Mental Health

History

The American mental health system has long neglected and minimized the needs of Deaf people, from those coping with serious mental illnesses requiring inpatient treatment, to those seeking support in dealing with everyday stressors in life. Between 1840 and the mid-1960s, psychiatric institutions were the treatment of choice for Deaf and hearing patients. The majority of medical and psychiatric professionals who worked with Deaf patients during these years did not receive specific training in working with the population, did not know sign language and did not believe that Deaf patients would benefit from treatment. They assumed, as did much of larger society, that Deaf people were deficient in cognitive and intellectual abilities and incapable of abstract thinking and reasoning. The paternalistic and oppressive attitude had a direct impact on quality of care. Insight-oriented psychoanalytic therapy, cognitive therapy and affective-based therapy were considered ineffective and inappropriate for use with Deaf patients. Any mental health treatment that was provided was likely to be grossly simplified and the prognosis one of minimal improvement.

Warehousing refers to the standard treatment intervention of confining Deaf patients to the back wards of psychiatric hospitals, or institutions veiled as special education programs. In these places, Deaf patients typically received little treatment beyond basic maintenance or custodial care. They suffered physical abuse when they did not cooperate with staff. It was common for patients to languish in isolation, without access to communication with their caregivers and other patients. Although many hearing patients were also treated inhumanely in these psychiatric institutions, the treatment of Deaf patients was exceptional in its severity due to language barriers and misperceptions of Deaf people in general.

[Page 682]The 1970s marked the beginning of the American mental health system’s shift toward deinstitutionalization and community-based programs. Shortly after, the growing emerging of ASL as a formal language, the successful Deaf President Now movement at Gallaudet University in 1988, and the passage of the Americans with Disabilities Act in 1992 brought attention to the substandard mental health treatment given to Deaf patients. Changes came slowly, with Gallaudet University offering graduate programs in rehabilitation counseling, then mental health and school counseling, and later, social work and school and clinical psychology. For the first time, clinical programs serving Deaf patients were established in a few urban areas. Despite these positive developments in the field of mental health and Deaf people, many issues remain problematic and ongoing.

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