Coping with mental illness: using case study research to explore Deaf depression narratives

Abstract

Optimal health is best achieved through direct access to effective holistic and relevant health prevention strategies, timely and accurate diagnosis, appropriate treatment, and follow-up (K. Woodcock & Pole, 2007). Effective two-way communication is an essential component in all of these stages. It increases the opportunity for a thorough assessment, and thereby contributes to an intervention plan that is appropriate, timely, and suitable to that particular consumer. This study explored how a group of Deaf adults, for whom ASL is their primary language, and all of whom have been diagnosed with depression, managed their symptoms of depression in a health care system that privileges hearing and speaking as the primary mode of communication. A case study methodology with individual, in-depth interviews, and the completion of a hand-drawn person and environment map were used. The participants shared the nature and depth of the barriers that exist and that intersect to prevent their equal access to quality mental health assessment, intervention, and follow-up otherwise available to their hearing counterparts. Faced with these intersecting barriers, negative attitudes from some in the dominant society, and the fear of discrimination from their own collectivist community, participants saw few formal options for managing their symptoms of depression. In most cases participants turned to a strategies of an intrapersonal nature. Some engaged in positive activities such as reading self-help books, volunteering within the Deaf community, walking, and, for two, accessing traditional counseling services. More frequently, however, participants were forced to engage in maladaptive activities such as isolating themselves in an attempt to avoid detection of their symptoms. Some distracted from their feelings of isolation and discrimination through exercise, though others used alcohol or over-eating as their strategy. A number of changes or enhancements were recommended by the participants, including creation of a comprehensive Deaf Awareness Training plan for professionals and the associated staff, an increase in the number and availability of ASL/English interpreters, and the creation of Deaf sensitive health promotional and prevention materials in modes easily accessible to Deaf visual language users. The study concludes by exploring implications for policy, practice, and future research.