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The Royal College of Psychiatrists Improving the lives of people with mental illness

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

As many as two in three Deaf people in the UK struggle with mental health problems, but most find it too difficult to access psychological therapy.

Guidance for commissioners of primary care mental health services for deaf people from the Joint Commissioning Panel for Mental Health (JCPMH) and Deaf health charity SignHealth, calls for improvement to deaf people’s access to mental health services.

Guidance - mental health services for deaf people

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, as recommended by the guide.

The guide’s recommendations for commissioners of primary mental health services could make a dramatic change to the mental health of many Deaf people.

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

This video highlights ten key recommendations for improving mental health services for Deaf people, translated into British Sign Language (BSL). Guidance for commissioners of primary care mental health services for deaf people has been produced by the Joint Commissioning Panel for Mental Health, led by Royal College of Psychiatrists and Deaf charity SignHealth.

Video Transcript

President, Royal College of Psychiatrists, Professor Sir Simon Wessely: “Everyone should have equal access to effective mental health services.  It is important that commissioners take on board the recommendations within this guide to make this a reality for Deaf people. As Deaf people have increased vulnerability for mental health problems, it is essential that they are able to access effective, evidence based, mental health services that match the specific challenges they face.”

Chief executive, SignHealth, James Watson-O’Neill: “I am really pleased the Royal College and the JCPMH decided to produce this guide with SignHealth. All too often Deaf people are forgotten about and overlooked. It’s great to see recognition of the challenges Deaf people face, and also some of the simple steps commissioners can take. I hope commissioners will see this guide as helpful and begin to improve access in their areas.”

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.


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