Tyler G James, Michael S Argenyi, Donna L Guardino, Michael M McKee, Jaime A B Wilson, Meagan K Sullivan, Eiryn Griest Schwartzman, Melissa L Anderson
{"title":"Communication Access In Mental Health And Substance Use Treatment Facilities For Deaf American Sign Language Users.","authors":"Tyler G James, Michael S Argenyi, Donna L Guardino, Michael M McKee, Jaime A B Wilson, Meagan K Sullivan, Eiryn Griest Schwartzman, Melissa L Anderson","doi":"10.1377/hlthaff.2022.00408","DOIUrl":null,"url":null,"abstract":"<p><p>Deaf and hard of hearing (DHH) American Sign Language users experience significant mental health-related disparities compared with non-DHH English speakers. Yet there is little empirical evidence documenting this priority population's communication access in mental health and substance use treatment facilities. This study measured mental health and substance use treatment facilities' noncompliance to Section 1557 of the Affordable Care Act (ACA), which requires health care facilities receiving government funds to provide effective communication access, such as a sign language interpreter, to DHH patients. Using nationally representative data from the Substance Abuse and Mental Health Services Administration, we found that 41 percent of mental health facilities and 59 percent of substance use treatment facilities receiving public funds reported not providing services in sign language in 2019 and were thus noncompliant with the ACA's mandate to provide accessible communication to DHH patients. We mapped these data to display state-level noncompliance, and we make detailed recommendations at the policy, facility, and provider levels. These include monitoring noncompliance among government-funded facilities, expanding state-by-state mental health licensure reciprocity and telehealth policies to improve access to American Sign Language-fluent mental health professionals and addiction counselors, establishing systematic processes to collect information on disability-related accommodation needs, and increasing the workforce of DHH American Sign Language-fluent providers.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"1413-1422"},"PeriodicalIF":0.0000,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"7","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health affairs (Project Hope)","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1377/hlthaff.2022.00408","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 7
Abstract
Deaf and hard of hearing (DHH) American Sign Language users experience significant mental health-related disparities compared with non-DHH English speakers. Yet there is little empirical evidence documenting this priority population's communication access in mental health and substance use treatment facilities. This study measured mental health and substance use treatment facilities' noncompliance to Section 1557 of the Affordable Care Act (ACA), which requires health care facilities receiving government funds to provide effective communication access, such as a sign language interpreter, to DHH patients. Using nationally representative data from the Substance Abuse and Mental Health Services Administration, we found that 41 percent of mental health facilities and 59 percent of substance use treatment facilities receiving public funds reported not providing services in sign language in 2019 and were thus noncompliant with the ACA's mandate to provide accessible communication to DHH patients. We mapped these data to display state-level noncompliance, and we make detailed recommendations at the policy, facility, and provider levels. These include monitoring noncompliance among government-funded facilities, expanding state-by-state mental health licensure reciprocity and telehealth policies to improve access to American Sign Language-fluent mental health professionals and addiction counselors, establishing systematic processes to collect information on disability-related accommodation needs, and increasing the workforce of DHH American Sign Language-fluent providers.
聋人和重听(DHH)美国手语使用者与非DHH英语使用者相比,经历了显著的心理健康差异。然而,很少有经验证据证明这一重点人群在精神卫生和药物使用治疗设施中的沟通渠道。本研究测量了精神健康和药物使用治疗机构不遵守《平价医疗法案》(ACA)第1557节的情况,该法案要求接受政府资金的医疗机构为DHH患者提供有效的沟通渠道,如手语翻译。利用美国药物滥用和精神卫生服务管理局(Substance Abuse and Mental Health Services Administration)具有全国代表性的数据,我们发现,41%的精神卫生机构和59%的接受公共资金的药物使用治疗机构报告称,2019年没有提供手语服务,因此不符合《平价医疗法案》为DHH患者提供无障碍沟通的规定。我们将这些数据映射到显示州一级的不遵守情况,并在政策、设施和提供者级别上提出详细的建议。这些措施包括监测政府资助机构的违规行为,扩大各州精神卫生执照互惠和远程医疗政策,以改善获得美国手语流利的精神卫生专业人员和成瘾咨询师的机会,建立系统的流程来收集与残疾有关的住宿需求信息,以及增加DHH美国手语流利的提供者的劳动力。