Mental Health Services: Sign Language Users

Lord Borwick Excerpts

Monday 2nd February 2015 Lords Chamber

[Lord Borwick (Con)]

My Lords, I declare an interest as a trustee of the Ewing Foundation for deaf children.

I am grateful to the noble Lord, Lord Ponsonby, for again raising for debate important issues on deafness, but I rather disagree with the noble Lord on the definition of deafness. It should not be defined as the characteristic of those who use sign language, because there are a host of elderly deaf people who do not use BSL and many children born with a profound hearing loss now have cochlear implants which, although leaving them still with a significant hearing impairment, enables them to communicate in spoken languages. Similarly, improvements in hearing aid technology have made it easier for other deaf children to communicate in a spoken language. The Oxford English Dictionary defines “deaf” as lacking the power of hearing or having impaired hearing. That is the definition we should use; a definition that depends on BSL implies that BSL is the only characteristic, and that is problematic.

Today’s debate is particularly important because there is a lot of evidence of depression and mental health issues among deaf people, including those who use sign language. All the evidence suggests that hearing loss can substantially increase the risk of mental health problems. Anxiety, paranoia and depression are particular risks. Those with hearing loss are overrepresented among samples of patients suffering from paranoid psychoses in later life. Older people with hearing loss are more than twice as likely to develop depression as their peers without hearing loss. It is therefore important that the appropriate mental health services are available for deaf people and that the right steps are taken to improve outcomes.

I know that some will argue that, because not everyone can use sign language, deaf people who use it may experience depression and mental health issues even more acutely. Deaf people using sign language to communicate may have fewer opportunities to access appropriate special services too, and there are still a few children who use BSL as their only language who would struggle to access mainstream mental health services because of language barriers. This no doubt accentuates the feelings of frustration. There is research showing that deaf children who live in families where BSL is the only language are less likely to experience mental health problems than deaf children in families who use English. If you cannot communicate with your family, it is little wonder that you feel isolated. However, that research is dated.

New technology, such as digital hearing aids and cochlear implants, is reducing the need for the BSL language, and early detection is further breaking down the reliance on BSL. We have to remember one crucial point in this debate: there is a whole range of deafness, and not all the people on the spectrum use BSL, but new technology and early detection mean that many more can take a full and active part in a hearing society while still being able to use sign language if they choose. Doors are opening and many deaf people or partially deaf people can enjoy the best of both worlds rather than becoming frustrated by the limitations of just one. Being able to access both deaf and hearing communities is going to be good for the mental health of those with hearing difficulties.

Much more care is being taken to focus on the mental and emotional health of deaf children. The National Sensory Impairment Partnership has worked with the National Deaf Children’s Society to produce documents for teachers of the deaf on emotional well-being. The website for the National Sensory Impairment Partnership has published guidance for teachers on how to deliver a course called Think Right Feel Good. This helps teachers to understand and develop emotional resilience in deaf children.

There are a host of foreign languages in the UK. All speakers of unusual languages have the same problem: the inability to communicate except in their own community. The number of deaf young people who are reliant on BSL to communicate and access teaching and learning has declined significantly, and this will be reflected over the next few years in the adult population. I am full of admiration for the wonderful children who use BSL while learning to read and write English at the same time, but technology is changing that and we have to embrace it. It is so exciting that we can bring deaf people into the speaking world. Look at the new apps available on smartphones nowadays. Google Translate and Skype Translator both instantly translate foreign languages. Siri is starting to do so on Apple products. The app Mimix says that it will simultaneously translate from English into American Sign Language. MotionSavvy will translate the other way. I am sure it is not yet perfect, but a great start would be for BSL users to carry this sort of technology when having a vital conversation with a doctor. This is a story of success—not perfect by any means but apparently getting better.

It is, of course, very sad that the situation was so bad in the past, but the important thing is that things get better, and it will be ameliorated by technology, not by government expenditure. The overall priority should be to integrate deaf children into society, and as a fully integrated group they will no doubt have a similar incidence of mental illness, tooth decay and cancer as the rest of society. Any incidence of mental illness is appalling, but I am not sure that it is sadder because the victim is deaf than because the victim speaks Pashto or Welsh.

I ask my noble friend the Minister if he is able to publish data on the characteristics of children referred to specialist deaf mental health services. What percentage of the children are lip-readers, use BSL or have cochlear implants? I believe that more information will only help us to learn and improve. It would be very helpful to see the data on the characteristics of children referred to specialist deaf child and adolescent mental health services to see what we can learn. If we were aware of the most common profiles of children referred to the specialist services, perhaps this would inform preventive work and where it should be targeted.