Deafness And Mental Health - More Specialist Services Required

Deafness has a far-reaching impact on people's social, emotional, and cognitive development. The condition is heterogeneous, and about 7 in 10,000 people are severely or profoundly deaf, with about 70,000 people in the UK alone being profoundly deaf. About 15 to 26% of the global population suffers from hearing loss; most of them come from the poorest countries.

Most hearing impaired people see themselves as a cultural minority, the deaf community, that has to use sign language in order to communicate.

A study in this week's Lancet by Dr Johannes Fellinger and his team in Austria, demonstrates that deaf people are twice as likely to suffer from mental health problems, compared with the general population. The study also reveals disparities in terms of access to and the quality of mental health care that deaf people receive.

U.S. research has established that about one in four deaf students also suffers from other disabilities, such as learning difficulties (9%), developmental delay (5%), specific learning difficulties (8%), visual impairment (4%), and autism (2%).

Fellinger and his team discovered that deaf children who cannot communicate efficiently within their own family have a four-times higher risk of being affected by mental health disorders, compared with those who can. Deaf children also have a higher risk of being maltreated at school. For instance, one study of deaf young Norwegian people revealed that deaf boys had a three times higher risk and deaf girls double the risk of sexual abuse compared with their hearing peers.

Deaf patients have reported they mistrust, fear and are frustrated in health-care services, given that aside from having to overcome communication barriers in clinical situations, they also reported that deaf patients' have limitations in accessing health information.

The researchers highlight two documents that can potentially reduce inequities in access to mental health care and improve the quality of services. The first document is the UN Convention on the Rights of Persons with Disabilities, which several countries have already approved and which describes the positive value of sign language. The second is the UK Government document Mental health and deafness - towards equity and access, which offers guidelines for best practice, that include establishing eye-contact with the patient, explanations with added visual elements, ensuring the patient has a good view of the speaker's face, and avoiding simultaneous comments during examination.

The document recommends treating each part of an examination process as an individual step, i.e. explain first what is about to be examined, examine the patient, and then explain what has been found.

Fellinger and his team conclude:

"Improved access to health and mental health care can be achieved by provision of specialist services with professionals trained to directly communicate with deaf people and with sign-language interpreters."

Dr. Andrew Alexander from the Royal United Hospital in Bath, UK, Dr Paddy Ladd from the Centre for Deaf Studies at the University of Bristol, UK, and Steve Powell from SignHealth in Beaconsfield, UK, emphasize in a linked comment that lip-reading is unreliable, writing notes inadequate, and British Sign Language (BSL) interpreters are rare amongst health-care settings for the deaf.

They write:

"Patients from the Deaf community have the same need for good communication and safe care as everyone else. Clinicians have a responsibility to recognize that communication is a two-way process, and that they need assistance to communicate with this group of patients. So what should you do when you meet your next patient from the Deaf community? Putting yourself in their shoes and asking them how best to communicate would be a good start."

The comment will be available for viewing in British Sign Language.

The Lancet editorial summarizes:

"The poor state of communication between the UK Government and medical professionals and patients must be addressed. Deaf patients face the prospect of a fragmented health service under the current Health and Social Care Bill. Fragmented services cause poor communication between agencies, and poor communication damages patient care.

If this government continues to ignore the warnings, a Deaf Clinical Network of the kind proposed by SignHealth will be more important than ever. Deaf people have long been denied the services they need. The Lancet looks forward to publishing more on the wellbeing of deaf people in future, and hopes to contribute to a new era of better communication and access to health care."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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03.28 | 0 komentar

A Wandering Mind Reveals Mental Processes And Priorities

Odds are, you're not going to make it all the way through this article without thinking about something else.

In fact, studies have found that our minds are wandering half the time, drifting off to thoughts unrelated to what we're doing did I remember to turn off the light? What should I have for dinner?

A new study investigating the mental processes underlying a wandering mind reports a role for working memory, a sort of a mental workspace that allows you to juggle multiple thoughts simultaneously.

Imagine you see your neighbor upon arriving home one day and schedule a lunch date. On your way to add it to your calendar, you stop to turn off the drippy faucet, feed the cat, and add milk to your grocery list. The capacity that allows you to retain the lunch information through those unrelated tasks is working memory.

The new study, published online March 14 in the journal Psychological Science by Daniel Levinson and Richard Davidson at the University of Wisconsin Madison and Jonathan Smallwood at the Max Planck Institute for Human Cognitive and Brain Science, reports that a person's working memory capacity relates to the tendency of their mind to wander during a routine assignment. Lead author Levinson is a graduate student with Davidson, a professor of psychology and psychiatry, in the Center for Investigating Healthy Minds at the UW Madison Waisman Center.

The researchers asked volunteers to perform one of two simple tasks either pressing a button in response to the appearance of a certain letter on a screen, or simply tapping in time with one's breath and compared people's propensity to drift off.

"We intentionally use tasks that will never use all of their attention," Smallwood explains, "and then we ask, how do people use their idle resources?"

Throughout the tasks, the researchers checked in periodically with the participants to ask if their minds were on task or wandering. At the end, they measured each participant's working memory capacity, scored by their ability to remember a series of letters given to them interspersed with easy math questions.

In both tasks, there was a clear correlation. "People with higher working memory capacity reported more mind wandering during these simple tasks," says Levinson, though their performance on the test was not compromised.

The result is the first positive correlation found between working memory and mind wandering and suggests that working memory may actually enable off-topic thoughts.

"What this study seems to suggest is that, when circumstances for the task aren't very difficult, people who have additional working memory resources deploy them to think about things other than what they're doing," Smallwood says.

Interestingly, when people were given a comparably simple task but filled with sensory distractors (such as lots of other similarly shaped letters), the link between working memory and mind wandering disappeared.

"Giving your full attention to your perceptual experience actually equalized people, as though it cut off mind wandering at the pass," Levinson says.

Working memory capacity has previously been correlated with general measures of intelligence, such as reading comprehension and IQ score. The current study underscores how important it is in everyday situations and offers a window into the ubiquitous but not well-understood realm of internally driven thoughts.

"Our results suggest that the sorts of planning that people do quite often in daily life when they're on the bus, when they're cycling to work, when they're in the shower are probably supported by working memory," says Smallwood. "Their brains are trying to allocate resources to the most pressing problems."

In essence, working memory can help you stay focused, but if your mind starts to wander those resources get misdirected and you can lose track of your goal. Many people have had the experience of arriving at home with no recollection of the actual trip to get there, or of suddenly realizing that they've turned several pages in a book without comprehending any of the words.

"It's almost like your attention was so absorbed in the mind wandering that there wasn't any left over to remember your goal to read," Levinson says.

Where your mind wanders may be an indication of underlying priorities being held in your working memory, whether conscious or not, he says. But it doesn't mean that people with high working memory capacity are doomed to a straying mind. The bottom line is that working memory is a resource and it's all about how you use it, he says. "If your priority is to keep attention on task, you can use working memory to do that, too."

Levinson is now studying how attentional training to increase working memory will affect wandering thoughts, to better understand the connection and how people can control it. "Mind wandering isn't free it takes resources," he says. "You get to decide how you want to use your resources."

The work was supported by the Fetzer Institute, the National Institutes of Health, and the Roke Foundation.

Article adapted by Medical News Today from original press release.
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