Low intensity psychological interventions for Deaf people in Primary

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Low intensity psychological interventions for Deaf people
in Primary Care:
Improving Access to Psychological Therapies in British Sign Language-
Widening Participation for Students who are Deaf
Karen Rea, Kevin Baker, Hazel Flynn
Contact: k.rea@ljmu.ac.uk; kevin.baker@nhs.net
AMH for
Deaf people with
New IAPT
Inpatient Treatment
Step Five
Out patient Treatment of by MH Specialists
Step Four
New HITS
IAPT
IAPT
PWPs
Treatment of moderate disorder in Primary Care
CBT / Case management / Counseling / IPT
Step Three
Treatment of mild to moderate disorder in Primary Care
Facilitated Self Help / Medication support / Signposting
Step Two
Recognition in Primary Care by GPs; Practice Nurses; Health Visitors;
District Nurses etc
Step One
“Watchful waiting”
New IAPT
for Deaf people
Initial pilot project – 2012-13
• Manager, hearing, counsellor, BSL fluent
• Performance Lead (data collection, support)
• High Intensity Therapist/clinical psychologist, Deaf,
BSL fluent
• 3 hearing BSL PWPs trained first (fast tracked)
• 6 BSL PWPs trained in 2012-13
• 9 Deaf BSL PWPs currently in training
Recruitment and Educational challenges
• Availability of appropriately educated and
academically qualified and interested applicants
• Use of APEL
• UG and PG academic routes of the programme
• Interviewing panel
• Acknowledging, respecting and working with
‘third’ parties in assessments and discussions
Adaptations & Practice
• Delivered in BSL
• All-Deaf cohort – peers
• Adapting materials
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IAPT video clips,
Outcome measures
Guided self help materials
Deaf experiences included in teaching and clinical examples
Taking notes while using BSL (eye-contact)
Drawing out an ABC formulation
Alternative ways of delivering support and interventions
• Use of video summaries at the end of the teaching day
Trainee’s feedback
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“Information is clear”
“Role plays are useful”
“Very interesting”
“Discussion is useful”
“Would like more practice with role plays”
“Very visual”
Lessons learnt
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Be prepared!
Be flexible!
Be honest!
Seek advice
Respect expert knowledge and experience
Services to people who are Deaf and who have common MH
problems
• Total number of referrals is 431 across all regions, 61% Female, 39%
Male
• Delivering IAPT services in the North West, South Central, North
East, East Midlands, South East Coast and Yorkshire & Humber
regions.
• Referral routes are Self referral (45%), GP referrals (19%),
Mainstream IAPT Services (15%) with the remainder
coming from Social Services, Community Mental Health Teams,
Other Independent Sector Mental Health Services etc..
• Majority of referral reasons are Mixed Anxiety and Depressive
Disorder, Depressive Episode and General Anxiety Disorder with the
remainder coming from the various other categories.
Contacts
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Karen Rea – k.rea@ljmu.ac.uk
Dr Kevin Baker – kevin.baker@nhs.net
Hazel Flynn – hflynn@signhealth.org.uk
Dr Sarah Powell – sarah.powell@signhealth.org.uk]
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