TRIGGER WARNING: contains descriptions of attempted suicide, suicidal thoughts, and emotional distress.
In April this year, Daniel MJ Webster ended his life. He was Deaf, and in his late 30s. He had been assessed as having severe mental health problems, and needed urgent attention.
However, instead of the specialist Deaf-focussed therapy requested by his GP, Mid-Essex Client Commissioning Group (CCG) referred Daniel to mainstream counselling with a BSL interpreter.
As a result, the UK Deaf Community lost a funny and lively young man who was much loved by many, with his family so consumed by grief that they have asked for total privacy. The specialist counselling service, Deaf4Deaf, have launched a JustGiving page for a MH support fund in his memory. They plan to raise £50,000 for six emergency counselling sessions to be offered to 278 Deaf people with severe mental health problems.
While I recognise that six sessions will never be enough, my hope is for the 278 to be recognised by the UK mental health system and gain access to longer-term counselling support administered by BSL-using professionals.
After all, this is happening against an UK-wide backdrop of mental health service cuts continuing for the ninth year under Tory governance, with 83% of schoolteachers reporting deteriorating mental health in children, and two thousand mental health staff a month leaving NHS England last year.
All of which mean double the barriers for Deaf people seeking qualified counselling support. Not only do they experience cuts in those services; they also experience cuts in accessing them. I am hardly surprised that Daniel’s request was rejected by a CCG.
When the coalition replaced Primary Care Trusts (PCTs) with CCGs in 2013, for the first time in its history the NHS’ commissioning of individual healthcare services became an open market. The PCTs’ code of practice required them to commission public services only, prioritising duty of care. Consequently, they were treated as de facto investments in the public’s health, with the higher cost reflecting quality of service. They funded Deaf-focussed counselling more willingly.
That changed with the CCGs. Public healthcare providers found themselves competing for bids with private bodies, who didn’t necessarily value duty of care, weren’t as qualified, and sought instead to undercut their public rivals whatever the cost. This is where the likes of Virgin Care muscled in, complaining about the NHS swiping service contracts from under their noses.
Let me show you a real-life experience of how those changes have impacted directly on Deaf users of counselling services: namely, mine.
I live with depression, anxiety and PTSD. I have made one suicide attempt in Weston-super-Mare, in 1992. I’d got myself very drunk and bagged a lift to the pier at a stupid hour of night, where I intentionally clambered onto the rocks before passing out. Next thing I remember, I was shivering from hypothermia in a foil blanket, still wishing I was dead, while the fluorescent corridor lights of the local A&E sped past from above.
I have contemplated suicide many more times since: particularly 2011, 2012, 2013, 2014, and last year. I haven’t always been mentally ill, because it’s usually triggered by traumatic life events. I have had two courses of counselling with SignHealth, in 2012 and 2013.
I’ve also had mainstream counselling. After my suicide attempt I was referred to my university’s mental health service, where I met a trainee counsellor who’d just cracked how to keep her emotions in check. Asking her to adapt communication was too much of a stretch. So I quit, and tried working through my depression on medication instead.
My next course of therapy was provided by MIND, who sweetly tried to match me with a disabled counsellor in 2001 following a messy relationship split, and my father’s cancer diagnosis.
She was certainly kind, accommodating, and very proficient. But her being disabled and not deaf, and my being deaf and not disabled – I know this sounds weird to some of you (it doesn’t to me and my deaf friends), but bear with me – ensured that I spent most of my time explaining my perspective as a deaf person, rather than addressing the actual issue in hand (however easy she was to talk to).
Twenty sessions later I declared time up, having found love again. In retrospect I wasn’t emotionally ready to move on, and the counsellor hesitated a little at first. Being so professional though, she understood it wasn’t her place to dictate what I should do.
I also saw two Relate counsellors on two separate occasions in 2011 and 2014, both times with BSL interpreting support. Both proved unsuitable because they lacked Deaf insight, and prattled on instead, thinking they knew better.
How much I have had to tolerate, and for so long, before I could properly express myself as a Deaf person with mental health issues, is as jaw-dropping a memory today as ever. I am capable of communicating in both oral English and BSL: yet I cannot avoid that being affected when I’m describing emotional trauma – however hard I try to maintain clarity throughout.
In that context a mainstream counsellor, even one relying on a perfectly competent BSL interpreter, would misunderstand their Deaf client far more than is necessary. I’m sure the last thing any qualified mental health professional with integrity would want to do is add more stress.
Yet that is exactly what I’m getting from the UK mental health system today. Despite the advances made by the DDA and its successor the 2010 Equality Act; despite the 1998 Human Rights Act; despite more Deaf people and BSL allies becoming qualified counsellors – I am struggling more to access it than before.
It’s not like I’ve shied away from discussing my problems either. Look: just one person can save a life. I am only here today because one person decided to get some fresh air at five o’clock in the morning in Weston-super-Mare, all those years ago. Just one person. It breaks my heart that no-one was there for Daniel Webster in his hour of need. So if I can save one Deaf person’s life with this blog, then it will have been worth my sharing something so raw and intensely personal. It is the least I can do.
After a quick succession of traumatic incidents in late 2017, and again in early 2018 triggering flashbacks, I started visiting my GP once a fortnight. They’d log issues as they arose, prescribe antidepressants, and refer me to a psychiatrist (for diagnosis) and SignHealth (for counselling). The last two times I did that – in 2012 and 2013 – I was seeing a Deaf-focussed therapist within a few months.
This time round, the referral has taken 15 months. BSL Healthy Minds, the counselling service run by SignHealth, assessed me for cognitive behavioural therapy (CBT) and depression only yesterday.
That happened because I wasn’t prepared to be accepted for mainstream counselling with BSL interpreting support, just like Daniel Webster. When I complained to my GP about my referral to them for assessment, my CCG interjected that I had to go down that route first before they could agree to the alternative – just like Daniel’s CCG.
Determined, I raised the issue in an email to the mainstream provider. They wrote to my GP, who wrote to the CCG, who wrote back saying they’d already rejected my request for BSL counselling, in February 2018. My GP then wrote to the mainstream provider, asking them to support my request in writing to the CCG, and posted me a copy of their letter.
Again I emailed, this time addressing both mainstream provider and BSL Healthy Minds, begging them to please make my request a priority. I got my daughter’s social worker to post her own written support – thus triggering a cross-party alliance of social services, GP, mainstream provider and BSL Healthy Minds, all badgering the same CCG to change their blasted minds.
Now, I have to wait another 28 days before I know if I can have 20 sessions with BSL Healthy Minds – even though I have a high score in all three areas assessed: depression, anxiety and suicidal tendencies. And I was diagnosed with PTSD by a psychiatrist in May last year. Tell me, how is this my CCG making my case a priority?
Clearly, my deafness has never been the problem. It is society’s attitude to it that is: the same society that flusters when they realise they have to find another way to communicate with a Deaf person. The same society that aggravates my mental health issues, and those of many others, like Daniel Webster. They know, only too well, that communication is a two-way street.
They have simply chosen not to make it so.
Click here to donate to the Daniel MJ Webster Deaf Mental Health Fund.
If you are a Deaf person with mental health problems and you are at crisis point, you can email the Samaritans for 24-hour support on email@example.com Otherwise, ask BSL Healthy Minds for a referral to their psychological therapy services on firstname.lastname@example.org
You can also self-refer to Deaf4Deaf here.