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Deaf Caseworkers Bring Vital Skills to Their Job

Deaf caseworkers bring vital skills to their job

By Cynthia Billhartz Gregorian, St. Louis Post-Dispatch 11/1/2012

Jody Newman estimates that she’s been hospitalized 20 times in the past 20 years. To be honest, she says, she’s lost count.

“I had many counselors over the years, and they just didn’t work for me. I was suicidal, and didn’t know how to cope with myself or situations,” said Newman, 58, of St. Louis, through an American Sign Language interpreter one recent afternoon. “But not now.”

Two years ago Newman, who has been deaf since she was 5, met Irvine Stewart, and her life hasn’t been the same since. She’s happier; more stable.

Stewart is a caseworker and member of the Deaf Services Team at BJC Behavioral Health in Kirkwood. Laura Shapiro, clinical supervisor, and Sarah Lograsso, case manager, make up the rest of the team. All three are either deaf or hard of hearing. They are the only caseworkers of the sort in Missouri.

The team “came out of a need expressed during several town hall meetings of the deaf community here,” says Schapiro. “About 100 people showed up for each meeting, saying there are no clinicians we can go to who understand what we’re talking about.”

They were tired of trying to communicate through interpreters, Stewart says. Interpreters change the dynamic of counseling. Meanings get lost in translation without the patient realizing it, and it’s often hard for the psychiatrist to get a deaf client to understand his or her diagnosis through an interpreter because the client’s vocabulary is unique and often limited.

“It’s also not as intimate and the trust is harder to get,” Stewart says. “They don’t trust the third person. It’s awkward.”

BJC Behavioral Health treats clients with serious chronic mental illness, including depression, bipolar disorder and schizophrenia. Missouri has about 1,100 deaf people with those types of issues. And 20 percent of them are children.

Historically, the state of mental health treatment for deaf people has been dismal, which is odd, Shapiro points out, because there are two schools for the deaf here.

Two years ago the Missouri Association of the Deaf and 13 deaf residents sued the Missouri Department of Mental Health and Missouri Department of Social Services, claiming that the agencies weren’t helping deaf clients and were wasting money on interpreters rather than using it to find therapists and counselors fluent in American Sign Language.

Lograsso points out that only 10 interpreters are trained in American Sign Language in the state and that providing services for deaf people can be a lot more costly than serving people with other disabilities.

“Bills for interpreters never stop, and they cost between $50 and $75 an hour with a two-hour minimum,” she says. “And most therapy groups are under 10 people, so they don’t have to hire an interpreter or make accommodations.”

The suit was settled earlier this year when the state agreed to provide more interpreters, enhanced mental health treatment and create a 24-hour crisis hotline for deaf people.

The settlement gave no stipulation that the interpreters be deaf. And the BJC Deaf Services Team was not a result of the suit. It was, in fact, created two years ago about the time the lawsuit was filed.

The staff at BJC Behavioral Health came up with the idea. Finding qualified candidates wasn’t easy though.

Only four colleges in the nation have social work programs for deaf people, and they’re in Texas, California, Washington, D.C., and Arizona.

“And those students tend to stay in those places,” Shapiro says.

Stewart and Lograsso, both graduates of Gallaudet University, a liberal arts university in Washington for deaf people, are from Missouri. Shapiro knew that when she asked if they’d be interested in joining the team.

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