EQUALITY IMPACT ASSESSMENT. Business Division/Directorate: Name of Service/Title of Policy or Strategy, Name of Event:

Transcription

1 EQUALITY IMPACT ASSESSMENT Business Division/Directorate: Service: Adult Community Policy: Name of Service/Title of Policy or Strategy, Name of Event: Event: South Yorkshire Service for Deaf People with Mental Health Needs Equality Impact Assessment Undertaken by: Rebecca Walls, Project Lead/CPN for Deaf People (South Yorkshire) Strategy: Date undertaken: 01/01/2013 Questions 1. What are the main aims and purposes of the Policy / Service / Event or Strategy? To provide a service for Deaf people with mental health problems covering the South Yorkshire areas of Barnsley, Doncaster, Rotherham and Sheffield. Its purpose is to improve the quality of services for this group. Evidence Base The group of Deaf people that the service offers support to are referred to with a capital D and have a cultural and linguistic identity that is distinct from that of hearing people. The convention has arisen that deaf with a lower case d refers to the audiological condition of not being able to hear (Meadow-Orlans & Erting 2000, Young et al. 2000). Deaf people use British Sign Language (BSL) for communication. This is a visual mode of communication using its own grammatical structure and syntax conveyed by gestures, facial expression and body language. It is not dependant on nor strongly linked to spoken English. It has no written equivalent, a point often missed by mental health professionals with no experience of assessing Deaf service users. Many professionals resort to the written word using English language phraseology, grammar and syntax that is not an effective mode of communication for many Deaf people. There is a significant link between mental ill health and Deafness. Deaf children have a prevalence of mental health problems of 40% compared with 25% in their hearing counterparts (Hindley 1993, 2000, Department of Health, 2005). In adults, a number of studies from different countries Reflect the higher incidence of mental health problems among Deaf people when comparing to the hearing population (Department of Health 2005). This has clear implications for mental health services in meeting the needs of the Deaf service user. Deaf people are no more likely to experience significant mental disorders than other people, e.g. schizophrenia, but are more likely to experience emotional, behavioural and adjustment disorders such as anxiety, depression and personality disorder. There is, therefore, a higher incidence of mental health problems among Deaf people compared to the hearing population. (It is estimated that there are 6000 psychotic Deaf patients in the UK).

2 General Overview There are approximately 100,000 Deaf (sign language users) in the UK (Action on Hearing Loss, 2013). Latest figures from the GP survey (2010) indicate there are approximately 2350 Deaf (BSL users and/or Deaf blind) people resident in the South Yorkshire region. A breakdown of this shows 312 resident in Barnsley; 594 within Doncaster, with a further 200 at Doncaster College for the Deaf; 560 resident in Rotherham; and 885 in Sheffield. Prior to commencement of the South Yorkshire Service for Deaf People with Mental Health Needs, a monthly / bi-monthly clinic was provided to the Deaf community in South Yorkshire by the John Denmark Unit (Specialist Centre for Mental Health and Deafness, Manchester). Initially, this was provided by a Consultant Psychiatrist and CPN and latterly by the CPN/Clinical Nurse Specialist. Clients requiring in-patient treatment had the option of transferring to the John Denmark Unit. The need for more immediate and long-term input from a Specialist service was highlighted. This would ensure more intensive and timely input than could previously be provided. The service is intended to benefit Deaf people i.e. that sub-group of the total deaf population whose primary means of communication is British Sign Language (BSL). The service will have a focus on Deaf people with severe mental health problems, but will also work to support the improvement of services for Deaf people with common mental health problems. It will cover both adults in contact with adult mental health services. Objectives The service will work with people aged years old who are experiencing mental, psychological or emotional problems that compromise normal functioning, and will operate within the framework of the Care Programme Approach. Service users will be known to local mental health services. Service users in contact with mental health services may also be known to learning disability services and/or drug and alcohol services. A service to Deaf 14 to 18 year olds will be provided in conjunction with Early Intervention teams and Young Adult Mental Health teams. The service will see Deaf adults (including those with primary additional needs such as mild to moderate learning disabilities and/or Deaf/blind) who present with mental, psychological and emotional problems. These will include: ~ Bipolar disorder ~ Schizophrenia/psychosis ~ Personality disorder ~ Moderate to Severe Depression ~ Moderate to Severe Anxiety ~ Dual diagnosis Service Description The service will be delivered as follows: The service is provided by a full-time specialist mental health worker (e.g. CPN or social worker) and a full-time project support (or STR)/administration worker with British Sign Language (BSL) skills. The specialist worker and the support worker are employed by and receive line management within Rotherham Doncaster & South Humber NHS Trust but work across the health organizations in South Yorkshire to develop high quality secondary mental health services for Deaf people within adult mental health services.

3 The specialist worker and the support worker take referrals from within secondary mental health services of people needing further assessment and support. They will work jointly with secondary mental health services, which will continue to provide care coordination. A protocol/referral process has been developed with the John Denmark Unit (National Specialist Centre for Mental Health and Deafness) to include provision of an in-patient service if required. Clients referred suffer from moderate to severe mental health problems appropriate for secondary mental health care. The role of the service in relation to these clients is: ~Assessment and care planning; ~Provision of specific treatment interventions. ~Working with the individual client and their local mental health services/care coordinator to ensure that appropriate support and packages of care are in place and that the individual is able to engage with services to enable their needs to be met. ~Working with local voluntary and community organizations specializing in support for Deaf people to ensure that service users are able to access appropriate mental health services. ~Supporting the integration of service users into the Deaf community and society at large. ~Acting as a source of information on the numbers and needs of Deaf people with severe mental illness. The specialist worker and the support worker work across a wide geographical area and are a limited resource. The service also has a facilitation and service development role, working with other agencies to improve the care of all Deaf people with moderate to severe mental health problems including: ~ Advice to primary care, other community service and care home staff as appropriate ~ advising on treatment interventions to meet these needs; ~ carrying out joint work where appropriate; ~ working with others to ensure that care pathways are agreed and in place for individuals; ~ ensuring Deaf people with mental health needs have access to appropriate interpretation services providing expertise and information to support the development and improvement of services for Deaf people with mental health problems ~ Provision of mental health awareness to Sensory Impairment teams and the Deaf community; ~ Provision of Deaf awareness to mental health teams including Approved Mental Health ~ Professionals (AMHPs) and trainee AMHPs; ~ Acting as a resource for students, e.g. nurses, social workers, OT, etc. To provide a service for Deaf people with mental health problems covering the South Yorkshire areas of Barnsley, Doncaster, Rotherham and Sheffield. Its purpose is to improve the quality of services for this group. 2. Who is involved in delivering the service, implementing the policy or strategy /

4 organising the event? (i.e., partnerships, stakeholders or agencies) The service is commissioned by Barnsley, Doncaster, Rotherham and Sheffield commissioning teams. The service is provided by a full-time specialist mental health worker (Community Psychiatric Nurse, CPN) and a full-time support (or STR)/project support worker with British Sign Language (BSL) skills. 3. What information / data or experience can you draw on to provide an indication of the potential inclusive / exclusive results of delivering this service or event / implementing the policy or strategy to different groups of people and the different needs of people with protected characteristics in relation to this policy / service / event or strategy? (Follow link for guidance prompts) Deaf people may experience the same issues and boundaries as those within the protected characteristics of the Equality Act. One in four people will experience mental illness and approximately 300 out of every 1000 will experience mental health problems every year. Deaf people are no more likely to experience significant mental disorders than other people, e.g. schizophrenia, but are more likely to experience emotional, behavioural and adjustment disorders such as anxiety, depression and personality disorder. There is, therefore, a higher incidence of mental health problems among Deaf people compared to the hearing population. (It is estimated that there are 6000 psychotic Deaf patients in the UK). The latest GP survey (2010) indicates that there are approximately 2351 Deaf people living in the South Yorkshire region. Deaf people often struggle to access services as the average reading age of a Deaf person is 9 years old. In addition, there are environmental boundaries such as intercom systems, having to make appointments via phone calls and delays in booking and difficulties obtaining appropriately qualified interpreters. Deaf people's cultural identity and how this may impact on their mental health may also be misunderstood or not taken into consideration when assessing their mental health needs. This service offers assessment of Deaf people that is culturally appropriate, in their first language (BSL) and materials that are adapted to specific needs. The team works in conjunction with secondary mental health teams and/or care co-ordinators to provide access to Deaf people and, thus, improve their quality of care.

5 Please use the following table to indicate the impact for the policy for the protected characteristics Protected Characteristics Positive Impact Negative Impact Neutral Impact Reasons for Impact The service is offered to adults receiving care from secondary mental health teams for people of working age. Support is also offered to people age 14 and over, and in contact with Early Intervention in Psychosis teams. Age Advice is given to services for older adults and assessment of needs may also be offered. Information regarding a Deaf and dementia project can be found at or The service is specifically for Deaf people (British Sign Language (BSL) users). This group of people may also have additional disabilities, e.g. blind, learning disabilities, and physical disabilities. Disability Support will be offered to non-bsl users where teams struggle to communicate with them. Support is not offered to people who have become deaf later in life or who have lived within the hearing community, although advice will be provided. This is because this group of people will have functioned in the hearing world and will not have Deaf cultural needs that impact on their mental health. Support will be offered to Deaf people within this protected characteristic if they also have secondary mental health needs. Gender reassignment Training regarding gender reassignment will be accessed. There is little locally and nationally specific to Deaf people and gender reassignment. Deaf people will be supported to access other services as needed and support given to staff regarding Deaf awareness. Marriage and civil partnership People who are married or in a civil partnership will be offered equal access to services and this will be in relation to their specific needs.

6 Pregnancy and maternity People who are pregnant or have children will be offered equal access to services and this will be in relation to their specific needs. There are national services in relation to Deaf people, pregnancy and children. Deaf people of any race will be offered a service. Deaf people of BME origin may have additional cultural needs that need to be taken into consideration during assessment and implementation of care. Race Support will be gained through a Deaf relay interpreter if required and interpreters of other languages will be sought where this is needed and in relation to contacting family. There are no known organisations locally focusing on BME and Deaf people. Deaf people will be supported to access other services as needed and support given to staff regarding Deaf awareness. Deaf people of any religion or belief will be offered a service. Support will be offered (where necessary) by the Trust chaplaincy departments with interpreters. Religion or belief The sevice has involvement with the Mental Health Working Team in conjunction with Sheffield diocese. There is a chaplain who has an interest in working with Deaf people. Work is being undertaken to develop training regarding mental health and faith specific to the Deaf community. Deaf people will be supported to access services as needed and support given to staff regarding Deaf awareness. Deaf people of either sex will be offered equal access to services. The current staff are both female so a choice in gender of worker is unable to be offered. Sex However, care can be offered through mental health teams with an interpreter and the Deaf mental health service can offer support in relation to working with deaf people. A choice of gender of interpreter can be requested and provided if available. Sexual Orientation Deaf people of any sexual orientation will be offered equal acces to services. There are no local LGBT groups but people can be directed to other organisations nationally.

7 Disadvantaged groups Deaf people have been described as being the most socially deprived group if they all lived in the same geographical area. The service aims to improve access to service and provide culturally appropriate assessment. 4. What positive impacts are there for this policy / service / event or strategy to better meet the needs of people with protected characteristics? The needs of Deaf people will be met no matter what protected characteristic they come under. There will be better access to services and a culturally appropriate service offered to Deaf BSL users. 5. What action would be needed to ensure the policy / service / event or strategy overcomes: Discriminatory negative impacts Exclusion Failure to meet the needs of people from across the protected characteristics and opportunities for promoting equality and inclusion are maximised. An Equality Delivery Strategy (EDS) for Deaf people has been created which will be reviewed annually and updated as services/resources are created and developed. These have been sent to Trust Equality and Diversity leads to be disseminated and actioned within each Trust that is covered by the service. The individual staff members provide support and advice to teams and care co-ordinators regarding making services and resources more accessible.

8 6. Recommended steps to avoid discrimination and ensure opportunities for promoting equality and inclusion are maximised. Include: Options for action Explanation if no further action is required Lead responsible for overseeing actions Timescales Costs (where applicable) See EDS for Deaf People Individual Trusts 7. Monitoring and reporting arrangements of EIA, for policies and strategies refer to section 7 of the Policy for the Development and Management of Procedural Documents. For services / events please include the following: How the equality impact of the service will be monitored Frequency of monitoring How the monitoring results will be used and where they will be published; Who will be responsible for reviewing monitoring results and initiating further action where required Any changes that have been made to remove or reduce any negative impacts as a result of conducting the equality impact assessment?

9 Any action points should be included in Business Division / Corporate action plans, with monitoring and review processes. Insert monitoring table here, use copy and paste function. Is further work / consultation required? If yes, please explain how this is to be carried out and the time frame for completion. Yes No Ongoing liaison with Trust Equality and Diversity leads and others, as requested and where necessary. The Equality Impact Assessment will be reviewed in line with changes to services, client or staff groups, legislation or policy review. Name: Rebecca Walls Designation: Project Lead/CPN for Deaf People (South Yorkshire) Signature: Date: