Paul Stemman

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Towards Equity and Access - ‘The TEA Report’

Mental Health and Deafness: towards equity and access is a report that was published by the Department of Health in March 2005. The report followed the Department’s initial consultation document, A Sign of the Times (2002).


‘Towards Equity and Access’ addresses many of the general issues surrounding deafness and mental health. The report also examines specific areas such as children’s services, primary care and prisoners. Brief information is provided on each of these issues, which suggests where some of the problems are. Examples of good practice are also highlighted.


The report contains 26 recommendations. These are aimed at health trusts to help them address the gaps in their existing services. Many of the steps are quite simple, such as providing Deaf Awareness training.


After the report was published, an Implementation Panel was set up. This group is attempting to support Trusts to respond to the recommendations. There are two Implementation Officers who work with the Deaf community and health Trusts. They make sure both Trusts and the Deaf community know about the report, and try to get the recommendations implemented.


The TEA report accepts that mental health problems are more common among the Deaf community. It looks at how the health service should respond to this by making its services more accessible and tailored for Deaf people. Although the report is specifically about mental health, it also addresses barriers to access in primary care (e.g. making an appointment to see your GP).


The Minister for Health, Rosie Winterton, recommended the report to health trusts. Because of the way the health service is structured, it is up to each trust to decide whether it wants to implement any of the recommendations. They are unlikely to do so unless there is pressure from their local communities. For that reason, the Deaf community has been urged to put pressure on the health service to follow the recommendations.

Summary of Recommendations

  1. That consideration should be given to conducting local Needs Assessments of the mental health of Deaf people.
  2. Primary Care and Hospital Trusts are asked to include Deaf awareness training in their training and development curricula for all front line staff. Local voluntary groups and local authority social services departments are likely to be able to provide the appropriate expertise.
  3. A telemedicine pilot should be established between one of the specialist providers and a suitable remote site to explore whether further developments of this kind can be justified. (Telemedicine is the use of telecommunication technologies, such as audio and video, to deliver medical information and services to locations at a distance from the person giving care or teaching.)
  4. That the BSL/English translation software developed by Sign - the UK charity that focuses on the mental health of deaf people - is made available to primary and secondary care as speedily as possible.
  5. Area Child Protection Committees should review local procedures, policies and training programmes to ensure that the needs of Deaf children are recognised and can be met.
  6. There should be links developed between the National Deaf Service for Children and local Child and Adolescent Mental Health Services (CAMHS) for advice and consultation.
  7. The use of video-links for this purpose should be piloted and proposals for roll-out of this facility developed should this prove useful.
  8. That Local Implementation Teams and CAMHS development teams make arrangements to access the data held by Local Authorities on Deafblind people as a starting point in considering how they might meet the needs of this group.
  9. That the specialist services consider how they wish to manage referrals of Deafblind individuals in future and what additional expertise or specialisation is required
  10. That consideration should be given to conducting a needs assessment of Deafblind people alongside any undertaken for Deaf people.
  11. Every primary care facility should have a minicom and a service agreement with a translation service which includes BSL.
  12. Consideration be given to the potential role of Gateway Workers in assisting Deaf people with a mental health problem to the service most likely to be of assistance at that time.
  13. That a proposal for a Healthy Living Centre pilot be developed in one or two areas initially.
  14. Primary Care Trusts consider whether there is a practice within their boundaries who could develop a special interest in the needs of Deaf people.
  15. That specialist CPNs (Community Psychiatric Nurses) are recruited to those parts of the country with the greatest need for an enhanced service.
  16. That consideration is given to replicating the Deaf Enhanced Support Team model.
  17. That the pattern of referrals, lengths of stay and eventual disposal of service users at Mayflower Hospital is carefully monitored with a view to establishing whether there is a firm case for a further medium secure unit.
  18. Mental Health Trusts involved in Prison Inreach should seek to identify Deaf prisoners with mental health problems and seek specialist advice on their management. Alternatively, if it were possible at some stage for the Prison Service to designate one prison as having a distinct role in managing Deaf prisoners, specialist inreach could be considered.
  19. That local Needs Assessments take account of the number of Deaf elders who may require residential care.
  20. Those responsible for planning carer support should be aware of the need to consider those carers who may have particular needs.
  21. In any needs assessment, attention needs to be paid to the implications of cultural and ethnic diversity
  22. In considering how to meet their aspirations for race equality, NHS bodies need to be aware of groups with particular access needs.
  23. Staff working in mental health settings should be encouraged to learn BSL and those in specialist services to acquire a fluency that would allow them to carry out their professional functions.
  24. Attention should be given to means of increasing the number of Deaf people employed in mental health services at all levels. Support, Time and Recovery Workers (see Department of Health Implementation Guide, 2003) may provide a model of how this could be done relatively quickly.
  25. Consideration needs to be given to the best mechanisms for increasing the pool of skilled interpreters. This may also need to encompass the employment status of such individuals. This will need to involve a number of agencies.
  26. The feasibility of developing specialist training in mental health for interpreters should be explored by the specialist providers.