Throughout September, Deaf communities all over the world celebrate their rich culture while promoting awareness of sign language and their shared experiences living in a hearing world. The last week of September is International Week of the Deaf. The Deaf and Hard of Hearing Services at Greater Nashua Mental Health Center is the only program in New Hampshire of its kind. The dynamic, multi-disciplinary team is comprised of deaf and hearing counselors and case managers who communicate via American sign language. The team members are exceptionally skilled at addressing mental health challenges often faced by members of this cultural and linguistic minority. Holly Rioux oversees this program, and she and her colleagues Adam Lemay, Hannah Long, Kelley Osborne and recent social work graduate Amy McCollum, have their work cut out for them. Together, with the support of a full-time American sign language interpreter, Ashley Woods and psychiatrist Dr. Marilou Patalinjug Tyner, provide various modes of outpatient treatment, including assessments, counseling, case management, community based supports and medication management to deaf and hard of hearing residents throughout the state. It is the mission of the Deaf Services team to provide culturally and linguistically competent mental health services to their clients, enhancing their quality of life by facilitating mental health, wellness and empowerment. As the only program of its kind in New Hampshire, established at GNMHC in 1995, the program has expanded exponentially and is exceeding current resources.

Rioux, a licensed clinical social worker who is deaf herself, recently shared some enlightening insights with fellow employees at GNMHC, as she aims to promote cultural awareness among agency staff as they interact with members of the deaf community in our facilities. As with many cultures, deaf culture embodies its own heritage, language, art and customs. Rioux stresses that it is important to understand that deaf folks, particularly those who primarily communicate via sign language, are a cultural and linguistic minority, with challenges often similar to those of other cultural and linguistic minorities. It is no secret that most hearing people value their ability to hear and struggle to imagine life without hearing. Deaf persons hold the same value for their ability to see and communicate visually. In our predominately hearing world, many efforts are made to alleviate hearing loss, with additional emphasis on speech development and communicating with the English language. “Hearing impairment” suggests a deficit or a handicap that must be corrected. The label “hearing impaired,” was actually deemed as inappropriate by the World Federation of the Deaf in 1987. “Deaf-mute” and “deaf and dumb” also are outdated and considered offensive.

“We are not mute; we have a fully functioning, rich language through which we can express ourselves, learn and connect with one another. We are not impaired, we can access the world through our eyes instead,” Rioux said.

People with significant hearing loss depend primarily on visual channels for communication. For those with normal hearing, the implications of this fact can be a challenge to comprehend. For one thing, American sign language is not English. It is an official language with its own set of grammatical rules, structures and syntax, as has been studied in the field of linguistics for decades. To expect that deaf persons can simply read something in lieu of hearing it, is an unrealistic expectation, as English is not their primary language. It would be like expecting English-speaking persons who have no understanding of Spanish to suddenly be capable of reading something written in Spanish. Despite this, many deaf and hard-of-hearing folks are considered bi-lingual or tri-lingual as they navigate a hearing and written world in their daily lives.

Rioux emphasizes that deaf and hard-of-hearing persons who are struggling are likely to have limited access to support and services as compared to hearing folks. Qualified, experienced signing providers are few. Despite this, there is significant research that supports positive outcomes when treatment is tailored to the cultural and linguistic needs of the person seeking help. The bottom line is that there is nothing better than getting help in one’s first language and within the framework of one’s own culture. As the state-designated Community Mental Health Center for Southern Hillsborough County, GNMHC is committed to this model of care. We are proud to announce that our Deaf Services team employs four deaf professionals who communicate directly with our clients and embody deaf cultural values, supporting best possible outcomes for those seeking treatment. Most of the English-speaking population may take for granted that they can simply find another counselor in their area if they are not satisfied. “It is critical that the Deaf and Hard of Hearing Services team provides high quality care to our clients, for there are limited options for them to go elsewhere in the state without compromising their cultural and linguistic needs in treatment,” Rioux said.

It is important for members of the deaf community to have direct communication with their mental health providers, engaging in treatment without a sign language interpreter as a middle-man whenever possible. Try to imagine bringing a third person into the room as you work with your counselor, sharing intimate challenges you face in your life. It is difficult for anyone to work through this process, relying on the assurance of privacy and developing a positive, trusting rapport with one’s counselor. Now, picture the third party, an interpreter, who is not only witness to your most private experiences, but also providing an interpretation of your thoughts, feelings and narrative. There are many pitfalls. Implications such as mistrust, misdiagnosis or poor treatment outcomes with well-meaning, unwitting providers and interpreters are well documented. Fortunately, GNMHC’s team of qualified providers, who are deaf and/or fluent in American sign language, are able to communicate directly and privately with our clients. Should additional supports be needed beyond the scope of direct communication between provider and consumer, the team works to identify the most appropriate and effective forms of access to communication to meet our clients’ needs. Furthermore, our interpreter has undergone 80-plus hours of mental health interpreting training as we strive to ensure effective communication in the unique setting that is deaf mental health services. GNMHC also strives to serve as a local model for effective sign language interpreting practices in mental health contexts, and is able to share these practices with the local deaf and sign language interpreting community.

In honor of Deaf Awareness month, the Deaf Services team is hosting a series of Silent Lunches with GNMHC employees as hearing employees gain insight to the deaf experience, practice communicating visually and learning conversational sign language. The employees are excitedly anticipating this celebration.

The Greater Nashua Mental Health Center has as its mission: Empowering people to lead full and satisfying lives through effective treatment and support. For more information about our deaf and hard-of-hearing services or any other programs offered, visit www.gnmhc.org.

Donna Albertelli Collins M.Ed., is communications and development coordinator for Greater Nashua Mental Health Center, 100 W. Pearl St., Nashua. She can be reached at 603-889-6147, ext. 1588.