Mental Health Services: Sign Language Users

Baroness Hollins Excerpts

Monday 2nd February 2015 Lords Chamber

[Baroness Hollins (CB)]

My Lords, I would like to add a couple of points to the debate from my experience as a psychiatrist. We have heard that deaf people continue to face unacceptable inequities in access to mental health services, and that is particularly the case for the estimated 25,000 deaf people in the UK who use British Sign Language as their first or only language. Deaf BSL users from black and minority ethnic communities, or who have additional needs arising from co-morbid visual impairment or intellectual disability, encounter even greater obstacles to accessing mental health services.

We have heard that deaf children are more likely to experience emotional, physical or sexual abuse, which contributes to later mental health problems. Deaf adults are much less likely to know how to report suspicions of abuse. Thus, children living in deaf communities are more likely to have their experience of abuse go unnoticed and unreported. The community interest company, Books Beyond Words, which I chair, has been commissioned by the NSPCC to help it develop pictorial resources to improve the reporting of such abuse to organisations such as the NSPCC.

We have heard that many deaf people leave GP consultations with no understanding of what went on, and consequently avoid going to see their GP altogether. Research has shown that a shocking one in seven people with hearing loss has missed a healthcare appointment because they did not hear their name being called in the waiting room. Those access problems continue despite the Disability Discrimination Act’s requirement for reasonable adjustments to be made, and they are compounded by a lack of deaf awareness training for professionals working in healthcare settings.

Within mainstream mental health services, few staff possess the BSL skills and experience needed to work effectively with deaf BSL users. Mental health services frequently fail to arrange for BSL interpreters to be present at appointments, often relying on family members, including children, to act as informal interpreters. That practice is unjustifiable, particularly in mental health services, where sensitive and personal issues, sometimes including abuse, may be disclosed. There is also an ongoing shortage of BSL interpreters in healthcare settings and a lack of specialist training for those who wish to work with people with mental health needs. What steps will the Government take to increase the number of BSL interpreters within mental health services?

The Sign Health charity highlights that over the past three years, it has trained 18 deaf and three hearing BSL users to work as psychological well-being practitioners in several geographic regions, but only seven are currently employed, reflecting a lack of recognition of the need for their services. Does the Minister agree that such provision would constitute a reasonable adjustment, and can he assure the House that action will be taken to improve deaf people’s access to IAPT services provided by therapists sufficiently fluent in BSL?

Deaf people are also overrepresented in secure mental health settings, and are thought to be overrepresented in the prison population, which may reflect a prior failure to address their mental health needs. It suggests the need for specialist prison in-reach services, so that deaf people with mental health needs can be identified and supported.

I highlight the importance of addressing the social determinants of mental well-being in deaf people. The exclusion, isolation and barriers that deaf people experience in education, employment and the community can negatively impact on their social and emotional well-being, along with their education and employment outcomes, thus perpetuating the cycle of adversity which puts them at greater risk of mental health difficulties. Can the Minister assure the House that recommendations to address those factors will be included in the Government’s forthcoming action plan on hearing loss?

A couple of examples were given to me by a psychiatrist working in one of the national deaf mental health services of children who he visited in mainstream schools. One child was using only BSL in a mainstream school where nobody else knows BSL. A young person in a special school whose only language was BSL was in a class with seven young people with learning disabilities, none of whom was deaf or knew BSL. That is clearly unacceptable. I look forward to the Minister’s response and thank the noble Lord, Lord Ponsonby, for raising these important matters.