Review: Mental Health Care of Deaf People. A Culturally Affirmative Approach

Authors: Neil S. Glickman and Sanjay Gulati. Review by Sally Austen, Consultant Clinical Psychologist, Denmark House, Deaf Mental Health Services, Birmingham.

This book took me a long time to get around to reading. I was somewhat put off by the few subheadings relative to the number of words. Also, the early chapters have a fierce political component that, although a rich resource of cultural information, I found a bit wearisome. However, now that I have read it, I think I will return to this book often and reference its sophisticated and balanced debate regularly. I don't think it is a book for hearing services with a lone deaf patient but I think it has great value for services and professionals that are in the process of developing or improving services for deaf people.

Of particular value is the emphasis on working clinically with people who are language deprived, psychologically unsophisticated or have additional difficulties. This is the reality of working within mental health services for deaf people and the open discussion and practical suggestions are extremely valuable and reveal the wealth of clinical experience of the authors. I read these chapters and felt relief that I am not alone in working with this complex and time-consuming client group.

It is with this linguistically deprived client group in mind that the CD-ROM of cartoons and visual explanations is provided. The pictures can be downloaded and printed as they are, or adapted to one's own particular audience. They refer to general mental health issues as well as to the specifics of substance misuse and sexual offending. I have heard many staff at my work place saying that they have plans to use it. It is clear that all the authors' base their work on sound theoretical foundations, even if they have to adapt the work to fit the client group. The chapter on Sensory Movement Interventions for example, describes a practical interpretation of Dialectical Behaviour Therapy which can be used to help patients regulated their emotions, cognitions and behaviours. The use of eclectic psychological approaches is very welcome: cognitive-behavioural, systemic and psychodynamic models co-exist and are applied to issues such as working with interpreters, cross-cultural issues, and the cochlear implant debate.

I think this is a book that managers of deaf services or general health provisions where deaf people may present, would be wise to read. These recommendations on the design, resourcing and staffing of services for deaf people with mental health problems are made by experienced clinicians and managers who come from a country (USA) where their equivalent of our Disability Discrimination Act has already led to many law suits against hospitals that do not provide adequately for deaf patients.

In summary, a great book to get your teeth into, a great CD-ROM if you want to bypass the meaty stuff, but I would have picked the book up sooner if it had been more rigorously edited.

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