University of Edinburgh
 

Mental Health and Deafness

Presented on 5 June 2008

Mental health disorders in deaf children and adolescents

Dr Constanza Moreno, Clinical Psychologist
Deaf Child & Family Service, South West London & St Georges Mental Health Trust

Shanée Buxton
Deputy Head, Oak Lodge School

Introductions: Who are we?

  • Shanée
  • Constanza

Who are you?

  • Age range of children work with
  • Education settings

Incidence of deafness

  • 840 babies born each year in UK with significant deafness
  • 1 in 1,000 children deaf at 3 years old
  • 20,000 children aged 0-15 moderately to profoundly deaf
  • 12,000 children aged 0-15 were born deaf
    (RNID website)

Where are they?

  • 90-95% of deaf babies are born to hearing parents
  • 95% of deaf children educated in mainstream settings

D/deaf?

  • 50-70,000 in Deaf community
  • 10,000 sign language users in schools

Incidence, your experience

Think about the number of children you currently work with / have worked with.

How many children have you had concerns about their emotional development, behaviour or mental health?

Incidence, research: Isle of Wight study (Graham & Rutter, 1970)

  • 11,685 children 5-14 years
  • Gen population 6.6%
  • Children with brain disorder 58.3%
  • Deaf (13 cases) 15.4%

Hindley (1993)

  • Group of 81 deaf/ hard of hearing schoolchildren
  • Estimated prevalence of psychiatric disorders 43 to 50.3%

Higher incidence?

Use of measures not validated with deaf children

Child interviewed?

  • Clinician's experiences / understanding of deafness
  • Use of interpreters
  • What do these mean?
    Eyes down
    Slight frown

Sinkkonen (1994)

  • Total population study in Finland (high parental signers)
  • Modified Rutter B(2) scales to screen all children and young people 6-21 (416/445)
  • No significant difference in rate of disorder amongst deaf with hearing controls (D18.7% H15.8%)
  • Low communication ability...
    among children with multiple handicaps was significantly associated with psychiatric disorder
    Associated with high scores on hyperactivity scale

Number crunching time

  • 15 - 30% of 20,000 0-15 year olds
    = 3,000 to 6,000 children potentially experiencing difficulties
  • How to reach this group of young people?

Mental health services for deaf children

  • In-patient (6 beds)
    London - Monday to Friday
    5 MDT, education team, + team of nurses and Child Mental Health Workers

  • Out-patient
    London - full time (MDT - 6 full time, 2 part time and access to in-patient SALT), national referrals
    York & Dudley - both part-time teams, specific referrals

Current outpatient caseload

Range between generic and specialist

  • Referrals that would not meet CAMHS criteria
  • Comparable to 'Standard' CAMHS eg; ADHD
  • Highly complex cases, multiple diagnoses, learning disabilities ...

What we do at Hightrees?

  • Initial assessments
  • Specialised assessment
    Sensory, cognitive, adaptive functioning, Speech & Language, social and communication
  • Direct interventions
    Individual therapy with various therapeutic approaches, family therapy
  • Working with systems
    Consultation, behavioural interventions, parenting, deaf awareness training, mental health training

Current outpatient caseload (rough snapshot)

  • ASD ~ 25%
  • Hyperactivity ~ 13%
  • Mixed conduct and emotional ~ 12%
  • Emotional disorders ~ 6%
  • Anxiety ~5%
  • Depression ~5%
  • + + Learning disabilities, psychosis, developmental delay, Tourette's ...+ +

What's available in Scotland?

  • BSMHD May 2008 conference
  • Scottish Council on Deafness - Mandy Reid
  • Scottish Mental Health First Aid - Deaf Connections, Glasgow
  • Lothian Deaf Counselling Services
  • Scottish Independent Advocacy Alliance - BSL DVD, 3 stories
  • Study by Glasgow Caledonian University