Assessment of Deaf dually
Rebecca Walls and Ian Hamilton
Purpose – This article seeks to explore the assessment issues for Deaf people who have a co-occurring
mental health and substance use problem.
Design/methodology/approach – The paper draws on the expertise of a clinician who works with this
client group, also using the available literature on this topic.
Findings – Dual diagnosis for Deaf British Sign Language (BSL) users has not been well researched.
Deaf people may be unable to access some forms of assessment/treatment due to compromised
cognition, understanding of concepts, and material not being accessible in an appropriate format. This
paper discusses an approach which may be of particular use to assessing this minority group.
Originality/value – This paper considers an approach which may be of particular use to assessing this
minority group. Although current techniques can be adapted such as cognitive-behavioural integrated
treatment (C-BIT), there is a need for further research to evaluate and develop appropriate screening
and assessment instruments for this client group.
Keywords Deaf people, Assessment, Dual diagnosis, Communication
Paper type Conceptual paper
There are approximately 50,000-70,000 Deaf (British Sign Language (BSL) users) in the UK
(RNID, 2010). Deaf (with a capital D) refers to individuals who primarily use BSL and actively
participate in the Deaf community. This is in contrast to the term deaf (with a lower case d),
which refers to individuals who prefer to use speech and do not identify themselves as a
member of the Deaf community (e.g. those who have lost their hearing after acquiring
speech). BSL users often identify themselves as being a cultural and linguistic minority
rather than disabled (Ridgeway, 1997). Understanding Deaf people’s cultural identity and
the linguistics of BSL enables a more meaningful assessment to be undertaken, as will be
described when discussing the use of tools with the Deaf community.
Approximately 25 percent of the general population will experience some type of mental
health problem at some point in their life (Mind, 2011). However, this increases to 40 percent
for Deaf people (Department of Health, 2005). It is possible that substance misuse may also
be greater within the Deaf mentally ill population compared to the hearing mentally ill
population. Although this is an area that is not well understood or researched
(Landsberger and Diaz, 2010).
The communication barriers resulting from Deafness make it easier for individuals who use
substances to deny, ignore or defend their lack of awareness of drug or alcohol-related
problems. As Deaf people are more at risk of experiencing mental illness and substance
abuse simultaneously than hearing individuals (Leigh and Pollard, 2004; Glickman, 2009) it
is important that assessment of dual diagnosis is undertaken and accurate. Research
regarding the needs of Deaf people is scarce and no studies could be found that gave
statistics in relation to this.
ADVANCES IN DUAL DIAGNOSIS
VOL. 5 NO. 1 2012, pp. 32-37, Q Emerald Group Publishing Limited, ISSN 1757-0972 DOI 10.1108/17570971211225154
Rebecca Walls is a
Nurse for Deaf People
South Yorkshire, UK.
Ian Hamilton is a Lecturer at
the University of York,