Referrers' use and views of specialist mental health services for deaf children and young people in England

Abstract

Background: Deaf children are at greater risk of mental health problems than hearing children. Generic child and adolescent mental health services cannot be expected to have the expertise to work with these children. Three teams in England currently provide specialist mental health services to deaf children.

Aims: The research sought to explore referrers' views of these specialist services.

Methods: Interviews and a postal survey were used.

Results: Referrers were very satisfied with the service and identified the features of the service which supported positive outcomes for users. Access was, however, a significant problem. Referrers suggested developments to the service should incorporate preventive work and cascading of skills to other professional groups.

Conclusions: Deaf children require services which are expert in deafness and mental health, and the findings suggest the specialist services are achieving this. Resolving issues of access and widening its remit are desirable ways forward in any future development of the service.

Keywords:

• Child psychiatry
• deaf children
• specialist services
• qualitative research
• referrer views
• survey

Acknowledgement

This work forms part of a research project ‘An evaluation of a national specialist mental health service for deaf children’ funded by the Department of Health. The views presented here are those of the authors and not necessarily those of the Department of Health.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Notes

1. A hearing loss of 41dB or greater is likely to limit access to conversational speech (Roberts & Hindley, 1999). Moderate hearing loss: 41–70dB loss; severe: 71–95dB; profound: 96 + dB.

2. BSL is the sign language used in the UK, using movements of the hands, body, face and head. BSL is a complete language in its own right, having a structure and grammar totally different from English. As with a verbal language, children develop BSL skills over the course of time. Some children will be fluent whilst others will use BSL in a more limited way.

3. SSE is a form of English that additionally uses signs to convey meaning.

4. Most people who use BSL see themselves as belonging to a distinct linguistic cultural group and are part of the Deaf community.

5. There is a higher proportion BSL users amongst those using the London service compared to the other two services because, until quite recently, this service only accepted referrals of children who used BSL.

6. Referred to as “specialist schools” for the remainder of this article.

7. NPSA: funding is agreed upon on a case by case basis by the Primary Care Trust.

8. Service Level Agreements: agreements between a provider and a commissioner which determine the range and level of service to be provided and the fee.

9. Clinical networks are “linked groups of health professionals and organisations from primary, secondary and tertiary care, working in a co-ordinated manner, unconstrained by existing professional and health board boundaries, to ensure equitable provision of high quality clinically effective services” (Lugon, 2003, p. 1).