Symposium addresses ways to improve deaf access to mental health care

There is a simple way to visualize why it is harder for deaf people to access mental health care, says Dr. Johannes Fellinger, an Austrian neurologist and psychiatrist. Imagine that everyone is wearing a backpack, but deaf people must carry heavier, overstuffed bags, representing a higher prevalence of mental health issues. Then picture these people with backpacks moving toward two entrances into a mental health clinic — one that is wide, and another that is narrow.

Deaf people are sent to the second door. “So they can’t enter,” explains Fellinger, who shared his painting of this evocative scene during Gallaudet’s mental health symposium on April 10. Hosted by the Psychology Program, Counseling and Psychological Services (CAPS), and the Deaf and Hard of Hearing Child Resilience Center (DHHCRC), the event featured Fellinger’s keynote address, “No Health Without Mental Health,” as well as Dutch psychologist Nynke Dethmers’ presentation, “Enhancing Psychological Well-Being in Deaf Students.”

Both experts shared information about the programs they have developed in their countries to widen this second door. Early in his career, Fellinger, whose father was deaf, witnessed a deaf psychiatric patient struggle in a system designed for hearing people. Fellinger came up with the idea to offer health care through sign language at a small outpatient clinic. That model has grown to several robust centers across Austria that are staffed by signing professionals.

Through this work, Fellinger has been able to spotlight how patients in these centers are dealing with an array of both physical and mental health problems. “On a general health questionnaire, the rate of symptoms was three times as high in the deaf population,” he says. 

But he sees hope in forming deaf communities. The Austrian clinics bring together parents for support groups, and invite elderly people to activities to keep them connected. “There is joy when interaction happens in a positive way,” he adds.

Dethmers also shared the image of Fellinger’s painting as part of her presentation. She is co-founder of Psywel, a program that aims to identify mental health issues in deaf children and teens. “It’s important to address problems early because most problems start out small,” says Dethmers, who is a psychologist at a deaf school in Amsterdam. Like a snowball rolling downhill, these problems only grow if you can’t catch them.

Unfortunately, mental health problems tend to be diagnosed several years later in deaf youth than their hearing peers, says Dethmers, who notes that issues are often overlooked or attributed to deafness. ”People assume it’s because a student is deaf in a hearing environment, but in fact, the student is depressed,” she adds.

A key part of the Psywel program is diagnostic assessment. Teachers, parents, and students all respond to questions about each child’s stressors, supports, vulnerabilities, and strengths. This provides a clearer picture of a situation so school psychologists like Dethmers can work with students using evidence-based therapies that have been adapted for deaf and hard of hearing children.

Dethmers offers the example of a deaf girl who was born in Afghanistan, attended school with hearing peers for several years in a refugee camp in the Netherlands, and then transferred to Dethmers’ school when she was 10. “Until she came to the deaf school, she had never met another deaf person and thought she was the only deaf person in the world,” Dethmers says. Because of the girl’s early experiences, she masked many of her fears and worries. 

The Psywel approach helped Dethmers uncover what she was going through. “The teacher didn’t see the girl’s problems. But the girl was good at identifying what she was struggling with,” says Dethmers, who is proud that the girl is now 20, and recently told her story at a conference in front of hundreds of people. “She was able to grow and develop because she was supported,” Dethmers says.