Mental health social work with deaf adults: ‘I’ve learnt so much working in this service’

Elaine Tinn is the principal social worker at the national deaf adults service based at South West London and St George’s mental health trust. Here, she tells us a bit about the role.

Tell us about your service…

We’re one of three specialist mental health services in England for deaf adults. Our service covers the southern part of England, then there are also services in Birmingham and Manchester. We’re multidisciplinary. Everyone is British Sign Language (BSL) trained. We have a community service and an inpatient ward with 16 beds.

What does your job entail?

We’re a tertiary service so the purpose is to get engagement from local services and help to improve their understanding of hearing loss and how to support people with it.

One of the issues we find is that mainstream community mental health teams involved with deaf people can sometimes find the communications barriers present problems. Our role is about offering advice and information to help those teams overcome those issues, guiding them on how to work with people and, for example, helping them to access interpreters.

My job is split between working the community and our inpatient services. I spend about two and half days on each. I’m also the safeguarding lead for the service. Each week I’ll be dealing with mental health tribunal reports, working with carers across both the services and dealing with a range of benefits and welfare issues. A lot of it is advisory because, being one person, I can’t get too heavily involved in casework. So I’ll support staff, signpost, as well as doing direct work with service users.

Are there specific issues that differ from other social work roles?

There is a whole new layer of complexity working with this group. You’ve got the complexity of mental health, and then you have the communications challenges, the need to understand deaf culture and specific ways of working with and understanding the history of each deaf person. Often their childhood, their upbringing and their schooling can be quite different to other groups of mental health service users. Their experiences of services can be quite different.

There are not that many teams out there that have the communications skills to work with this group so they are often misunderstood or misrepresented. A lot of mental health professionals and social workers in local authorities don’t feel skilled up to support this group of people so it can be difficult getting access to services. These are the kind of things we try to help people with. We try to get services to recognise the importance of that communication with deaf people and how miscommunication can lead to so many misunderstandings about the presentation of a person.

What do your assessments involve?

It will all get tailored towards the individual. We’ll use a lot of visual cues and a lot of the assessment will be adapted. Because a mental health assessment for someone who is deaf is so specialist, we have access to a good range of interpreters. Getting good interpreters is something that a lot of mainstream services struggle with.

A lot of people we support will speak British Sign Language, but some won’t. Even if someone does there are different regional variations. Then different countries have their own sign languages too so, for example, American signing is quite different.

What does your work on the ward involve?

A lot of that is about working with individuals around placements and issues at home. The majority of service users we work with will be in touch with local services. In those cases my role is about working with the local services, trying to get them to fully understand what that individual’s needs are and working alongside them to get the necessary support in place. That can be all sorts – supported housing, independent living, outreach, residential placements.

It can be difficult given the strain on resources, especially because the services this group of people need are quite specialised. For example, there are only a handful of residential placements that cater for people who are profoundly deaf and have mental health needs as well. The challenges in a way are trying to get the person’s needs met as close to home as possible. You don’t want, if possible, for people to move out of their local area. You want to get the support tailored to people so that they can live at home.

What’s the best bit of the job?

Just working with this client group and finding creative ways to get a person’s needs met. It is such a specialist team here that you do get to learn so much that you might not get in other services. As social workers, our training places a huge emphasis on communication but it’s only when you come to a service like here, that you come to appreciate just how critical communication is to everything that we do.

We’ve had social work and nursing students come on placement.  It think it does really open them up to a whole different set of ideas about the type of work they might consider doing. They come in and they are really challenged by it at first but it’s always interesting that by the end of it a lot of them are independently going off and doing their BSL training.