Deaf Aotearoa Position Statement on Mental Health Services

20 May 2023

The purpose of this position statement is to acknowledge and emphasise the importance of culturally and linguistically appropriate communication for Deaf people when accessing mental health services and recognises the psychosocial impact of the experience of being deaf[1]has had on Deaf people’s mental health throughout their life.  

General position

Mental health services for Deaf people and NZSL users in New Zealand is dangerously inadequate. When Deaf people attempt to access mental health care, they often experience under- or over-diagnosis. Service providers with no knowledge of Deaf culture can, and do, mistake language and communication issues for developmental delays, mental illness and/or retardation, which can have severe unintended consequences, eg Deaf people being referred to, and held in, residential psychiatric facilities.

Deaf Aotearoa recommends that Deaf people receive mental health care from culturally and linguistically competent providers using appropriate support services.

This means that providers accept Deafness as an integral and valued part of the individual and understand and respect the communication choices the Deaf person and their family needs. Overall, Deaf Aotearoa affirms that attitudes towards the Deaf from mental health service providers must improve.

Culturally and linguistically competent providers

Deaf Aotearoa concurs with the US National Association of the Deaf’s description of the skills of culturally and linguistically competent providers[2], which have been adapted here to include:

  • ability to communicate directly with Deaf and NZSL users, requiring fluency in NZSL
  • appropriate use of services and adaptive technology as is best identified and utilised by the client and their family members, e.g., use of NZSL interpreters, assistive listening devices and/or real-time captioning services
  • intensive and extensive awareness of the cultural and linguistic differences, and psychosocial impact associated with hearing loss
  • awareness of and sensitivity to the cultural and linguistic factors that impact the quality of the delivery of mental health services to the Deaf community.

Use and choice of NZSL interpreters

Deaf Aotearoa affirms the following with respect to the use and choice of interpreters in mental health settings:

  • requests from, or expectations of, providers to use family members to interpret is not acceptable or appropriate (unless this is the client’s self-determined choice)
  • providers shall endeavour to book the client’s preferred interpreter/s (this can be done in advance with knowledge of the client’s preferences).

Overall, it is important that mental health service providers understand that it is the Deaf client’s choice on how they want to be supported.

Recommendations

Deaf Aotearoa asks the Government to urgently develop a nationally co-ordinated approach and workforce development strategy to deliver culturally and linguistically appropriate mental health services to the Deaf community.

In practical terms, this means funding the development of:

  • interpreters with specialised skills in mental health 
  • qualified Deaf counsellors
  • health promotion and illness prevention information in NZSL
  • Deaf-friendly services, e.g., on-call interpreters, staff who are competent in using the NZ Relay Service, provision of NZSL on websites etc
  • widespread availability of Deaf awareness resources for health professionals.

Actioning this recommendation will assist the Government meet the recommendations of the Inquiry into Mental Health and Addiction[3] which concluded, amongst other things’, that there should be ‘services that fit with the different cultures people are from’.

Additional information / further reading

More detailed information can be found in Deaf Aotearoa’s submission on the Mental Health and Addiction System and Service Framework 2022-2032 Core Concepts [add link].


[1] Factors such as language deprivation, impoverished communication, isolation, negative attitudes, bullying, and medicalisation.

[2] https://www.nad.org/about-us/position-statements/position-statement-on-mental-health-services/

[3] https://mentalhealth.inquiry.govt.nz/

DOWNLOAD