DID YOU KNOW.....A YEAR IN REVIEW









39,000 Alabamians who are deaf or hard of hearing will need counseling,
psychological, or psychiatric care in their life span. (Based on NAMI
estimates). Based on Surgeon General's report, at least 20,000 of these
will be Severely Mentally Ill.

(SENT 3/10/04)







Maternal Rubella can significantly impact developing fetus, especially
in the first trimester. In addition to deafness, maternal rubella can
considerably impact neurological development leading to language and
cognitive problems which in turn, could result in emotional and/or
behavioral disorders later in life.

(SENT 3/15/04)







Usher's syndrome which is made up of several related genetic conditions,
involves one variation which causes deafness and also involves a
predisposition to schizophrenia. (Vernon & Daigle-King, 1999).

(SENT 3/22/04)







During pregnancy, certain infections can lead to neurological impairment
in the fetus including Toxoplasmosis. 40% of infected women pass on
the infection to the fetus. 10% of infants with the disease show
symptoms at birth. These severe symptoms include seizures,
chorioretinitis and hydrocephalus. The rest of the affected infants will
develop symptoms later with chorioretinitis, motor problems, blindness,
deafness and retardation. Uncooked contaminated meat is the primary
source. Kitty litter also presents a risk because cats carry
toxoplasmosis without symptoms and excrete the protozoa in their feces
(Shuhaiber et al., unpublished).

(SENT 3/31/04)







Based on several studies, it appears that it is a nearly universal
experience for deaf people with mental illness who present for treatment
to have been physically or sexually abused at some point in their lives.
Some studies indicate that a higher percentage of men are sexually
abused than women. At least one study has indicated that as many as
100% of all deaf people receiving inpatient (mental health) treatment
have been physically or sexually abused. Most studies indicate a
significantly higher percentage of deaf individuals are abused in
comparison to their hearing counterparts.

(SENT 4/5/04)







Repeated studies of self esteem among deaf individuals correlate early
exposure to language with positive self esteem. In most studies, deaf
children of deaf parents score statistically higher in self esteem than
deaf children of hearing parents. In all studies children of parents
who report early language intervention (usually parents who sign) report
higher self esteem then those who do not.

(SENT 4/13/04)







The Southern District Court in Florida ruled in Tugg v. Towey (1994)
that providing mental health services through an interpreter is not the
equivalent of providing mental health services through a therapist who
is fluent in a client's language.

(SENT 4/19/04)







Schizophrenic psychoses are found equally among deaf as hearing people.
However, there are more deaf schizophrenic people in hospitals than
hearing possibly as a result of communication difficulties and a
misdiagnosis of paranoia or learning disability resulting in longer
hospitalization. One study found that the average stay in hospital to
be 148 days for the general population and 19.5 years for deaf
inpatients. (Kitson and Fry 1990).

(SENT 05/03/04)









In a study conducted by Y. Kubota et al (Schizophrenia Research 61,
2003) of recognition of facial affect, deaf schizophrenia patients
performed more poorly on anger and surprise recognition compared with
hearing schizophrenia patients. They surmised that the deficit may be
attributed to the dysfunction of deaf signer's neurocognitive systems
underlying face recognition, possibly caused by schizophrenia pathology.
Kubota's study also found that both schizophrenia groups (deaf and
hearing) performed more poorly on fear and disgust recognition compared
to healthy controls.

(SENT 5/10/04)





Bird and Kitson (2000) stated that psychotropic medications can place
deaf patients at risk for a greater degree of side effects depending on
the etiology of their hearing loss. For example, those with renal,
cardiac or thyroid dysfunctions secondary to maternal rubella are at a
heightened risk for side effects from lithium, commonly prescribed to
treat bipolar disorder and regulate mood.

(SENT 5/17/04)





The connotations of the English expression "mental health" are
powerfully negative within the Deaf community and typically parallel
among the deaf population to mean "insanity". The consequence to this
is that if a client recognizes an English expression but associates it
with a meaning that does not precisely match the standard definition may
appear to be making irrelevant or inappropriate observations.
(Steinberg, Lowe & Sullivan, 1999)

(SENT 5/24/04)








Deaf Sex Offenders in a Prison Population


Katrina Miller , McCay Vernon

Very little is known about deaf sex offenders. This descriptive study of
a population of 41 deaf sex offenders incarcerated by the state of Texas
provides information about the prevalence of sexual offenders in the
deaf prison population, the educational achievement and IQ scores of
deaf offenders, and the incidence of secondary disabilities in this
population. The rate of sexual offending by deaf offenders was 4 times
the rate of sexual offending by hearing offenders with 30% recidivism in
the population. Sexual offending by deaf adults is discussed in relation
to the sexual abuse of deaf children. Sixty-two percent of deaf sex
offenders were functionally illiterate, a literacy rate considerably
below the average for deaf adults who remained in school until age 18 or
above. However, the performance IQs of deaf sex offenders were
comparable to those of the overall prison population.







"Mental Health systems are, by their very nature, seclusionary to Deaf
people."



-National Association of State Mental Health Program Directors/NTAC

Third Technical Report on Seclusion and Restraint, 2002









McCrone (1994) projected the presence of approximately 3,505 deaf heroin
users, 31,915 deaf cocaine users, 5,105 deaf crack users, and 97,745
deaf marijuana users in the United States. These figures were based on
the U.S. Department of Justice reports of the overall incidence of
illicit drug use in the United States for 1992 and the assumption that
deaf people represent 0.5% of the general population. Further the
National Council on Alcoholism has suggested that at least 600,000
individuals in the United States experience both alcoholism and hearing
loss (Kearns, 1989).

(sent 6/29/04)









Mental health providers must also learn how to recognize and address the
differences in how a deaf individual displays feelings and expressions
from those who are hearing. For example, someone who is deaf may pound
on the floor to get attention. While this is considered aggressive by
those who can hear, it is actually quite accepted and normal within the
deaf community. Furthermore, while strong emotional displays are pretty
much frowned upon in the hearing community, members of the deaf
community count on vivid expression of emotion to convey meaning. As a
matter of fact, one retrospective study found that clinicians often
labeled rapid signing as a symptom of psychotic behavior rather than the
change of mood that was actually indicated
<http://bipolar.about.com/library/weekly/aa000425a.htm#Shapira#Shapira>
(Shapira, et al., 1999).



SENT: July 03, 2004





Research shows that people who are deaf:

*Have the same rate of biological mental illness as hearing people.

*Are more likely to have adjustment and personality disorders.

*Are more likely to have substance abuse problems.

Deaf people have an increased incidence of alcohol and substance abuse
than the hearing population. (Rendon 1992).

(Sent July 13, 2004)



There is some evidence in literature of concurrent psychiatric symptoms,
particularly psychotic symptoms, associated with Usher's syndrome, and
several theories around this association have been proposed. These
theories of associations include a genetic link between the genes
responsible for schizophrenia and the genes for Usher's syndrome; a
neuropathological explanation as radiologic studies have revealed that
patients with Usher's syndrome have CNS abnormalities in multiple brain
structures; and a sensory deficit model which proposes that the
stressors associated with sensory impairment and the brain's adaptation
to changes in sensory inputs place an individual at increased risk for
psychopathology.



(Waldeck, Wyszynski and Medalia, 2001)

Sent July 19, 2004







Research has indicated that sensory impairments are more common in
people with Intellectual disability. Studies have also shown a higher
prevalence of psychiatric disorders in children with hearing impairment
and a higher incidence of deaf people in psychiatric hospitals than in
the general population. Psychiatric disorders in children with hearing
impairment are particularly associated with low IQ and low communication
ability, especially in those with multiple handicaps.



(S. Carvill, 2001)

SENT July 26, 2004





Several studies have found that the average stay of a deaf patient was
far greater than hearing inpatients, with many staying over twenty years
in the system, possibly because of limited inpatient care and no
appropriate outpatient services (Vernon % Daigle-King, 1999). However,
Mental Health facilities specializing in Deafness report that deaf
patients stayed no longer than hearing patients with 97% staying less
than a year. (Daigle 1994).

Sent August 2, 2004





In a survey of Intellectually Disabled populations in England and Wales,
it was found that only 20% had normal hearing. Nearly half o the group
with Down's syndrome (47%) had a hearing impairment. It appeared from
the results that people with Down's Syndrome are prone to developing a
high-frequency hearing loss in early middle life, similar to that seen
in presbyacusis.

Years (1989, 1992, 1995).

Sent August 9, 2004




While it is typically common knowledge to individuals working in the
field of deafness that only 30% of English phonemes can be understood
through speechreading (Gatty, 1996), the average deaf person understands
only 5% (Raifman and Vernon, 1996). Statistic would be lower for those
in psychiatric crisis. (Stuesser, 2000).


Sent August 27, 2004





Five factors that determine the appropriateness of psychological tests
for deaf individuals:



1) Purpose or goodness of fit to the evaluation question,

2) The way instructions are conveyed,

3) The nature and content of the items or tasks,

4) The response modality, and

5) The scoring methods and norms.



The test or collection tool will be biased if, in any of these five
areas, there is evidence that hearing loss, fund of information, limited
competency in English, or sensory or socio-cultural aspects of life as a
deaf or hard-or hearing individual would play an undesirable role.

(Pollard 2002)







Mental health problems of deaf Dutch children as indicated by parents'
responses to the child behavior checklist.

van Eldik T, Treffers PD, Veerman JW, Verhulst FC.

Emotional/behavioral problems of 238 deaf Dutch children ages 4-18 years
were studied. Parental reports indicated that 41% had
emotional/behavioral problems, a rate nearly 2.6 times higher than the
16% reported by parents of a Dutch normative sample. Mental health
problems seemed most prevalent in families with poor parent-child
communication. Deaf children ages 12-18 showed more problems with
anxiety and depression and more social problems than those ages 4-11.
Deaf children with relatively low intelligence showed more social
problems, thought problems, and attention problems than those with
relatively high intelligence. The authors stress the need to get
information on deaf children's mental health functioning not just from
parents but from other informants such as teachers and the children
themselves. An expansion assessment of deaf children, and of special
services and treatments for deaf children and adolescents with
emotional/behavioral problems, is recommended.



(sent 9/7/04)





There is general agreement among the most comprehensive investigations
that serious emotional disturbance is present in 8% to 22% of deaf
children, as compared to 2 to 10% of children in the general population.
(Vernon & Andrews, 1990)





(sent 9/27/04)





Although professional interpreters appear to function successfully with
impartiality and neutrality in many settings (e.g., classrooms, business
meetings), the therapeutic setting appears to be unique in terms of
greater emotional import.



Studies clearly indicate that an interpreter can influence the
therapeutic process affectively and behaviorally in subtle yet important
ways.



However, rather than viewing the interpreter as an impartial
psychological presence having no effect on the alliance, the therapist
can recognize and become more cognizant of the interpreter as a dynamic
member of a triadic therapeutic process (Halgin & McEntee, 1986; Hoyt,
Siegelman, & Hilde, 1981).



Evidence suggests that interpreters, rather than being "blank slates"
facilitating a dyadic relationship, have a substantial interpersonal
influence.



Neutral/slightly cheerful interpreters may act as a buffer against the
impact of despondent therapists. However, despondent interpreters may
elicit greater dysphoric mood changes in the deaf recipient.



Practicing psychologists need to consider the susceptibility of deaf
clients to the nonverbal mood presentation of sign-language interpreters
and its implications on the therapeutic alliance. By identifying the
individual influences (such as mood states) that have an impact on the
deaf recipient and the nonsigner, the significant role of the
interpreter may be further enhanced. (Julianne Gold Brunson and P.
Scott Lawrence, 2002)





(sent 10/4/04)





DID YOU KNOW......



In a study published in the American Journal of Psychiatry (1998), the
following percentages of Mental Health terms were recognized by adult
Deaf ASL users.





"Crazy" 100%

"Depression" 87%

"Counselor" 87%

"Addiction" 80%

"Social" 80%

"Psychologist" 69%

"Anxiety" 63%

"Insane" 57%

"Manic" 56%

"Psychiatrist" 46%

"Schizophrenia" 44%

"Therapist" 44%

"Hallucination" 43%

"Paranoia" 35%

"Psychosis" 22%

"Obsessive-compulsive" 22%

Sent 10/18/04





According to French researchers, Bailly, Dechoulydelenclave, and
Lauwerier, accurate evaluation is hampered by the immature language
exhibited by many hearing-impaired children and by the difficulties that
may be encountered in establishing rapport if the child does not
understand the examiner's verbal exchanges (sic.) Several authors point
out the lack of communication skills and experiences with
hearing-impaired children on the part of many examiners. In addition,
delays have been observed for the development of social maturity in
hearing-impaired children and the parents' descriptions may reflect
their own worries, rather than the emotional-behavioral functioning of
the child. The measurement of psychiatric symptoms is then compromised
insofar as many of the assessment procedures are highly verbal and were
standardized for normal-hearing children. These difficulties may explain
that the pre-valence rates of mental disorders in hearing-impaired
children and adolescents found in the literature vary from 15% to 60%.



Bailly D, Dechoulydelenclave MB, Lauwerier L. 2003, [Hearing impairment
and psychopathological disorders in children and adolescents. Review of
the recent literature], Encephale. Jul-Aug;29(4 Pt 1):329-37.

[Article in French]



sent October 25, 2004





* 20% of Deaf people use a nonstandard form of sign language.
(Miller, 2001)



sent 1 November 2004





In a study of 38 deaf and hard-of hearing individuals who had diagnoses
of depression-related disorders, results showed that the higher ratings
of depression are associated with less perceived care by mother and
greater perceived overprotection by both mother and father. In
comparison to hard-of-hearing counterparts, deaf participants were less
depressed and had more positive ratings of communication with their
parents.



(Leigh and Anthony, 1999)



sent November 8, 2004






The risk of mental distress for individuals with hearing loss was higher
in those with more communication problems, lower levels of self-esteem,
and poorer acceptance of the hearing loss.

(RON DE GRAAF, PHD, AND ROB V. BIJL, PHD, 2002)



(11/29/04)







In an investigation focusing on the socialization experiences and coping
strategies of deaf adults using spoken language, especially looking at
those raised in mainstream settings, most respondents reported social
isolation because of (1) limitations in communication with hearing peers
(2) missing information in social, academic and work settings; and (3) a
sense of being different.



(Bain, Scott, Steinberg, 2004)



(12/6/04)





Journal of Deaf Studies and Deaf Education 9:1 Winter 2004

(Wallis, Musselman, MacKay)



Hearing Mothers and Their Deaf Children: The Relationship between
Early, Ongoing Mode Match and Subsequent Mental Health Functioning in
Adolescence

DID YOU KNOW.....

In the few studies that have been conducted, researchers have typically
found that deaf adolescents have more mental health difficulties than
their hearing peers and that, within the deaf groups, those who use
spoken language have better mental health functioning than those who use
sign language.

This study investigated the hypotheses that mental health functioning in
adolescence is related to an early and consistent mode match between
mother and child rather than to the child's use of speech or sign
itself.

Using a large existing 15-year longitudinal database on children and
adolescents with severe and profound deafness, 57 adolescents of hearing
parents were identified for whom data on language experience (the
child's and the mother's) and mental health functioning (from a
culturally and linguistically adapted form of the Achenbach Youth Self
Report) was available. Three groups were identified: auditory/oral
(A/O), sign match (SM), and sign mismatch (SMM).

As hypothesized, no significant difference in mental health functioning
was found between the A/O and SM groups, but a significant difference
was found favoring a combined A/O and SM group over the SMM group.

These results support the notion of the importance of an early and
consistent mode match between deaf children and hearing mothers,
regardless of communication modality.



(Sent 12/20/04)







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