Misinterpretation of Psychiatric Illness in Deaf Patients:Two Case Reports

The Deaf/hard of hearing population is growing rapidly and the medical community is facing a higher demand for this specialneeds group. The Deaf culture is unique in that spoken word is via sign language. What one person may see as mania or psychosisis actually a norm with Deaf individuals. The fear of the unknown language often creates immediate conclusions that are false. Assuch, being culturally sensitive becomes a large component of properly assessing a Deaf patient in any psychiatric situation. In thefirst case, the patient is a 26-year-old prelingually Deaf male, who was placed under an involuntary hold by the emergency roomphysician for acting erratic and appearing to respond to internal stimuli. The patient was later interviewed with an interpreterand stated he became upset because the staff was not providing him proper care as they lacked an ability to communicate withhim. The patient’s family was called who corroborated the story and requested he be discharged. Case two presents with a 30-year-old Hispanic male who is also prelingually Deaf. He was admitted involuntary for bizarre behavior and delusions, with a pastdiagnosis of schizophrenia. Upon interview, the patient endorsed delusions via written language; however, through an ASL-languageinterpreter he was able to convey a linear and coherent thought process. Caring for special needs patients must be in the repertoireof any trained healthcare professional. Deaf Individuals experience mental illness just like the general population. Symptoms suchas auditory hallucinations are not brought up in the same manner and are thought to be a visual construct interpreted by the patientas a vocal expression. It is imperative that these subtle differences are known in order to differentiate out an actual mental illness.In any case where language is a barrier, an interpreter must be present for a thorough assessment. These cases lend further thoughtinto policy reform for Deaf individuals within healthcare.