Communication Access In Mental Health And Substance Use Treatment Facilities For Deaf American Sign Language Users

James, Tyler G.; Argenyi, Michael S; Guardino, Donna; McKee, Michael; Wilson, Jaime A. B.; Sullivan, Meagan K.; Schwartzman, Eiryn Griest; Anderson, Melissa L.

doi:10.1377/hlthaff.2022.00408

Cited by 12 publications

(10 citation statements)

References 32 publications

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“…Of particular concern is the high level of unmet need for treatment among adults with disabilities who are LGBT. Although federal law in the United States requires that health-care providers are accessible to all persons, disparities remain (James et al, 2022). Other studies have separately examined barriers to and ways to improve access to mental health treatment for persons with disabilities and persons who are LGBT, but information is lacking about how the mental health system can address the intersectionality of disability and LGBT identity.…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, persons with disabilities have higher levels of unmet need for mental health services than others (Xie et al, 2022), perhaps due to communication difficulties, cultural insensitivity, diagnostic issues including diagnostic overshadowing, or lack of accommodations (James et al, 2022; Whittle et al, 2018). Persons who are gay or bisexual are more likely to seek mental health treatment than others (Li et al, 2016; Ross et al, 2018), yet face a number of barriers in accessing such treatment including a lack of staff training, stigma, inability to pay, and insufficient insurance (Ferlatte et al, 2019; Smith et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

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Mental health experiences in 2021 for adults with disabilities who are lesbian, gay, bisexual, or transgender.

Brucker¹,

Surfus²,

Henly³

2023

Rehabilitation Psychology

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Purpose/Objective: Examine the prevalence of mental health issues, receipt of mental health treatment, and self-reported unmet need for mental health treatment among U.S. adults with and without disabilities by lesbian, gay, bisexual, or transgender (LGBT) status during the pandemic. Research Method/Design: Logistic regression and predicted probabilities using nationally representative, cross-sectional, household survey data from the U.S. Census Bureau's weekly Household Pulse Survey conducted during the COVID-19 pandemic (July 21, 2021-October 11, 2021. Results: Controlling for age, educational attainment, employment, health insurance coverage, and race/ethnicity, adults with disabilities, regardless of LGBT status, had statistically significantly increased odds of having mental health issues, receiving mental health treatment, and reporting the unmet need for mental health treatment compared to adults without disabilities who were not LGBT. Adjusted rates of receipt of mental treatment ranged from a low of 9% for persons without disabilities who were not LGBT to 27% for persons with disabilities who were LGBT, a gap of 18 percentage points. An even larger percentage point gap (22 percentage points) was noted in the unmet need for treatment between persons without disabilities who were not LGBT (9%) and persons with disabilities who were LGBT (31%). Conclusions/Implications: These results highlight the need for expansions of the mental health service delivery system in the United States as well as a prioritization of accessibility and inclusiveness practices. Impact and ImplicationsIn 2021, U.S. adults with disabilities who identified as lesbian, gay, bisexual, or transgender (LGBT) experienced worse mental health and had higher levels of unmet need for mental health treatment than adults without disabilities who did not identify as LGBT. The mental health service delivery system in the United States needs to expand access to accessible and inclusive mental health treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mental health experiences in 2021 for adults with disabilities who are lesbian, gay, bisexual, or transgender.

Brucker¹,

Surfus²,

Henly³

2023

Rehabilitation Psychology

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“…For example, DHH people who use American Sign Language (ASL) and DHH people who use spoken English typically have different sociomedical experiences including age of onset, early childhood language access, and distal social outcomes including educational attainment, employment, and access to health promoting resources. For example, DHH people who use ASL to communicate are at high risk of not receiving effective communication access in healthcare environments, which may diminish the quality of care (James, Argenyi, et al, 2022; James, Coady, et al, 2022; McKee et al, 2011). For this reason, the goal of the study was to assess differences in emergency department care among DHH ASL-users and DHH English-speakers, in comparison to non-DHH English-speakers.…”

Section: Example Study: Emergency Department Utilization Among Deaf A...mentioning

confidence: 99%

Integrating Transformative Considerations and Quantitative Results Through a Participant Selection Joint Display in Explanatory Sequential Mixed Methods Studies

James

DeJonckheere

Guetterman

2022

Journal of Mixed Methods Research

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Integrating philosophical or paradigmatic dimensions in mixed methods research studies facilitates the development of stronger meta-inferences. The transformative paradigm and the explanatory sequential mixed methods design share a focus on developing sampling criteria, but with different priorities. This article contributes to the field of mixed methods research by presenting a method of integrating transformative sampling considerations in explanatory sequential designs through a participant selection joint display. The approach presented addresses concerns regarding transparency of research decisions in mixed methods studies, while providing a method of centering the transformative paradigm in mixed methods integration procedures.

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“…In the United States, 49–55 million people have hearing loss, 12–14 and DHH people with younger ages of onset are at higher risk of poor familial communication, which is linked to poorer health outcomes in adulthood 10,15 . Federal regulations in the United States (e.g., Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act and the Patient Protection and Affordable Care Act) protect DHH patients' communication access but, despite these regulations, many healthcare facilities are noncompliant 16–18 . Consequently, DHH patients report ineffective communication in healthcare environments, 6,19,20 including the emergency department (ED) 21 …”

Section: Introductionmentioning

confidence: 99%

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

James,

Sullivan,

McKee

et al. 2023

Health Expectations

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BackgroundDeaf and hard‐of‐hearing (DHH) patients are a priority population for emergency medicine health services research. DHH patients are at higher risk than non‐DHH patients of using the emergency department (ED), have longer lengths of stay in the ED and report poor patient–provider communication. This qualitative study aimed to describe ED care‐seeking and patient‐centred care perspectives among DHH patients.MethodsThis qualitative study is the second phase of a mixed‐methods study. The goal of this study was to further explain quantitative findings related to ED outcomes among DHH and non‐DHH patients. We conducted semistructured interviews with 4 DHH American Sign Language (ASL)‐users and 6 DHH English speakers from North Central Florida. Interviews were transcribed and analysed using a descriptive qualitative approach.ResultsTwo themes were developed: (1) DHH patients engage in a complex decision‐making process to determine ED utilization and (2) patient‐centred ED care differs between DHH ASL‐users and DHH English speakers. The first theme describes the social‐behavioural processes through which DHH patients assess their need to use the ED. The second theme focuses on the social environment within the ED: patients feeling stereotyped, involvement in the care process, pain communication, receipt of accommodations and discharge processes.ConclusionsThis study underscores the importance of better understanding, and intervening in, DHH patient ED care‐seeking and care delivery to improve patient outcomes. Like other studies, this study also finds that DHH patients are not a monolithic group and language status is an equity‐relevant indicator. We also discuss recommendations for emergency medicine.Patient or Public ContributionThis study convened a community advisory group made up of four DHH people to assist in developing research questions, data collection tools and validation of the analysis and interpretation of data. Community advisory group members who were interested in co‐authorship are listed in the byline, with others in the acknowledgements. In addition, several academic‐based co‐authors are also deaf or hard of hearing.

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Communication Access In Mental Health And Substance Use Treatment Facilities For Deaf American Sign Language Users

Cited by 12 publications

References 32 publications

Mental health experiences in 2021 for adults with disabilities who are lesbian, gay, bisexual, or transgender.

Mental health experiences in 2021 for adults with disabilities who are lesbian, gay, bisexual, or transgender.

Integrating Transformative Considerations and Quantitative Results Through a Participant Selection Joint Display in Explanatory Sequential Mixed Methods Studies

Emergency department patient‐centred care perspectives from deaf and hard‐of‐hearing patients

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