WICHE Mental Health Report
July 02, 2007
Volume 1, Number 6
RECENT ISSUES: February 2007 . March 2007 . April 2007 . May 2007 . June 2007
In this Issue:
InFocus: Deaf and Hard of Hearing Populations in the West
There is a significant Deaf Culture in the United States, one that is often invisible and misunderstood but that nevertheless is as vibrant and substantial as that of any other minority group. - Barry Chritchfield, Director, Office of Deaf Services, Missouri
Note: The following are excerpts from a larger document: Information Gaps on the Deaf and Hard of Hearing Population: A Background Paper.
Across the United States, there have been historical difficulties in recruiting and retaining an effective behavioral health workforce that is prepared, both culturally and linguistically, to serve the deaf and hard of hearing communities. In addition, the recent report of the Surgeon General’s Call to Action to Improve the Health and Wellness of Persons with Disabilities described in detail the significant challenges faced by persons with disabilities, including deaf and hard of hearing, to access the services needed to maintain good health and wellness.
These challenges include:
- significant gaps in public and professional knowledge and training about hearing loss and deaf culture
- accessibility of services
- availability of culturally appropriate providers and programs
- acceptability of care based on historical perceptions of mistreatment
- establishment of mental health policy without consideration of the impact on deaf and hard of hearing communities.
What follows is a summary of relevant concerns in several areas of deaf and hard of hearing populations, including 1) the lack of a consistent definition of hearing loss and culture in the United States, 2) the lack of accurate and thorough epidemiological data at the state and federal levels, and 3) the lack of accessibility, availability and acceptability of behavioral health services.
Epidemiological Issues
- There is currently no national database of deaf and hard of hearing persons.
- 8.6 percent of the total U.S. population 3 years and older were reported to have hearing problems.
- Within the 15 WICHE states, there are an estimated 6 million deaf and hard of hearing individuals (see table below).
Mental Health and Deafness
- We can estimate there are over 5 million deaf individuals in the United States who need mental health treatment every year.
- Only about 2% of these deaf individuals receive appropriate treatment for mental illness due to barriers in the effective diagnosis of mental illness.
- The prevalence of adults with serious mental illnesses (SMI) and children with serious emotional disturbances (SED) is likely greater in the deaf population than in the hearing population, sometimes estimated to be 3 to 5 times greater.
- Deaf children experience physical and sexual abuse two to three times higher than that of their hearing peers.
- There are no current attempts or future plans to collect or track the incidence of violent death or suicide in the deaf population.
An appropriate context and parallel for understanding many issues that impact the quantity and quality of mental health services for deaf and hard of hearing populations is the area of rural mental health. Many of the challenges and difficulties that impede service delivery for general populations in rural areas are also present for deaf populations, rural and urban.
Like rural Americans, deaf or hard of hearing individuals face problems with the availability, accessibility, and acceptability of mental health services. Too often, quality care is not available, cannot be reached or paid for, and may be stigmatized. A majority of deaf persons live in rural areas, which compounds the problem of limited services based on geography by even more limited services specifically for this population. Thus, there are strong parallels between rural and deaf or hard of hearing populations.
State and local population estimates are not computed by any of the national survey programs because the households sampled are not representative of each state’s individual population. According to Holt (1994) this is unfortunate due to the fact that in most states, the allocation of resources and administration of services for deaf populations occur at the state and local level.
The following state estimates were computed at WICHE based on the estimate of 8.6 percent of the population established by NHIS. It is important to note that while these numbers are based on the best information available and can be stated with some confidence, they are still rough estimates based on debatable definitions of deafness. Individual states will need to take the initiative to reliably determine the numbers of deaf individuals within their borders.
| WICHE States | Total 2004 Population | Deaf & Hard of Hearing | Deaf | Hard of Hearing |
|---|---|---|---|---|
100% |
8.6% |
0.9% |
7.7% |
|
United States |
293,655,404 |
25,254,364 |
2,642,898 |
22,611,466 |
WICHE States |
|
|
|
|
Alaska |
655,435 |
56,367 |
5,899 |
50,469 |
Arizona |
5,743,834 |
493,969 |
51,695 |
442,274 |
California |
35,893,799 |
3,086,866 |
323,044 |
2,763,822 |
Colorado |
4,601,403 |
391,359 |
40,956 |
350,403 |
Hawaii |
1,262,840 |
108,604 |
11,366 |
97,238 |
Idaho |
1,393,262 |
119,821 |
12,539 |
107,282 |
Montana |
926,865 |
79,710 |
8,342 |
71,368 |
Nevada |
2,334,771 |
200,790 |
42,026 |
158,764 |
New Mexico |
1,903,289 |
163,683 |
17,130 |
146,553 |
North Dakota |
634,366 |
54,555 |
5,709 |
48,846 |
Oregon |
3,594,586 |
309,134 |
32,351 |
276,783 |
South Dakota |
770,883 |
66,296 |
6,938 |
59,358 |
Utah |
2,389,039 |
205,457 |
21,501 |
183,956 |
Washington |
6,203,788 |
533,526 |
55,834 |
477,692 |
Wyoming |
506,529 |
43,561 |
4,559 |
39,002 |
|
|
|
|
|
Total WICHE States |
68,814,689 |
5,913,698 |
639,889 |
5,273,810 |
Further Reading:
Suregeon General's 2005 Call to Action to Improve the Health and Wellness of Persons with Disabilities
Critchfield, A.B. (May, 2002). Cultural Diversity Series: Meeting the Mental Health Needs of Persons Who are Deaf. National Technical Assistance Center for State Mental Health Planning (NTAC).
HHS Office of Minority Health and Resources for Cross Cultural Health Care (1999). Recommended Standards for Culturally and Linguistically Appropriate Health Care Services (Resources for Cross Cultural Health Care).
Myers, R.R. (Ed.). (1995). Standards of Care for the Delivery of Mental Health Services to Deaf and Hard of Hearing Persons. Silver Spring: National Association of the Deaf.
Ries, Peter W. (1994). Prevalence and characteristics of persons with hearing trouble: United States, 1990-91. National Center for Health Statistics. Vital Health Statistics, 10(188).
Willis, A.G., Ph.D.; Willis, G. B., Ph.D.; Male, A., M.A.; Henderson, M.H., M.P.A; and Manderscheid, R.W., Ph.D. (2001) Mental Illness and Disability in the U.S. Household Population. Mental Health 2000, U.S. Department of Health and Human Services, Center for Mental Health Services.
Resources:
The Gallaudet Research Institute (GRI) - GRI researchers gather and analyze data concerning the demographic and academic characteristics of deaf and hard of hearing populations, primarily to provide information needed by educators in the field.
Substance and Alcohol Intervention Services for the Deaf (SAISD), Rochester Institute of Technology - SAISD provides substance abuse recovery resources for consumers, their families and friends, nd providers.
National Association of the Deaf (NAD) has a position statement on Mental Health Services For People who are Deaf and Hard of Hearing.
FYI…
Accessible Mental Health Information Videos for Deaf and Hard of Hearing Consumers
Teaming up with the Ohio Department of Mental Health, CSD of Ohio and CSD-TV have developed American Sign Language (ASL) videos as a resource for deaf or hard of hearing mental health consumers. The videos are also captioned and voiced. Some of the video topics are "Child and Adolescent Depression," "What is Post-Traumatic Stress Disorder," "Anxiety Disorders in Adults," "What Are Mood Disorders," and many more. These Web-based videos were produced for a community resource network called the Network of Care, the first online community resource in the health and human services arena. Ohio is one of 13 states who operate a statewide Network of Care (www.networkofcare.org).
To check out the new Ohio Network of Care Web site and the videos, go to www.ohio.networkofcare.org.
As part of The Colorado Trust’s Health Professions Initiative, CHI is making available in one location data and information on Colorado’s health care professionals. The site is a key component of CHI’s Health Professions Database work and will provide information on changes in the supply and demand of Colorado’s primary health care workforce over time.
Features include:
-- A workforce home page that includes weekly WorkforceStats that you can use for presentations or publications; Spotlights alerting you to interesting health professions reports or data; and a quick link to workforce-related indicators that you can sort by geographic location or topic.
-- A new data section where you can create customized reports about Colorado or any of its 64 counties, or see how counties compare on specific workforce-related indicators. Download or print your information in table, graph or map format.
--Separate sections on the physician, nursing, oral health, mental health, pharmacy and allied health professions. Each section includes data resources, publications, studies and initiatives, and other information to make the site a unique resource for policymakers, providers and others concerned with the future of Colorado’s health workforce.
The workforce site is embedded into a newly redesigned Colorado Health Institute Web site (www.ColoradoHealthInstitute.org), which also includes:
-
A new home page that puts resources on dozens of health-related topics at your fingertips.
-
An improved search engine to make it easier for you to find the information you need.
- A new companion Web site on Colorado's health care safety net ( www.ColoradoHealthInstitute.org/safetynet). Supported by The Colorado Health Foundation, the safety net site also features indicators and other resources about related topics. Find information on providers, users, the workforce and financing of safety net efforts across the state and elsewhere.
CHI wants to make www.ColoradoHealthInstitute.org/workforce the most comprehensive and easy-to-use resource available on health workforce issues and policy in Colorado. Enjoy exploring this new site, as well as the revamped CHI site and the new safety net site, and please pass this message along to others who may be interested. Last but not least, let us know how we’re doing at info@ColoradoHealthInstitute.org.
Job Opportunities
Recent Job Announcements Webpage
On this page you will find recent job announcements pertaining to either the WICHE West or to rural mental health areas.
WICHE MH Personnel
Dennis Mohatt, MA Mental Health Program Director
Scott Adams, Psy.D. Associate Program Director
Chuck McGee, MA Project Director
Mimi McFaul, Psy.D. Research Associate
Candice Tate, Ph.D. Research Associate
Fran Dong, Statistical Analyst
Jenny Shaw, Administrative & Project Coordinator
Tell Us How the WICHE Mental Health Program Has Impacted You
The Western Interstate Commission for Higher Education is seeking your comments on how our services have affected mental health services in rural communities. Please send an e-mail telling how WICHE has influenced you to ctate@wiche.edu. We would also love to hear your nominations for promising rural practices. Feel free to also contact us with requests for state-specific rural assistance or to just ask us a question about our experience with rural mental issues and public policy.
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