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The TeamMany of the problems of
team work revolve around language. On the one
hand, the use of sign and on the other, the demands of English. It is fair to say that 99%
of information in the area of mental health is available in English or in another written
language. A great proportion of the
professional communication is conducted on paper and by case conferencing. English is the language used in the UK for these
purposes. Characteristically, meetings of
teams is conducted in English. Where possible
an interpreter is provided but commonly one member of the team acts as interpreter. In cases where interpreters are available, they
are rarely trained in mental health. It is easy to predict the
problems. The interpreting situation
immediately puts the deaf person at a disadvantage. Information
arrives late or not at all. The effectiveness
of the interpreter is dependent on personal as well as intellectual factors and a sick
interpreter means a problematic translation. Typical
comments/questions like what does the deaf member of
the team think? are often impossible to deal with as the deaf person has been achieving only about 40%
comprehension of the information. But it
seems that it is just too hard to change the
meeting to be deaf oriented - hearing people are in the majority. On the other side, sign
language information is difficult to convey to hearing people. A deaf person in touch with a deaf patient may
detect specific experiential factors and may wish to interpret these in cultural rather
than psychological terms. Although the
sign-English translations exist, they do not capture the full meaning. Typically even an interpreter will not be able to
cope with the full meaning. Additionally, the
sign-English equivalences may not be equivalences at all.
The content of deaf mental ill-health may be quite different from that of
hearing people. I will consider this a little
further in a later part of the paper. The net result of these
language barriers are frustration and incomplete communication in the team meetings. What it then obscured is the TRUTH. That is hearing people have a theoretical
framework to apply, based on hearing research and hearing experiences but this may not
match the cultural experiences which deaf people have.
A good deal of this can be seen in John Denmark’s book (1994) where he
describes the types of patients which he has experienced. A related problem which has
to be mentioned is the one of terminology. There
is a legacy of disabling language in the hearing literature. Although one can argue that this is “only
words”, use of this terminology tends to obscure the true characteristics of the
person and tends to delay the professional in addressing the problem. Terms applied in the field
such as : preverbally deaf people, problems related
to their deafness, immature, being without speech, limited verbal language. There are many more. To many of the team they may seem innocuous and in
translation they may even lose their impact in sign language. But they have an effect which obscures the process
of understanding. Preverbal deaf person implies that there is a fixed
time when verbal competence is available. We
know from extensive research on language development that this is not true except in the
most crude description. Children are “verbal”
from their very first interactions and the proto-conversations which can be described
occur from the first few months of life. Problems related to deafness could be precise and
refer to medically related aspects of whatever has caused the deafness - eg being run over
by a car, or other components of the syndrome which has brought about the deafness - but
it is usually taken to be a description of adjustment problems. Such adjustment is an issue but it does not relate
to deafness per se and thus could be expressed in much more positive terms in relation to
need of support services, counselling or other. Likewise,
immature deaf person has come to be a negative
description of deaf behaviour when maturity is completely socially determined and is a
factor in the adjustment process. To say,
someone is immature is to label the person instead of trying to understand the process and
needs of the individual. A deaf person without speech is a rather old term
which is simply wrong. Even the strongest
oralist educator will never accept that a deaf person is without speech.
Difficulties in speech arise from reduced interaction possibilities and the
inability to hear but it cannot be expressed in these absolute terms. Limited
verbal language is also a negative obscuring term which conflates the concepts of language and limited. Deaf people may have limitations in their verbal
performance in comparison to hearing people but this does not relate to or predict their
language competence per se. Terminology like
this serves to complicate deaf-hearing relations. We can see from all of
these points that many problems arise from the differing linguistic and cultural base from
which deaf and hearing professionals come together. Some
of the problems could be overcome if there were a clearer statement of a common goal. |
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