Mental health inequalities for deaf and disabled people

Mental health inequalities for disabled and deaf people are a significant problem, according to a report published last week by the London Assembly Health Committee.

Studies have shown that disabled and deaf people are more likely to experience common mental health problems, especially anxiety and depression. Around one in three people with chronic physical impairment experience a mental health problem, compared to one in four in the wider population.

Deaf people are twice as likely to suffer from depression as hearing people, and around 40 per cent of people who lose their sight develop depression.

But there is little data available at a regional level to determine how prevalent mental ill health is among disabled and Deaf people in London.

The links between physical and sensory impairment and mental health are complex. But depression and anxiety are not the inevitable consequences of being, or becoming, a disabled person. Disability rights campaigners have raised concerns that many, including some health professionals, believe that depression and physical/sensory impairment go together unavoidably, especially when the impairment is acquired later in life. This has led to a lack of focus on the mental health needs of disabled and Deaf people and on the prevention of avoidable mental health problems.

Eight out of 10 people with a physical impairment were not born with it. The vast majority become impaired through injury, accident, or illnesses such as stroke. The prevalence of disability therefore rises with age. This means that mental health services need to know how to support people who become disabled later in life, as well as those who are born with impairments.

There is likely to be an increase in the number of people living with impairment in the future.

Rises in the rate of long-term conditions that can lead to disability, such as diabetes, coupled with rises in life expectancy, mean that people will be living for longer with disability. For example, diabetes-related sight loss is the leading cause of vision impairment in working age adults in the UK. And the number of people with diabetes has risen by 60 per cent in the UK in the last decade.10

The incidence of mental ill health in disabled and Deaf Londoners is likely to increase unless more is done to support good mental health in this population group.

Having information about how to manage your own mental health is an important part of prevention. But information on how to protect and promote positive mental wellbeing is not always accessible to disabled and Deaf people. We heard that, other than some mental health services offering information in large print, there is little more offered to accommodate the needs of blind and partially sighted people. Services are often advertised in inaccessible formats, such as posters and leaflets in clinics. Similarly, blind and partially sighted people often experience problems receiving information in their preferred format, such as in audio or braille.

Deaf users of British Sign Language (BSL) also report that even basic information is not routinely available to them in a format that they can understand. For example, Action on Hearing Loss told us that the NHS website contains over 900 health videos, but only 1 per cent of these are in BSL.11 And the increasing reliance on online and digital health promotion resources means that the one in four disabled adults in the UK who have never used the internet are at risk of missing out on key information around mental health support.12

The issue can be further compounded by the lack of a shared mental health vocabulary between health professionals and disabled or Deaf service users. Contributors to our investigation told us that it can be difficult for some disabled and Deaf people to recognise the symptoms of depression or anxiety and to articulate them to people who could offer support. So it is vital that information on how to recognise mental ill health is made more widely available.

Prevention and resilience should be at the heart of the Mayor’s mental health strategies. It is therefore critical that resources and information are delivered in accessible ways to enable disabled and Deaf people to benefit. We would welcome confirmation from the London Health Board that plain English, BSL and audio formats of the Mayor’s mental health programmes will be made available free of charge to disabled and Deaf people.

Much of the emphasis in mental health promotion is around staying physically active and maintaining supportive social networks. Ensuring that activities and programmes which are disability and Deaf inclusive are more widely promoted by the Mayor would be a welcome step forward for disabled and Deaf Londoners.

Dr Onkar Sahota AM, Chair of the London Assembly Health Committee, said:

“It’s appalling that such a major health inequality exists within the health system, especially when there are quick wins, which could make a significant difference to the lives of disabled people and Deaf people. Simple changes, like providing a mobile number to text when a Deaf person is in a crisis situation could open up services.

Supporting independent living is also absolutely crucial for good mental wellbeing. The Mayor has powers in housing, transport, employment and crime and could do more to ensure disabled people and Deaf people have choice and control over their lives.

We need to include the voices of disabled people and Deaf people in shaping the services they need. The Mayor of London needs to step up to the challenge of addressing this major health inequality.”
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