The deaf community has long suffered from difficulties in accessing competent and sensitive mental health services. Many deaf people with mental health issues have either been denied treatment or treated inappropriately. Due to a lack of trained mental health professionals who can communicate with deaf patients through sign language and other means in their own community, these patients are often kept overnight at distant facilities. A linguistic and cultural minority, the deaf community is often misunderstood and denied access to mainstream society, creating further mental health problems in a cycle of alienation.
Since 1989, the South Carolina Department of Mental Health (SCDMH) has developed and sponsored a progressive program of mental health services directed to the needs of deaf and hard of hearing citizens. The program includes community-based counselors who are mobile and flexible to client needs, residential alternatives for more serious cases, and a small inpatient treatment unit to support the community programs.
Instead of forcing deaf patients to remain institutionalized in order to benefit from care in their own language, therapists who are fluent in American Sign Language and other communication modalities travel to every county in the state to ensure high-quality, individualized service to people with hearing impairments and mental health needs. One of the program's main psychiatrists even uses real-time video conferencing technology to deliver "telepsychiatry" services across the state in sign language.
Initially, the notion of a single service provider crossing geographic boundaries was considered impossible, but by training inpatient staff to communicate with deaf patients and keeping them mobile and flexible, huge increases in efficiency have resulted. Before the program's inception, the average length of stay at a mental health facility for deaf patients was over 9 months, but by 1999, it had been reduced to 17 days, with no long-term in-patients in any state psychiatric facility. At the same time, the number of deaf clients served has increased from 160 in 1991 to over 450 in 1999, as members of the deaf community learn that seeking mental health care no longer leads to a "life sentence" in an institution.
These results are particularly impressive considering that the program has been developed despite the disconnected and rural nature of the state, the poverty of the typical consumer served, and the scarcity of available resources. To date, SCDMH deafness professionals have given consulting services to their peers in over sixteen states, and many other jurisdictions have shown interest in adopting aspects of the "South Carolina model" after learning about its results.