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
Deputy Head, Oak Lodge School
Introductions: Who are we?
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
Where are they?
- 90-95% of deaf babies are born to hearing parents
- 95% of deaf children educated in mainstream settings
- 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%
- Group of 81 deaf/ hard of hearing schoolchildren
- Estimated prevalence of psychiatric disorders 43 to 50.3%
Use of measures not validated with deaf children
- Clinician's experiences / understanding of deafness
- Use of interpreters
- What do these mean?
- 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
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
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