The lived experience of depression among culturally Deaf adults

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Abstract
Accessible summary • Depression is a significant health concern. Psychiatric and advance practice nurses often screen patients for depression. However, culturally Deaf adults (those who communicate primarily in American Sign Language and view themselves as members of a unique culture) are rarely screened for depression. Consequently, very few Deaf adults ever receive the mental health care they need. The researcher conducted interviews with Deaf adults, who described their depression and events that led to depression. • Symptoms of depression among Deaf adults are no different from symptoms experienced by hearing people. Communication barriers often make it difficult for Deaf patients to even discuss their symptoms of depression with nurses and other health care providers. Therefore, few Deaf patients receive appropriate treatment for their depression. • The Deaf individuals interviewed for this study described feeling isolated as children because there was no common language within the family. Everyone interviewed was the only Deaf person within the family. Parents expected their children to learn to lip-read, and were often upset when the Deaf child wanted to learn American Sign Language. Sexual and physical abuse occurred, and the Deaf individual never knew how to obtain assistance. The Deaf children grew up feeling defective. As adults, the Deaf individuals were stared at or laughed at. Many felt hopeless and attempted suicide as a way to escape. • Nurses must recognize the difficulties experienced by Deaf patients, especially in communication. Deaf people may not verbalize. This does not reflect intelligence or lack of depression. Abstract Culturally Deaf adults lost hearing at early ages, communicate primarily in American Sign Language (ASL), and self-identify as culturally Deaf. Communication barriers lead to isolation, low self-esteem, abuse, and inadequate health care. Screening Deaf patients for depressive symptoms poses challenge. Nurses are rarely familiar with ASL, and depression screening tools aren't easily translated from English to ASL. Consequently, Deaf adults are not adequately screened for depression. Qualitative interviews were conducted with culturally Deaf adults, and certified interpreters helped to enhance understanding. Text was generated from interview transcriptions and researcher observations. No novel depressive symptoms were described. Various ASL signs were used to represent depression; two participants used a unique gesture that had no meaning to others. Childhood experiences leading to depression included sexual or physical abuse, feeling ostracized from family and like a burden. Suicidal gestures communicated severity of depression. Adults felt interpreters were unwelcome during mental health encounters. No participants were asked about depressive symptoms despite frank manifestations of depression. Study describes antecedents and consequences of depressive symptoms among Deaf adults. Understanding symptom manifestations and challenges experienced by Deaf patients helps identify those at risk for depression, thereby reducing morbidity and mortality.

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