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Ethical Considerations in Providing Mental Health Care to Deaf Community

5/15/2017

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Kathleen Mitchell, MSW, LMSW, ACSW​

 
The mission of the social work profession is rooted in a set of core values. One of the core values is Competence. The ethical principle is social workers practice within their areas of competence and develop and enhance their professional expertise.
 
Background
 
In order to understand the unique needs  and aspects of the Deaf, a study that was completed by the Division on Deaf, DeafBlind and Hard of Hearing in Michigan in 2005 estimates there are approximately 866,879 individuals in Michigan with hearing loss and 90,720 who are severely to profound Deaf. Professionals often have limited knowledge of deafness or Deaf culture which seriously impacts their ability to accurately assess and intervene.  Often, social workers lack the understanding that Deaf, Hard of Hearing and DeafBlind people each have their own culture, with unique needs, communication methods, and abilities.
 
Competent practice with deaf individuals is impossible without a Deafness knowledge base, which acquisition of sign language, exposure to deaf people, or a membership in the Deaf community. In addition to the history and culture of deaf persons, a firm foundation will include information about audiological, genetics and language categories. Further, the professional working with deaf clients must be familiar with issues of cultural differences in the deaf works.
 
It is also important to understand how the hearing status differences- pre and post-lingually deaf, hard of hearing, deaf child of deaf parents, mainstreamed, late-deafened, and those with cochlear implants affect the deaf individual’s adjustment in the setting.  The political, linguistic, and social characteristics of these groups all have implications for accurate empathy, assessment, treatment planning, and responsible research.
 
Ethical Standards
 
1.03  Informed consent
           
(a) Social Workers should use clear and understandable language to inform clients of the purpose of the services.. Keep in mind, each Deaf individual have their preference.  It is common for social workers to overlook sign language as a language. Working with Deaf people is in many ways very different than working with the hearing.  For example, Deaf people are visual learners; they may have poor reading and writing skills (since English is their 2nd language); they have different values and cultural norms. Taking a sign language class does not enable a practitioner successfully work with this population.
 
(b) If clients have difficulty understanding the primary language used in the practice setting then Social Worker should arrange for a qualified interpreter.
 
Consider how you can arrange for a qualified sign language interpreter. It is also important to know the interpreter’s qualification. Be familiar with Deaf Persons Interpreter Act – Michigan law that mandates specific certification in mental health field.

Contact Division on Deaf, DeafBlind and Hard of Hearing – 877-499-6232 for assistance. 
 
1.04     Cultural Competence and Social Diversity
 
(b) Social Workers should have a knowledge base of their clients’ cultures and be able to demonstrate competence in the provision of services that are sensitive to clients’ cultures and differences among people and culture groups.
 
Social Workers should be aware of different groups within the Deaf community (individuals from Deaf parents vs hearing parents, language acquisition, Residential school vs mainstreamed, hard of hearing normally do not use sign language but may need different communication method). Language deprivation individuals may need Certified Deaf Interpreter (CDI). Deaf person who are language deprived have poor language skills in any language.
 
(c) Social Workers should obtain education about and seek to understand the the nature of social diversity and oppression with respect to race, ethnicity, national origin, color, sexual orientation, age, marital status, political belief, religion, mental or physical disability.
 
Social Workers should attend workshops, seminars to gain knowledge in deaf culture and gain better understanding of how American Sign Language (ASL) is different than English. Contact the NASW-Michigan office (517-487-1548) for more information regarding workshop/training on Deaf, Deaf, Hard of Hearing and Deaf Blind.
                  

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    Social workers across Michigan are encouraged to post stories, op-ed and other articles. Please email nasw-michigan@nasw-michigan.org with your submissions.. Posts do not constitute an endorsement by NASW.

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