Deaf individuals seeking mental health support or treatment often come across a wide variety of barriers: linguistic, cultural, scarcity of resources (especially local ones), and more. In a study from 1998, 54 deaf participants were interviewed regarding their knowledge, attitudes, and beliefs about mental health issues and services, and more than half (56%; 30 participants) could not locate accessible mental health services (Steinberg et al., 1998). Currently, accessible mental health service includes, but is not limited to: interpreter-facilitated therapy sessions; interpreter and deaf interpreter-facilitated therapy sessions; a therapist who is Deaf and/or aware of the Deaf culture, and/or is fluent in American Sign Language; and providing options for both in-person and, more modernly, virtual therapy sessions.

In Steinberg and colleagues' study, the participants cited the following as their main source of mental health information: deaf service agency, friends, doctors, schools for the deaf, and telephone book (in the modern day, this may expand to newsletter postings, social media, and the Internet in general). 

Due to the scarcity of accessible mental health services for the deaf, these participants often relied on informal counseling, moral support, and shelter from members of the deaf community (e.g., family members, friends, etc.) who were respected for their sensitivity, common sense, and life experience. The most cited reasons these deaf participants did not receive mental health service or treatment were: communication difficulty, fears of prejudice or false beliefs about the deaf culture (from the practitioner), and ignorance of existing resources.

While interpreters often reduce communication barriers in mental health settings, a more recent study assessed complaints from deaf individuals regarding interpreters in health care settings, and found that out of 108 participants from Idaho, 48.2% were told that an interpreter was “not available;” 28.7% of customers received an unqualified interpreter, and 18.5% were promised an interpreter that was later not provided as promised (Schniedewind et al., 2020). This greatly contributes to the fears among deaf individuals about their ability to achieve quality communication with their therapist or mental health provider, especially since the number of deaf individuals seeking mental health treatment far exceed the number of deaf or ASL-fluent therapists.

Regarding fears of prejudice or false beliefs about the deaf culture, Steinberg’s et al. (1998) interviews showed a common source of this fear: power imbalances between deaf individuals and hearing professionals. Participants in this study viewed mental health practitioners as authoritarian, restrictive, and prejudiced. This led to the feeling that deaf individuals were “powerless and at mercy” of their mental health providers, and the possibility of prejudice may lead to the deaf client being unnecessarily committed to a mental hospital due to miscommunication or a misunderstanding. The deaf community has a prominent set of cultural behaviors, called “Deaf Bings,” that may easily be misunderstood by a person outside of their culture. One example of a Deaf Bing is stomping on the ground to get someone’s attention, as shouting may not work due to the individual being deaf; stomping on the ground, however, may be perceived as an act of aggression in the eyes of a hearing individual who has no knowledge of the deaf culture. This emphasizes the importance of mental health providers being culturally sensitive and aware of the cultural behaviors within the deaf community in order to provide a deaf individual with the most optimal and quality possible mental health service.

Quality mental health services and providers that are accessible and culturally sensitive, however, are very difficult to find. In the city of Austin, Texas, a simple search on Psychology Today showed only a total of 12 therapists who are either deaf and ASL-fluent or hearing and ASL-fluent who are available for in-person sessions, while an additional 8 therapists are available for only online consultations (Psychology Today). Some of these therapists are high-quality, while others have questionable ethics. Not only that, only a few of them offer a sliding scale method of payment, which adjusts the cost of service based on the client’s financial situation. Many deaf individuals struggle with poverty (my immediate family, for example, relies on Social Security in the state of California, which only offers about a few hundred dollars for a whole month after paying for rent), so flat-rate pricing often discourages them from seeking mental health treatment. Then, when a deaf individual has the money to seek mental health treatment, the sources of where to find this information is scarce. For example, the Texas Deaf and Hard of Hearing Services (TXDHHS) branch of the Texas state government offers a masterlist of resources for deaf and hard of hearing people. Their masterlist, however, lacks resources regarding mental health services for the deaf; the only resource they offer is a national one: DeafLEAD, which is a crisis intervention organization that specalizes in emergency mental health treatment. What about the deaf people who need mental health services on a daily or weekly basis? DeafLEAD does not provide that, and TXDHHS offers no alternatives to mental health treatment.

This severely limits deaf people from successfully securing quality mental health services, and so this petition aims to address the three barriers to quality and deaf-friendly mental health care: mandate culturally sensitive training for all employers and employees to include accurate instances from the deaf culture, mandate all abled mental health and health care providers to pick up and maintain their American Sign Language fluency (if a practitioner has a disability related to the use of their hands, they may be exempt from this mandate), and mandate all educational, governmental, and mental health service offices to have a comprehensive list of quality local and national mental health and counseling/therapy resources that are deaf-friendly.

Once we reach 5,000 signatures, I will propose these reforms at an Austin City Council meeting.

Sign the petition now to help us improve accessibility to quality mental health services and treatments for the deaf community in Texas!