Anglemyer Ethan, Crespi Craig
Palm Beach Consortium of Graduate Medical Education/University Hospital and Medical Center, 7201 North University Drive, Tamarac, FL 33321, USA.
Case Rep Psychiatry. 2018 Jun 7;2018:3285153. doi: 10.1155/2018/3285153. eCollection 2018.
The Deaf/hard of hearing population is growing rapidly and the medical community is facing a higher demand for this special needs group. The Deaf culture is unique in that spoken word is via sign language. What one person may see as mania or psychosis is actually a norm with Deaf individuals. The fear of the unknown language often creates immediate conclusions that are false. As such, being culturally sensitive becomes a large component of properly assessing a Deaf patient in any psychiatric situation. In the first case, the patient is a 26-year-old prelingually Deaf male, who was placed under an involuntary hold by the emergency room physician for acting erratic and appearing to respond to internal stimuli. The patient was later interviewed with an interpreter and stated he became upset because the staff was not providing him proper care as they lacked an ability to communicate with him. The patient's family was called who corroborated the story and requested he be discharged. Case two presents with a 30-year-old Hispanic male who is also prelingually Deaf. He was admitted involuntary for bizarre behavior and delusions, with a past diagnosis of schizophrenia. Upon interview, the patient endorsed delusions via written language; however, through an ASL-language interpreter he was able to convey a linear and coherent thought process. Caring for special needs patients must be in the repertoire of any trained healthcare professional. Deaf Individuals experience mental illness just like the general population. Symptoms such as auditory hallucinations are not brought up in the same manner and are thought to be a visual construct interpreted by the patient as a vocal expression. It is imperative that these subtle differences are known in order to differentiate out an actual mental illness. In any case where language is a barrier, an interpreter must be present for a thorough assessment. These cases lend further thought into policy reform for Deaf individuals within healthcare.
聋人/听力障碍人群正在迅速增长，医学界对这个特殊需求群体的需求也越来越高。聋人文化的独特之处在于，口语是通过手语来表达的。在聋人个体中，一个人可能视为躁狂或精神病的情况实际上是常态。对未知语言的恐惧往往会立即得出错误的结论。因此，在任何精神科情况下，文化敏感性都成为正确评估聋人患者的重要组成部分。在第一个案例中，患者是一名26岁的先天性聋人男性，他因行为怪异且似乎对内部刺激有反应而被急诊室医生非自愿拘留。该患者后来通过口译员接受了询问，并表示他很生气，因为工作人员由于缺乏与他沟通的能力而没有给他提供适当的护理。患者的家人被叫来，他们证实了这个说法，并要求让他出院。第二个案例是一名30岁的西班牙裔男性，他也是先天性聋人。他因怪异行为和妄想被非自愿收治，过去被诊断为精神分裂症。在询问时，患者通过书面语言认可了妄想；然而，通过美国手语翻译，他能够传达出一个连贯的思维过程。照顾特殊需求患者必须是任何受过训练的医疗专业人员的技能范围。聋人个体和普通人群一样会经历精神疾病。诸如幻听等症状的表现方式不同，被认为是患者将视觉结构解释为语音表达。必须了解这些细微差别，以便区分出实际的精神疾病。在任何语言存在障碍的情况下，必须有口译员在场才能进行全面评估。这些案例进一步引发了对医疗保健领域中聋人政策改革的思考。
