Evaluating the Effectiveness and Cost Effectiveness of BSL (British Sign Language) IAPT (Improving Access to Psychological Therapies)
This study compares two kinds of service for Deaf people experiencing mental health problems: one where the therapist and Deaf person usually communicate using a sign language interpreter, and a second where the therapist and the Deaf person uses British Sign Language.
The following video presents a plain summary in BSL, including subtitles and voice dubbing. A complete transcript is offered in the menu below the video.
Plain summary (written English)
British Sign Language (BSL) is a fully grammatical visual language separate from English. Rates of anxiety and depression are much higher among Deaf people who use BSL than among the general population. This study compares two kinds of service for Deaf people experiencing mental health problems.
In the first, namely standard Improving Access to Psychological Therapies (IAPT), the therapist and Deaf person usually communicate using a sign language interpreter. In the second, the therapist is a Deaf person who uses the same language as the client, namely BSL. We wanted to find out which was best at helping the Deaf client to recover and which was better value for money.
However, before we could do that we also needed to develop some new measurement tools. The ones usually used to assess progress in therapy and how healthy someone feels were not available in BSL. We also needed to find out about whether or not there were differences in how standard IAPT services treated Deaf BSL users. We have now developed new versions in BSL of common assessments used to measure anxiety, depression and health.
We have found out that there is little difference in the recovery levels of Deaf people who use either BSL-IAPT or standard IAPT. However, this result is not strong because most standard IAPT services had seen hardly any Deaf people. It is not certain whether or not BSL-IAPT is better value than standard IAPT using an interpreter to achieve the same outcomes for clients
Scientific summary (written English)
This exploratory, mixed-methods study is focused on adults who are Deaf, who use British Sign Language (BSL) as their first, preferred or strongest language, and who experience anxiety and/or depression. BSL is a fully grammatical visual language separate from English. Its users (Deaf people) are formally recognised as a cultural–linguistic community in the UK and are distinguished from the larger number of deaf people who use spoken language.
Deaf adults experience poorer mental health than the general population and face significant barriers to accessing mental health services. Poor treatment outcomes are related, in part, to late access to preventative and primary mental health services.
Improving Access to Psychological Therapies (IAPT) services deliver approved psychological interventions to address anxiety and depressive disorders in primary care settings and follow the National Institute for Health and Care Excellence-approved stepped care model. IAPT has been adapted for Deaf people and delivered by Deaf therapists using BSL in some parts of England (BSL-IAPT). Elsewhere, Deaf people usually access standard IAPT through an interpreter.
This study both carries out preliminary effectiveness and cost-effectiveness evaluations of the two approaches to psychological therapies for Deaf people and lays the groundwork for a potential large-scale study by addressing deficiencies in instrumentation, population profiling and outcome data, service modelling and patient involvement in research design.