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Pathways to rights: Deaf-led Belfast Statement on Mental Health and Deafness

Presenter(s)

Brian Symington
Stefania Fadda
Lauri Rush
Ulrike Strauss
Brian Symington
Chair Sense NI, Member of Board of Trustees Sense UK, Member of board of Governors, Jordanstown school for Deaf and Visually Impaired Children, Jordanstown, Northern Ireland
Stefania Fadda
Psychologist and Psychotherapist, Director CABSS/Onlus, President ESMHD, Roma, Italy
Lauri Rush
Psychologist, Director Mental Health Center, Gallaudet University, Washington D.C., (USA)
Ulrike Strauss
Psychologist, Hospital St John of God, Linz, Austria

The Belfast Statement on Mental Health and Deafness ( “Statement” )  is an outcome of the 6th World Congress hosted in Belfast in 2014. The Congress was organised by the ESMHD, in collaboration with the Royal College of Psychiatrists ( NI ) and Queen’s  University Belfast. The theme of the Congress was Pathway to Rights.

The Statement sets out the right to effective communication access in mental health settings for Deaf, late deafened, hard of hearing and Deafblind people of all ages. This right is enshrined in key international declarations such as the UN Convention on the Rights of Persons with Disabilities. The Statement was drawn up in close consultation with Deaf people and it reflects their first hand knowledge of the issues they face in mental health provision. In particular Michael Schwartz, an eminent lawyer from the United States, who is himself Deaf, oversaw the final draft.

The Statement has an impressive list of endorsements, including the World Federation of the Deaf ( WFD ), ESMHD, the British Deaf Association ( BDA ) and Sense / Sense International.

Dr Liisa Kauppinnen, WFD Hon President and the 2013 United Nations Human Rights Awardee, presented the first draft of the Statement at the World Congress.

She encouraged the Statement to be released and distributed to stakeholders concerned about mental health. This included the World Health Organisation ( WHO ), governments, non-governmental organisations, national mental health providers, as well as families of those who are Deaf, late deafened, hard of hearing and Deafblind persons who have mental health issues. In her view, the Statement contains what is the basis of Deaf identity: need for respect of sign language and Deaf culture from the beginning. She said that it is the responsibility of governments to promote access to services in sign languages and they should be reminded of their duties regularly.

The Belfast Statement sets out rights that are enshrined in key declarations and it is recommended to anyone involved in policy making and mental health provision. It was Liisa Kauppinnen who said, “I want to live in a world where mental health services and information are provided in sign language so as to make them accessible to the Deaf community.”

Looking ahead after childhood mental health problems

Presenter(s)

Nynke Dethmers
Sandra Hommers-Verhallen
Sogand Asfar
Youssra Lkhorf
Peter Brokking
Anne Geerts
foto: Jessica Ernest
Jessica Ernest
Harm Verhagen
Nynke Dethmers
Mental Health Psychologist, Royal Kentalis, Utrecht, The Netherlands
Sandra Hommers-Verhallen
Mental Health Psychologist, Director Compas College, Royal Kentalis, Utrecht, The Netherlands
Sogand Asfar
Experience expert, The Netherlands
Youssra Lkhorf
Experience expert, The Netherlands
Peter Brokking
Experience expert, The Netherlands
Anne Geerts
Experience expert, The Netherlands
Jessica Ernest
Experience expert, The Netherlands
Harm Verhagen
Experience expert, The Netherlands

Nynke Dethmers is one of the founders of Psywel (Psychological Well-being), a program monitoring psychological well-being and problems in DHH students by 2 yearly screening and offering specialist counseling and treatment. She is affiliated with Kentalis, where she works as PhD researcher on the current state of mental health problems in DHH children and adolescents, as school-psychologist at Signis, school for DHH students in Amsterdam and as staff member of Deelkracht, developing information products for parents, professionals and DHH youth with mental health needs.

Sandra is a director and psychologist. As one of the founders of Psywel (psychological well-being), she provides information about the early intervention program and threatment for psychological problems in DHH children and adolescents. Sandra works as a principal at Kentalis Compas College, a secondary special education for DHH youth. This school provides education with its own location and in collaboration with 2 regular secondary schools

We will take you through the stories of 5 young adults, their experiences with mental distress and the help they received in the process. We will interact and give you, the audience, insight into experiences, tips and opportunities to reshape mental health care. We begin by giving a brief insight into where to find more information about mental health issues for DHH youth in the Netherlands (products and website). The collaboration between the moderators and DHH youth in creating the Psywel JONG website was the inspiration for the presentation during Joining Forces 2024. During this presentation, the young adults tell in brief what they tell their peers more extensively on the website.

Assessing and Understanding Mental Health and Quality of Life in Deaf and Hard-of-Hearing Children and Adolescents

Presenter(s)

Chris Margaret Aanondsen
Chris Margaret Aanondsen
Clinical Psychologist, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

Dr Chris Margaret Aanondsen completed her graduate degree in clinical psychology at the University of Constance in Germany. She is a qualified clinical psychologist who currently works with Deaf and hard-of-hearing children and adolescents at the regional Deaf CAMHS at St. Olavs Hospital, Trondheim University Hospital in Norway. Previous work experience includes working with DHH children and adolescents at Statped, the National Service for Special Needs Education and working with typically hearing children in CAMHS. She completed her PhD «Assessing and Understanding Mental Health and Quality of Life in Deaf and Hard-of-Hearing Children and Adolescents» at the Faculty of Medicine and Health Sciences at the Norwegian University of Science and Technology in Trondheim in 2022. Deaf and hard-of-hearing children’s mental health, Quality of Life and communication are topics she is especially passionate about both as a clinician and a researcher.  

Mental health problems are more prevalent in deaf and hard-of-hearing – DHH – children. Using written measures to assess mental health problems in DHH children and adolescents has been found to underestimate symptoms. Controversies still exist regarding the Quality of Life (QoL) in DHH children compared to typically hearing (TH) children.

To improve assessment and interventions for DHH children, this study’s aim was to translate reliable and valid questionnaires for mental health and QoL into Norwegian Sign Language (NSL) and validate these. The second aim of the study was to gain a better understanding of signing DHH and hard-of-hearing (HH) children’s mental health, QoL and communication as well as associations between these aspects. The Strengths and Difficulties Questionnaire (SDQ) and the Inventory of Life Quality in Children and Adolescents (ILC) were translated into NSL. 60 DHH and 47 HH children, and their parents completed the self- and parent-reports of the SDQ and ILC.

The psychometric properties of the written Norwegian and NSL versions are presented for the SDQ and ILC. The mental health problems and QoL of DHH children are addressed based on both self- and parent-report. Associations between communicative competence, mental health and QoL are discussed.

DHH youths as victims, perpetrators, and bystanders of digital sexual violence

Presenter(s)

Laura Avemarie
Katharina Urbann
Laura Avemarie
Professor für Sonderpedagogik, Department Pädagogik und Rehabilitation, Ludwig-Maximilians-Universität München, Germany
Katharina Urbann
Research Associate, Department of Rehabilitation Sciences, Humboldt-Universität, Berlin, Germany

Laura Avemarie (Ludwig-Maximilians-Universität München, Professorship of Special Education – Education of Deaf and Hard of Hearing People, including Inclusive Education) and Katharina Urbann (PhD, research associate of the Department of Sign Language and Audio Pedagogy, Humboldt-Universität zu Berlin) initiated the project „Digital protection of sexual violence against DHH children and youths” in 2021, which is financed by the German Federal Ministry of Education and Research for four years

Laura Avemarie1 , Dennis Oberleiter1 , Eva Hartmann1 , Malte Schott1 & Katharina Urbann2

1 Ludwig-Maximilians-Universität München (Germany)

2 Humboldt-Universität zu Berlin (Germany)

Background: 40 % of hearing youths have already experienced digital sexual violence. It can be assumed that DHH youths are particularly vulnerable to this specific form of violence. Empirical data on digital sexual violence against DHH youths is nonexistent. Methods: Data on lifetime prevalence of digital sexual violence experiences, perpetration, and bystander behavior of DHH youths were collected for the first time. In a mixed-methods study design, a guided questionnaire survey (N = 276) and qualitative interviews (n = 34) were conducted with students from schools for the DHH in Germany. Participants were between 11 and 21 years of age (M = 14.97; SD = 1.92). Results: 77 % of the participants experienced at least one type of digital sexual violence. DHH victims reported that they were perpetrated by peers more frequently than by adults. 20 % of the participants were bystanders, i. e. they witnessed peer perpetration. Discussion: Based on these results, there is an urgent need for preventing DHH youths from suffering and perpetrating digital sexual violence.

Stress and resilience in adolescents with hearing loss (deafness or hard of hearing) or with developmental language disorders (DHH/DLD)

Presenter(s)

Len Martijn
Len Martijn
General Remedial Educationalist, VierTaal College Amsterdam & Radboud University, Nijmegen, The Netherlands

Since 1997 I have been working at schools for children/adolescents with hearing loss (deafness or hard of hearing) or with developmental language disorders (DHH/DLD). Once starting as a speech therapist, I nowadays work as an autism specialist and remedial educationalist generalist at a special education secondary school. At the same time, I conduct research in stress and resilience in adolescents with DHH/DLD as an external PhD candidate at the Radboud University.

I will present data from my research on stress and resilience in adolescents with hearing loss (deafness or hard of hearing) or with developmental language disorders (DHH/DLD).

Adolescents with DHH/DLD appear to be vulnerable to multiple stressors in daily life. They are vulnerable to having stressful communication experiences (SCEs) and to stress stemming from adverse childhood experiences (ACEs). Accumulated stress can cause a toxic stress impact on the brain with detrimental effects on its development and negative effects on one’s well-being. Resilience is a protective factor against one’s stress impact. Although resilience appears a ubiquitous concept, resilience is still a black box when it comes to its development and the (role of) contributing determinants. I’ll discuss the relationship between stressors (SCEs, ACEs) and their stress impact, and will explore resilience and its role in this relationship.

Psywel: a screening and treatment program for psychological problems in the Netherlands

Presenter(s)

Nynke Dethmers
Daan Hermans
Sandra Hommers-Verhallen
Nynke Dethmers
Mental Health Psychologist, Royal Kentalis, Utrecht, The Netherlands
Daan Hermans
Psychologist, Senior Researcher, Royal Kentalis, Utrecht & Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
Sandra Hommers-Verhallen
Mental Health Psychologist, Director Compas College, Royal Kentalis, Utrecht, The Netherlands

Nynke Dethmers is one of the founders of Psywel (Psychological Well-being), a program monitoring psychological well-being and problems in DHH students by 2 yearly screening and offering specialist counseling and treatment. She is affiliated with Kentalis, where she works as PhD researcher on the current state of mental health problems in DHH children and adolescents, as school-psychologist at Signis, school for DHH students in Amsterdam and as staff member of Deelkracht, developing information products for parents, professionals and DHH youth with mental health needs.

Daan Hermans is a cognitive psychologist, and is working as a senior researcher at Kentalis and the Behavioural Science Institute (Radboud University Nijmegen). His current research focuses on deaf and hard-of-hearing children’s cognitive development and psychosocial functioning.

‘Sandra is a director and psychologist. As one of the founders of Psywel (psychological well-being), she provides information about the early intervention program and threatment for psychological problems in DHH children and adolescents. Sandra works as a principal at Kentalis Compas College, a secondary special education for DHH youth. This school provides education with its own location and in collaboration with 2 regular secondary schools.’

The prevalence of psychological problems in deaf and hard-of-hearing (DHH) children and adolescents is higher than in their hearing peers. That is one of the reasons why Kentalis developed and implemented a screening and treatment program (called Psywel) that aims to detect and treat psychological problems at an early stage. In this presentation we will briefly explain how this screening and treatment program works. In the last four years, we have also conducted several research and development projects on Psywel in Deelkracht (www.deelkracht.nl). We will describe these initiatives and go into detail on one of the projects conducted in the last three years: a research study on the prevalence of psychological problems in special schools for DHH children and adolescents in the Netherlands.

School Based Mental Health Care: support and treatment for students at a Kentalis School in The Netherlands

Presenter(s)

Hendrik de Jong
Caroline van den Berg
Hendrik de Jong
Behavioral Therapist, GGMD, Utrecht, The Netherlands
Caroline van den Berg
Mental Health Psychologist and Psychotherapist, GGMD, Utrecht, The Netherlands

In this workshop we mainly let the students of the treatment group (age range: 8-12) and their parents speak through video material. This is about how they experience this treatment group at a special school for deaf and hard of hearing students.

This treatment group has been developed for deaf and hard of hearing students with psychiatric problems. Because of these problems, they demand a lot of extra time and attention from their teacher. This does not leave enough time for the regular curriculum.  The behavioral problems can also have an impact on the safety of the student and that of the other students in the classroom.  Finally, their school performance may suffer so significantly from these problems that the students in question are at risk of dropping out. The treatment spans across four half-days a week. The students attend lessons in their own classroom during the other half of the day. It is an intensive form of treatment,  which has led to a great improvements in their behavior and school performance. 

The treatment is given by a deaf behavioral therapist from GGMD and a hearing schoolteacher. The school based treatment is supported by the team of professionals working at GGMD, ambulatory Mental Health Care Service  for Deaf people. This team includes deaf, hard of hearing and hearing professionals. They can be involved with treating or supporting the parents or the whole system of the students. There is extensive cooperation with the school in order to be able to generalize the learned behavior changes of the students to daily functioning in their own classroom.

Psychotherapy in Sign Language

Presenter(s)

Lieke Doornkate
Jeantine Janse
Lieke Doornkate
Mental Health Psychologist and Psychotherapist, Doof & Co, Amsterdam, The Netherlands
Jeantine Janse
CBT and EMDR therapist, Doof & Co, Amsterdam, The Netherlands

Lieke Doornkate, psychotherapist, specialized in EMDR, CBT and SFT. Fluent in dutch sign language. 30 years of experience in the field of mental health for deaf clients.

Jeantine Janse, CBT and EMDR therapist, specialized in EMDR, CBT and SFT. Native dutch sign language user. 30 years of experience in the field of mental health for deaf clients.

Doof & Co is an outpatient clinic for deaf and hard of hearing adults . In our treatments, empowerment of our clients is a central theme. Our mission is to treat clients in their own preferred communication; this can be fluent sign language, Dutch supported with signs or spoken Dutch. This will diminish language barriers and can make state of the art psychotherapeutic techniques accessible.

In this lecture we will elaborate on the specific techniques, for example EMDR, Schema Focused Therapy, Cognitive Behavioral Therapy and Family Therapy, and how we can make these deaf-friendly and adjustable to our clients.

In reviewing these techniques, we consider new developments in the deaf community such as cochlear implants and modern technology and the ramification for identity issues, communication possibilities and psychopathology.

Integrated treatment for deaf and hard of hearing clients: focusing on social skills and emotion regulation

Presenter(s)

Dineke Kramp
Michelle Bonsink
Dineke Kramp
Social Psychiatric Nurse, GGMD, Utrecht, The Netherlands
Michelle Bonsink
Psychomotor therapist, GGMD, Utrecht, The Netherlands

My name is Dineke Kramp. I am deaf with cochleair implants. I have been working for 30 years with the deaf and hard of hearing community.

In addition to that I am a mental health trainer specializing in Goldstein and emotion regulation training. My education has been tailored and adapted based on my extensive years of experience,

Michelle Bonsink: Since the beginning of 2020 I have been working at GGMD as a psychomotor therapist. With great interest and pleasure, I work with deaf and hard of hearing clients. Every day I learn new gestures and try to adapt as much as possible to my clients. I would like to continue to support them now and in the future, to get the best out of their lives.

Growing up in a hearing environment, deaf and hard of hearing people may be found at an increased risk of experiencing persistent communication problems, social misunderstandings and other social adverse circumstances. Such adversities can be regarded as environmental stressors interfering with mental health. Restricted access to essential social information may lead to limited possibilities to develop social skills, which consequently may interfere with the development of emotion regulation, and developing and maintaining social relations. Therefore, training social skills and emotion regulation can be an important focus in our treatment.  

General mental healthcare focuses on the treatment of mental health disorders for hearing people. However, adjustment is essential to make it fit for deaf and hard of hearing people. By using existing training modules (Goldstein and ART), we have created a social skills and emotion-regulation training for deaf and hard of hearing people which will be introduced to you in this presentation.

The senses and the mind. Linguistic, educational, and psychological studies on the myths of people who are deaf or deafblind.

Presenter(s)

Jesper Danmeyer
Jesper Danmeyer
Professor Department of Psychology, Kopenhagen, Denmark

The minds of people who are deaf or deafblind have been discussed since ancient times. How is a person who is deaf able to learn a language and how does a person who is deafblind think? From research over the past few decades, we have been able to come closer to an answer to some of these questions. Scientific studies have contributed to a better understanding of the links between sensory loss and language acquisition, risks of mental disorders, and identity formation.

Basic and applied research on the history and future of deaf and deafblind education, visual and tactile language development, and mental health promotion will be discussed.

National Mental Services for deaf children in the UK:  applying lessons learned over the past decade to plan for the future

Presenter(s)

Victoria Fernandez
Constanza Moreno
Victoria Fernandez
Consultant Child and Adolescent Psychiatrist and Clinical Lead National Deaf CAMHS, South West London & St George’s Mental Health NHS Trust, London, United Kingdom
Constanza Moreno
Clinical Psychologist and Professional Lead, South West London & St George’s Mental Health NHS Trust, London, United Kingdom.

Early social communication skills critically moderate mental health trajectories in deaf children

Presenter(s)

Daniel Holzinger
Magdalena Dall
Sabine Windisch
Daniel Holzinger
Clinical Linguist, Director Centre for Communication and Language, Hospital of St. John of God, Linz, Austria
Magdalena Dall
PhD Candidate Public Health, Hospital of St. John of God, Linz, Austria
Sabine Windisch
Communication Teacher, Hospital of St. John of God. Linz, Austria

Daniel Holzinger is a clinical linguist and director of the Centre for Communication and Language at the Hospital of St. John of God offering diagnostic services and intervention for children and adults with deafness, speech-language disorders and autism spectrum disorders. He is deputy director of the Research Institute for Developmental Medicine at the Johannes Kepler University in Linz where he is involved in research about language and communication assessment and intervention including associations with mental health.

Madalena Dall graduated in public health and is currently involved in her PhD program investigating the impact of social communication on human development. She is research coordinator of the AChild study seeking to understand predictors of the development of deaf children and research administrator of the Research Institute for Developmental Medicine at the Johannes Kepler University in Linz.

Sabine Windisch (D) is a communication teacher and director of a multidisciplinary intervention team based at the School for the Deaf in Salzburg. In addition to her roles as parent-peer and Deaf Mentor she supports families (with typical hearing or deafness) in their development and everyday use of facilitative communication strategies that promote child social communication (SC) from very early on.

After introducing the definition, complexity and measurements of social communication (SC) we present data on links between SC skills and mental health outcomes based on total population studies. Subsequently, data from international research and particularly from the Austrian AChild study demonstrating SC diffiiculties and correlations with different aspects of mental health in deaf and hard-of-hearing children and in their families will be shown. Finally, we report feasible ways to measure and monitor the early development of SC and practical ways to specifically support and enhance SC skills independent of communciation modalities. Illustrations of interventions will include the support of parents in early parent-child interaction by use of the visual modality by a Deaf teacher. Overall, the presentation substantiates the mental health impact of early SC and its malleability via family centered early intervention.  

Organising Children and Young People’s Deaf Mental Health Services for the future

Presenter(s)

Tim Richardson
Jayne Langdale
Tim Richardson
Provider Collaborative Lead
LYPFT
Jayne Langdale
Occupational Therapist

Tim managed the National Deaf Child and Adolescent Mental Health Service from 2010 to 2021.  Tim was involved in the development of the Deaf Service both regionally and nationally.  Tim sits on the Board of ESMHD and until recently was co-editor of the IJMHD.

Jayne has worked at National Deaf Child and Adolescent Mental Health Service since for over 13 years.  Jayne started as a Deaf Family Support Worker before taking up the post of Specialist Deaf Outreach Worker.  She is now a qualified Occupational Therapist working with deaf children and families in the North West of England.

Tim and Jayne will talk about the design, development and delivery of the National Deaf Child and Adolescent Service in the North of England.

The service works with deaf children and young people (0-18 years old) and children of deaf parents/carers who are experiencing mental health difficulties. 

The service starts from the principle that for a deaf mental health service to be effective, it must be properly represented – i.e., the service must have experts in both mental health and deaf lived experience.  Once we recognise the needs of deaf children and families, we need to create teams with the right people to provide the service required and we need to structure the service so that team members can be confident and supported in their roles.

Between 2010 and 2012, Deaf CAMHS (North) underwent a transformation process which created meaningful career pathways for deaf staff, employed interpreters as integral team members and introduced innovative ways of working.  It is currently rated as an Outstanding Service.

Trauma-sensitive approach in Kids Hasselt

Presenter(s)

Katrien Timmerman
Femke van Hoef
Katrien Timmerman
Orthopedagogue, KIDS vzw, Hasselt, Belgium
Femke van Hoef
Logopedist, Coördinator Deaf and Hard of Hearing Children, KIDS vzw, Hasselt, Belgium

At KIDS Hasselt we felt the need to take another perspective looking at what we previously called “problem behavior” of children and adolescents and to deal with it in a different way. From literature and research we know that deaf and hard of hearing children and adolescents are more likely to experience traumatic experiences. By putting on what we called the “trauma glasses,” we started to look differently and therefore also act differently. The trauma-sensitive approach has become a basic attitude at KIDS. 

In this presentation we will explain to you how we let theory enter the daily practice of education and care to create a safe and supportive environment for our deaf and hard of hearing children and youngsters. The goal here is that all professionals in the organization (teachers, speech therapists, physiotherapists, educators, pedagogues, …. ) share a common language and use the same tools when guiding children, adolescents and their contexts.

The CABSS Model: Crossing International Boundaries

Presenter(s)

Stefania Fadda
Stefania Fadda
Psychologist and Psychotherapist Centro Assistenza per Bambini Sordi e Sordociechi Onlus/Assistance Center for Deaf and Deafblind Children (CABSS), Roma, Italy

She is the President of the European Society for Mental Health and Deafness (ESMHD) and the Director of the Assistance Center for Deaf and Deafblind Children (CABSS) that offers individualized multisensory early intervention programs to deaf and deafblind children and their families. She is a member of the scientific committee at the Italian Society of Behavioural and Cognitive Therapy (SITCC). Dr. Fadda graduated in children and adolescent psychology and completed her specialization in Mental Health and Deafness, Early intervention for Deafblind Children, Cognitive Psychotherapy, Sensorimotor Psychotherapy and TIST (Trauma Informed Stabilization Treatment). She is one of the main consultants for the US-Italy Fulbright Commission for the Cultural Exchange Italy and the United States She has published books and articles in the area of “Psychology and Deafness” and “Mental Health and Deafness”. She has been the recipient of numerous awards for her commitment to deaf and deafblind children in Italy.

Stefania Fadda*, Giusy Caravello*, Marta Cidronelli*, Laura Harripersad*

*Assistance Center for Deaf and Deafblind Children (CABSS)

The presentation will describe the CABSS Model of Early Multisensory Intervention for children who are Deafblind and their families in Italy and abroad. The specialists at CABSS have developed an early intervention model, the only one of its kind, for children who are deafblind based on their experience with children for the past 12 years in Rome, Italy. CABSS is the first Italian center to provide early multisensory intervention and mental health programs. The CABSS model will be discussed in detail and will show the results that have been achieved in children, families, and educators over the years. At CABSS, our goal is to support children at the earliest age possible and their parents by giving them the tools, information and strategies needed to ensure that their children get off to a great start in life. Early intervention services for deafblind children are critical as well as having an environment and trained professionals in deafblindness to intervene at the earliest age possible to minimize the impact of the combined loss of both hearing and vision. In conclusion, a focus on how CABSS supports children outside of Italy and the need of creating international connections that can provide continued specialized services to children when they return in their home country.

Mind the gap, join forces! Let’s improve the health of deaf and hard of hearing people in the Netherlands

Presenter(s)

Annika Smeijers
Annika Smeijers
Pediatrician and Linguist specialised in Sign Linguistics, Amsterdam UMC, Amsterdam, The Netherlands

Anika Smeijers is a paediatrician specialised in social paediatrics and a sign language linguist. In 2019 she presented here dissertation ‘Availability and accessibility of healthcare for deaf and hard of hearing patients’. Anika has longstanding experience in (mental) healthcare for deaf and hard of hearing people and works as a consultant for DHH people at Centre for Consultation and Expertise (CCE). The CCE is is a supplementary service to standard healthcare services; should patients or their caregivers be no longer able to find solutions, they can apply to CCE for customized advice and support. As a member of Dovenschap (independent interest group for Deaf people in the Netherlands), Anika will lead this interactive session on how to improve the health of DHH in the Netherlands.

Deaf and hard of hearing people (DHH) experience poorer health due to reduced access to healthcare and health information. The Corona pandemic and the acknowledgement of Dutch sign language as an official language of the Netherlands made DHH healthcare issues more visible. Now it’s time to actually close the gap. During this workshop the Dutch participants will debate on how to do this.

Pedagogy in the context of flight, trauma and deafness/hearing loss. Subjective perspectives of educational professionals and future needs

Presenter(s)

Claudia Becker
Claudia Becker
Professor Department of Rehabilitation Sciences, Humboldt-Universität zu Berlin, Berlin, Germany

Claudia Becker is professor and the head of the Department of Sign Language Pedagogy and Audio Pedagogy at Humboldt-Universität zu Berlin, Germany. Her research focuses on education in the context of deafness/hearing loss including inclusive education, sign language acquisition, multilingual education with sign languages, spoken and written languages and social-emotional development in deaf and hard of hearing children and young people. Together with Prof. David Zimmermann, she founded the Competence Centre “Flight, Trauma and Disability in the Context of School” (FluKoS, www.kora-berlin.de/forschung-evaluation/projekte/flukos), which supports professionals in their school work with children and young people with refugee experiences. The focus is on pupils with suspected or diagnosed special educational needs. In addition, in cooperation with other European partners, she has developed the training programme “The Mind Readers” to promote Theory of Mind in deaf/hard of hearing children (https://protom-education.com).

High life stress in the context of flight cannot be clearly distinguished from developmental risks in the context of deafness/hearing loss (DHH). Possible developmental impairments are shown to be subject-logical and complexly interwoven with personal and social experiences. This gives rise to specific needs, of which the school is of particular importance, as it does not have to deal with past traumatic experiences but is always a part of a traumatic process – in a beneficial or chronic way. This results in a considerable need for professionalisation and institutional development.

The FLuKoS project aims to professionalise teachers through training/supervision and the compilation of information. The research (group interviews with 44 professionals including 8 deaf/hearing teachers for DHH pupils) aimed among other things to find out what experiences educational professionals have in their work as result of the traumatic experiences of pupils with disabilities and how this affects their professional self-experience.

Central findings are that social relations of inequality, lack of resources in and outside school, and professional beliefs are intertwined in complex ways. Past and present stresses of the pupils and the desire to manage them as well as possible at all levels – emotional, social, cognitive/academic – are often associated with high levels of emotional concern, stress and uncertainty on the part of the educational professionals themselves. At the same time, the new challenges also contribute to the development of their own practices and to school development.

Needs for the future:

  1. Binding support system for DHH pupils with refugee experience that is not limited in time and that refers to complex individual development trajectories.
  2. Binding system of cooperation with different actors and joint design of transitions.
  3. Supporting educational professionals to initiate reflection processes on their own practice, their integration in social, institutional and subjective processes as well as the impacts on DHH children with refugee experience and their families.
  4. Supporting colleagues to develop a culture of (appreciative) mutual criticism. Training and supervision must be an ongoing part of this process.

Deaf People with cognitive challenges and their mental health – now and in future

Presenter(s)

Johannes Fellinger
Johannes Fellinger
Neurologist-Psychiatrist, Head of the institute for Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria

Johannes Fellinger, M.D, P.D., is Head of the Institute of Neurology of Language and Senses at the Hospital of St. John of God in Linz and Head of the Research Institute for Developmental Medicine, Johannes Kepler University Linz, Austria.

After finishing his medical degree, he specialised in Neurology, Psychiatry and Neuropaediatrics. During his residency, he noticed a lack of medical services available for Deaf people and started an outpatient clinic for the Deaf.

This developed into the Institute of Neurology of Language and Senses including a neurological and linguistic clinic, a paedo-audiological centre with an early intervention program for deaf and hard of hearing children, a centre for autism spectrum disorder, an outpatient clinic for inclusive medicine and Lebenswelt – therapeutic living communities for Deaf people with multiple disabilities.

Additionally to his clinical work, Johannes Fellinger is involved in research, particularly in the field of developmental medicine, with a focus on Deafness. He teaches at the Johannes Kepler University, Linz as well as at the Medical University Vienna.

The presentation gives an overview about prevalence, aetiologies and specific developmental and living conditions of individuals who a prelingually deaf or hard of hearing and have mostly intellectual disabilities.

The term “Deaf+” is introduced, with respect to the presence of other disabilities, but also to highlight the positive potential.

Research data shows that this vulnerable population is large. 40% of children born deaf or hard of hearing have additional medical or developmental difficulties.

Today’s adult Deaf+ population has experienced severe communicative deprivation beginning in their early lives and show very heterogeneous developmental profiles.

Study data illustrate discrepancies between cognitive functioning and adaptive skills, especially in the social and communicative domain.

Furthermore, the issue of challenging behaviour is addressed by research data, which show that maladaptive behaviours were occurring two to three times more frequently in the Deaf+ population compared to data from general populations.

In Austria three therapeutic community programs were established because of the need to create a living environment for Deaf+ individuals with fully accessible sign language. The program will be introduced.

The right to life in a communicative accessible social environment as mentioned in the UN CRPD has to be realised for Deaf+ adults, which is also endorsed by a Position Paper of the World Federation of the Deaf (WFD).

A Norwegian Developmental Narrative: From Traditional Institutional Psychiatry to Modern Mental Health Care

Presenter(s)

Hege Saltnes
Hege Saltnes
Psychiatrist, Head Norwegian National Unit for Sensory Loss and Mental Health, Oslo University Hospital, Oslo, Norway

Hege Saltnes is a chief physician and specialist in psychiatry, and she holds a master’s degree in health management. She is head of  the Norwegian National Unit for Sensory Loss and Mental Health. In addition to her professional expertise, she also has personal experience because she is married to a deafened man. This combination gives her a unique background to understand how sensory loss affects functioning in all areas of life and how it can also impact the development of mental illness.


Over the course of 45 years, Norwegian National Unit for Sensory Loss and Mental Health has transformed from a small center for deaf individuals with psychiatric disorders in the capital, Oslo, into a robust national service. This service now caters to individuals with various types of sensory loss, engages in extensive competence building, and offers education in mental health care both within the field and in society at large.

Fifteen years ago, the service had 11 employees, and it has now expanded to a workforce of 36 full-time specialized health care professionals. The most recent expansion included the provision of services for the visually impaired, as it became evident that visually impaired individuals encounter many of the same barriers as those with hearing impairments when accessing healthcare services.

Norway, with its vast geographical expanse and varying population density, necessitates collaboration with smaller units spread across the country. The overarching goal is to ensure that individuals with sensory loss have access to mental health care services that are as effective as those available to the general population.

Even in a wealthy country like Norway in 2023, there remains a shortage of expertise regarding the specific challenges and burdens faced by individuals with hearing and visual impairments, whether in the healthcare system, the workplace, or daily life.

This presentation will focus on the efforts to secure and advance equitable mental health care for individuals with sensory loss, addressing the obstacles faced, lessons learned, and how to challenge the hurdles on the track in the future.

Some key points from the presentation include:

1. Understanding the need for a specialized service.
2. Recognizing the importance of ongoing sign language education.
3. The organizational positioning of a specialized service and the continuous struggle for its existence.

4. The importance of cooperation with user organizations
5. Financial considerations and constraints.
6. Maintaining connections with the broader professional community and staying updated.
7. Creating a communication environment for employees with hearing and visual impairments, including the integration of interpreters.
8. Disseminating knowledge about the existence of the service in a world of competing messages.

Hege has extensive experience in collaboration with user organizations. The combination of professional expertise, research that documents needs, and political influence through the channels of user organizations has proven to be invaluable in the development of the service in recent years.

History of Deaf Mental Health: Deaf Professionals

Presenter(s)

Herbert Klein
Lenka Novakova
Lenka Novak
Herbert Klein
President British Society for Mental Health and Deafness (BSMHD) and Independent Mental Health Advisor, London, United Kingdom
Lenka Novak
Deaf Advisor, South West London and St George’s Mental Health Trust, London, United Kingdom.

Deaf Professionals have a vital role in shaping mental health services for Deaf people and ensuring that services are culturally and linguistically affirmative.

Most studies focus on accessibility for Deaf people in healthcare settings but not so much is written about employment of Deaf professionals and their influential roles on continuing health care provision for deaf population.

30 years ago, it would be unimaginable to employ a Deaf person in health care, but data based on evidence showed that there is positive impact on deaf service users interacting with Deaf professionals.

Implicit in all of this is empowerment and leadership by asserting responsibility for their own proactive participation according to their lived experiences, qualifications, and linguistic and cultural preferences. Deaf professionals highlighted key areas such as importance of co-production with deaf service users in quality improvement and innovation projects that are directly shaping our services to provide not only accessibility and inclusion but also to continuously push boundaries to modernise deaf mental health care and beyond for deaf people with mental health issues and creating educational and employment opportunities for those following their steps. This presentation will focus on history of employment within National Health Service (NHS) in mental health settings in England, evidence-based examples of good practice; service users’ values related interaction with Deaf professionals, health management and decision-making based on preferred language and cultural competency.  

Challenges in locating, assessing, and reporting evidence on health inequalities in Deaf signing populations. 

Presenter(s)

Katherine Rogers
Katherine Rogers
National Institute for Health Research (NIHR) Post-Doctoral Fellow and Senior Lecturer, co-lead Social Research with Deaf people (SORD) group, University of Manchester, Manchester, United Kingdom.

Workshop Organisation Deaf Mental Health Services Part 1

Presenter(s)

Tim Richardson
Jayne Langdale
Tim Richardson
manager, Provider Collaborative Lead Deaf CAMHS Leeds and York Partnership Foundation Trust (LYPFT) Leeds/York, United Kingdom
Jayne Langdale
Occupational Therapist, Deaf CAHMS, Manchester, United Kingdom

Organising Children and Young People’s Deaf Mental Health Services for the Future

Workshop Organisation Deaf Mental Health Services Part II

Presenter(s)

Sophie Roberts
Abigail Gorman
Sophie Roberts
Consultant Child and Adolescent Psychiatrist LYPFT, Clinical Lead Deaf Mental Health Services (NHS England), Leeds/York, United Kingdom
Abigail Gorman
Policy and Public Affair Manager SignHealth, London, United Kingdom

Shaping the Future of Deaf Mental Health Services in England

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