Missouri deaf community fights for better mental health services

From The Fulton Sun in Missouri:

Calls for improved mental health services won't fall on deaf ears if Jeff Prail has anything to do with it.

He and other deaf community advocates met with Department of Mental Health
Commissioners last week to stress priorities in addressing deaf mental health.

“What we're trying to do is make the Department of Mental Health realize and recognize that deaf service is completely different in terms of uniqueness and that you have to design a system that is appropriate to work with the deaf community,” Prail said. “Right now they're saying they don't have the funds to make that happen and if we want that we need to go down to Jeff City and start talking to legislatures, but a lot of deaf communities don't have faith in the system at all.”

But Prail - coordinator of deaf and hard of hearing services for Paraquad - has fought for deaf rights and equal services and believes equatable coverage isn't being provided by DMH. It provides mental health coverage via interpreters, who act as a bridge between a mental health professional and the patient.

“At times they don't want a third party involved, but want someone they can talk to one-on-one just like a hearing person does,” Prail said. “The National Association for the Deaf sides with us and says a licensed interpreter is still not the correct combination for a deaf mental health patient.“

In Florida, a federal judge ruled in 1994 that a licensed interpreter is not equal accommodation and we're trying to work with the department to provide a solution.”

Prail and others - including Missouri Association of the Deaf president Ella Eakins and a DMH Steering Committee - have reached out to the deaf community to determine how to better serve them. Their work may have paid off in DMH's proposed budget for next year. It designated $1.7 million to improve coverage for that minority of its patients.

However, the budget has to be approved by state legislators and deaf services ranks 23 out of its 27 items. John Heskett - interim director of deaf services for DMH - says its low ranking is because consideration for new or extended services fall behind costs of inflation and maintaining the current level of service in all areas.

“Many individuals in the deaf community already receive services through the department via an interpreter,” Heskett said. “We recognize it's preferable, it's better to be able to provide mental health services directly through a psychiatrist, a psychologist who can sign themselves and don't have to go through an interpreter.

“I think the ranking is a reflection that we are talking about improved services, not necessarily that the deaf have been without services in the past.”

But professionals fluent in American Sign Language are scarce and the proposed new funding will use technology to bridge distance and compensate that shortfall. Telemedicine - which is already being used by the Missouri School for the Deaf - connects doctors to patients via cameras, audio and the Internet.

“Students can sit in a room on campus and talk with their psychiatrist via an interpreter for medication checks or therapy sessions,” MSD superintendent Barbara Garrison said. “It's much less pervasive and much more cost effective because we don't have to be on the road transporting children.”

However, Garrison agrees that the deaf community has unique mental health needs that have not been filled.

“The mere fact that they cannot hear isolates them and when the majority do not have other deaf people to associate with or even families proficient in sign language that heightens that isolation,” Garrison said. “We know we are all being asked to do more without an increase of funds to do that, but relative to the deaf community, they've been grossly underserved when it comes to mental health services.”

Direct service can also mean better diagnosis.

“A deaf person can understand when another deaf person is getting mad and not blow it out of proportion, but the counselor who doesn't understand the frustration might misdiagnose him and think the deaf person is out of his mind,” Prail said. “Inappropriate treatment might be provided because of that misdiagnosis.”

Heskett acknowledges the proposed changes will be better, but sees a possibility that parts of the budget might be cut.

“It's definitely possible when the stock market takes a 500 point tank in one day,” Heskett said. “It's all dependent on the state of the economy and is likely to be approved if the economy stays strong.

“If not, all of our requests are subject to very, very careful scrutiny by the general assembly and by the governor,” he continued. “It's important to the DMH, and we want to work with the deaf community to provide services at a level that is responsive to their needs.”