In lieu of an abstract, here is a brief excerpt of the content:

18 2 The Diversity of Consumer Knowledge, Attitudes, Beliefs, and Experiences ANNIE G. STEINBERG, RUTH C. LOEW, AND VICKI JOY SULLIVAN Attitudes toward health care influence the ways in which individuals in any community seek, utilize, and benefit from its services. Consequently, the provision of accessible and compassionate health care demands that clinicians possess an acute understanding of the beliefs and viewpoints prevalent in the communities in which they work (Groce & Zola, 1993; Helman, 1984; National Public Health and Hospital Institute, 1994). There is an urgent need for increased awareness in the medical community of the concerns of deaf consumers, particularly given the evidence that these individuals may have considerable difficulty utilizing the health care system (Harmer, 1999; Monaghan, 2008). Although deaf individuals may suffer as much or more from serious health problems than their hearing counterparts, it is more likely that utilization patterns result primarily from cultural differences and poor communication between clinician and client, leading to misdiagnoses and inappropriate care (Phillips, 1996; Zazove et al., 1993). This need for sensitivity to the values and attitudes of deaf consumers is particularly crucial for those providing mental health services to the deaf population, a traditionally underserved and seriously overrepresented minority in the populations of correctional institutions and mental health inpatient facilities (Freeman, 1989; Misiaszek et al., 1985). Deaf and hard of hearing clients may have less access to basic clinical services than their hearing peers and receive disproportionate amounts of case management and continuing treatment services; and clinicians, prevented by communication barriers from conducting full diagnostic interviews, are apt to misdiagnose deaf clients (Freeman, 1989; Leigh & Pollard, 2003). In keeping with the movement toward development of standards of care for minority populations (e.g., National Latino Behavioral Health Workgroup, 1996), there have been professional efforts to establish standards of mental health care for deaf consumers (Myers, 1995) and collaborations between the Deaf and hearing communities to create integrated community models of mental health care (Tuohy & Cooper, 2007). One recent British study found that hearing mental health service providers’ contact with deaf individuals who are of equal or higher status may be of greater benefit than heightened knowledge in changing their attitudes toward deaf people as a group (Cooper, Rose, & Mason, 2003). Still, few mental health service providers possess knowledge of deafness or appropriate communication skills for working with deaf clients (Heller, 1987; Leigh & Pollard, 2003; McEntee, 1993; Steinberg, 1991). Of those clinicians providing services to deaf consumers, 85–87% did not address deafness during their training, and roughly half Diversity of Consumer Knowledge 19 could not sign (McEntee). Despite this shortage of specialized professionals, referral networks have not been established to ensure that clients are connected with qualified providers (Ebert & Heckerling, 1995; McEntee). The availability of communication technology to provide and support clinical mental health care from a distance has yet to be implemented in a systematic and effective manner, and providers do not have adequate knowledge about its use (Austen & McGrath, 2006a, 2006b). The diversity of the deaf population in socioeconomic status, educational attainment, communication skills and preferences, and racial/ethnic identity argues against a one-size-fits-all solution and renders the need for consumer input all the more urgent. This chapter draws from the findings of a 2-year study in which 54 deaf adults were interviewed about their knowledge, attitudes, and beliefs about mental health and mental health services. Participants were encouraged to tell stories of their own or other deaf individuals’ experiences with mental health care and to relate Deaf community folklore on the subject. Personal experience with mental health services was not a requirement for participation in the study. Most, though not all, of the participants identified with the signing Deaf community. The researchers endeavored to recruit a sample as varied as possible in age, racial/ ethnic background, educational attainment, and socioeconomic status. Because the objective of the study was to obtain qualitative and often highly personal data on a potentially sensitive topic, deaf individuals willing to be interviewed were not eliminated on the basis of demographic characteristics. Therefore, the sample is not a representative cross section of the deaf population. Table 1 summarizes some of the demographic characteristics of the participants. Table 1. Participant Characteristics (54 participants) Characteristic Percentage Gender male female 43% 57% Racial/Ethnic Identity non-Hispanic white Hispanic African-American 81.5% 7.4% 11.1% Age 18–29 30–45 46–60 61 and over 18.5% 24.0% 26.0% 31.5% Highest Education Level Completed grade 11 or below...

Share