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231 Final Conclusions Mental health and deafness is not just a specialization within the field. It is rapidly becoming acknowledged as a complex issue that involves people who are members of minority groups and are at constant risk of social exclusion and having their human rights violated. In the past 30 years, countries such as Holland, England, France, Belgium, Switzerland, Spain, and the United States have developed public mental health services that have been designed to better meet the needs of deaf people. However, these services are not available in most other countries , including Mexico, the home of the Fifth World Congress on Mental Health and Deafness. It is unfortunate that the host country of this international forum does not yet have a specialized, accessible network of public mental health services for its deaf residents. This book presents a compilation of international research by members and friends of the worldwide Deaf community for the benefit of that community. The right to health is a human right recognized and protected by international rules that nations are obligated to uphold, thus respecting and protecting the right to health of their citizens, who include deaf persons and other minority groups. We draw attention to the fact that, globally, these rights may not be recognized for persons with disabilities. Many developed countries have laws that protect the human rights of these people, and public and private institutions work to ensure the implementation of these laws. Nonetheless, in other countries these human rights may exist only on the paper on which they were written. Access to health care in a trustful relationship free of communication barriers and respectful of Deaf culture can be regarded as a basic right of Deaf people and the foundation of the necessary respect for human rights. Much work remains to be done, and the human rights chapter in this book is one effort in the continuing insistence on the need for individual countries to make a social and political commitment to ensure due respect for and observance of the basic human rights of deaf people and others with disabilities. These rights to health for Deaf people must protect them from suffering direct or indirect discrimination as they seek professional health care. But the Deaf ara86542_14_conclusions.indd 231 ara86542_14_conclusions.indd 231 12/10/15 6:56 PM 12/10/15 6:56 PM 232 Final Conclusions community cannot do this alone; it needs the support of the legal framework and the public health policies of their country, which must understand that proper health care for Deaf people with mental disorders is an ethical issue and a human rights question, not a matter of cost-effectiveness. The topic of human rights is relevant to the lack of mental health services for deaf people in Mexico, a country where such services have not existed until recently. The paucity of demographic and epidemiological information about the Deaf population there, its inadequate access to education and other public services, and the dearth of employment opportunities all constitute severe human rights violations. Unfortunately, this reality is still the status quo in most countries. We know that, historically, Deaf people have been marginalized and treated as pariahs, but, like hearing people, they can become mentally ill and in some cases require psychiatric treatment. This means that mental health professionals need to be trained and skilled in various aspects of the deaf person’s experience: communication and language choices and their impact, medical and developmental complexities and influences, and social, cultural, and emotional issues. Familiarity with these factors is vital to the accurate diagnosis and treatment of Deaf persons. Deaf staff are also a critical element in providing services that are culturally accessible and inviting to potential patients. With respect to the pharmaceutical treatment of mental illness within the deaf and hard of hearing population, specific psychopharmacological research on this clientele is severely lacking. For this reason, psychiatrists need to be aware of these patients’ potentially greater sensitivity to medication, including undesired and often serious side effects. A thorough knowledge of the application , effects, side effects, contraindications, and interactions with other medications is utterly essential. Regarding cochlear implants and the mental health of deaf recipients, medical researchers have long desired to develop ways to remedy hearing loss, seeing this as a means of integrating deaf and hard of hearing individuals into the mainstream of society. As Irene Leigh states in her chapter, it is time to end the eitheror paradigm: either cochlear implantee or culturally Deaf.1 Within...


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