Commissioning Deaf Mental Health Services

Despite having poorer mental health than the rest of the population, the 60,000 people across the UK who use sign language as their main language often come up against barriers when seeking mental health services.

The difficulties Deaf people face when seeking mental health help are often woefully misunderstood by commissioners of NHS services, who in some cases assume that booking a British Sign Language (BSL)/English interpreter is enough.

This does not work for most deaf people, and can often make mental health treatments less effective as the three-way conversation can cause stress or misunderstanding. Deaf people should be able to choose to see a therapist fluent in sign language.

Guidance to improve Deaf people’s access to mental health services
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Guidance to improve Deaf people’s access to mental health services

Ten key messages for commissioners within the guide

  1. Deaf people find it difficult to access healthcare, face communication barriers and, as a consequence, have poorer mental and physical health than the rest of the population.
  2. Everyone who uses mental health services should have equitable access to effective interventions, and equitable experiences and outcomes. Under the Equality Act 2010 deaf people are included as having ‘protected characteristics’.
  3. Due to their unique life experiences, Deaf people require different primary mental health car. Commissioners should commission appropriate cultural and linguistic provisions when planning services for Deaf people.
  4. Psychological therapy in British Sign Language (BSL) is as cost effective, if not moreso, than a hearing therapist using a BSL/English interpreter.
  5. Deaf people should be able to choose to receive primary care psychological therapy services in BSL directly from a BSL practitioner, without needing a sign language interpreter, if that is their choice.
  6. A comprehensive commissioning strategy is required to enable an appropriate BSL psychological therapy service to be available.
  7. Commissioners need to ensure that Deaf people have a clear care pathway that is equitable to the general population.
  8. Commissioners need to include Deaf professionals in their workforce planning strategy.
  9. Deaf people need to be involved with the ongoing development of Deaf primary care mental health services.
  10. Where services are commissioned that require sign language interpretation, commissioners must ensure the provision of interpreters is of high a standard, as highlighted in NHS England’s Quality standards based on the Principles for High Quality Interpreting and Translation Services in Primary Care 2016.