes to understanding the challenges in delivering good clinical care to Deaf adults in a system that operates from a hearing frame of reference.
REC name
London - Fulham Research Ethics Committee
REC reference
18/LO/0878
Date of REC Opinion
1 Jun 2018
REC opinion
Favourable Opinion