Those who have physical disabilities such as being deaf, hard of hearing (HH), blind, or visually impaired have always faced more barriers to basic life necessities.
From employment biases to lack of education and accessibility of media, those with hearing and sight disabilities have had to overcome many different obstacles.
Not all rehab centers have programs specialized for people with visual and hearing impairments, and many barriers get in between these groups and their recovery.
However, some facilities are working toward meeting the needs of those who are deaf or blind, and there are methods of treatment that can be very effective for these individuals.
Treatment Methods For Those Who Hard Of Hearing Or Visually Impaired
Many treatment centers have the training, equipment, and accessibility to provide specialized treatment for people who are deaf, HH, visually impaired, or blind.
These treatment programs may feature the same treatments but use different methods of communication.
People who are visually impaired and deaf or HH should receive the full continuum of care, including:
- inpatient or outpatient care
- group, individual, and family therapy
- aftercare planning services
Addiction Treatment For Those Who Are Deaf And Hard Of Hearing
Rehab programs that treat individuals who are deaf or hard of hearing use American Sign Language (ASL) in every service or activity.
ASL may be used in the following ways:
- individual counseling sessions: the therapist may be trained in ASL, or have an interpreter in the room to communicate with their clients.
- group discussion and therapy: there will be an interpreter present who can ensure a deaf or HH client understands the discussion.
- video materials: if video materials are used, treatment centers that offer services for individuals who are deaf or HH will provide closed captioning or ASL interpretation.
These treatment centers will also use ASL to effectively communicate the process of withdrawal, recovery, and stages of relapse during treatment.
Many people who are deaf or HH were never educated on substance abuse. For this reason, many programs will spend more time explaining what to expect from recovery mentally and physically.
Additionally, visual materials are used whenever possible, such as pictures and videos with closed captions.
There may also be specialized groups to discuss the psychosocial, physical, mental, and emotional issues that affect people who are deaf or HH with addiction issues.
Addiction Treatment For The Visually Impaired
As with those who are deaf or HH, treatment programs for people with visual impairments largely consist of the same level of treatment and services as those available for non-visually impaired people.
Their programs may be tweaked to include:
- fewer visual materials and more audio-based materials
- braille for any written materials
- the use of service animals
- navigational features to aid individuals with visual impairments traveling around the facility and treatment rooms
- alternatives to sight-based treatments
- groups set aside for individuals who are visually impaired to discuss the unique challenges this group faces with substance abuse
- peer support and mentoring that connects those who are visually impaired
Resources For Those Who Are Those Who Are Deaf And Blind
Finding addiction treatment can be difficult, especially when not all programs have services to meet your needs as a deaf, HH, blind, or visually impaired person.
The resources below can help you to take the next step toward finding help by learning about addiction and knowing your options for treatment.
Finding A Treatment Program
The first thing you’ll need to do is find a treatment program that can help if you’re overcoming addiction.
The following resources can offer assistance:
- FindTreatment.gov: Use this government website to find treatment centers, learn about your options in addiction recovery, and find more information related to addiction.
- SAMHSA Behavioral Health Treatment Services Locator: This tool can be used to find mental health and substance abuse treatment centers near you.
- U.S. Department of Veterans Affairs (VA): The VA offers resources for those who are blind and have low vision, have hearing loss, and need mental health or substance abuse treatment.
Financing Your Treatment Program
There are many government-funded resources for primary health, mental health, and substance abuse treatment.
These government-funded programs can offer assistance to those who are deaf or blind:
- Medicaid: those who are deaf, HH, visually impaired, or blind, qualify for benefits from Medicaid, which covers substance abuse treatment (covered services vary for each state).
- SAMHSA block grants: these grants provide funds for certain qualifying individuals to receive substance abuse treatment.
- Lions Vision Resource Network Grants: grants are available for improving quality of life, transportation services, seeing aids, medical aids, and more.
There are several organizations dedicated to advocating for the rights of blind and deaf individuals and increasing accessibility of services such as substance abuse treatment.
- American Council of the Blind (ACB): The ACB provides programs, scholarships, supportive resources, and more for those with vision loss and blindness.
- American Foundation for the Blind (AFB): Find information on education, employment, news, and events important to those who are blind or visually impaired.
- My Blind Spot: This is a place for people of all visual abilities to arm themselves with resources on inclusion, empowerment, and accessibility.
- National Family Association for DeafBlind: This organization supports families with individuals who are deaf-blind, a combination of both sight and hearing loss.
Housing can often be a barrier to getting addiction treatment, but there are a number of resources available to those who are blind, visually impaired, deaf, and HH.
Housing assistance is available through:
- Housing Finance Agency: Low- and middle-income households can find financing options here for affordable housing.
- Section 811 Supportive Housing for Persons with Disabilities: This program provides housing for people with disabilities by subsidizing rental properties.
- Specially Adapted Housing Grant: The VA offers this grant for service members and veterans who have service-related disabilities, including blindness and hearing loss.
If you need assistance locating a job or with vocational training, there are multiple organizations and resources available to you.
Employment resources for deaf and blind individuals include:
- ACB Job Connection: find nationwide job announcements.
- AFB Employment Initiatives: webinars, training programs, disability employment research, and more are available on the AFB website.
- National Association of the Deaf (NAD) National Employment Resource Center for the Deaf and Hard of Hearing: find jobs, tips, vocational rehabilitation, and more.
- National Industries for the Blind (NIB): this is an employment resource for those who are blind in the U.S. They also help veterans and service members.
- Tommy Nobis Center: this organization provides services in vocational evaluation, skills training, employment, and more for individuals with disabilities.
Oftentimes, it’s helpful to be in a community with like-minded individuals who can offer support through your journey to recovery from mental illness, addiction, or another challenge.
Find peer support with:
- ACB Peer Support and Mentoring: this organization offers mentoring and peer support with more than 20 affiliates and committees.
- AG Bell Association for the Deaf and Hard of Hearing chapters: these support groups provide services to communities across the U.S.
- Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous: these are 12-step groups offer support for those overcoming addiction.
- Hearing Loss Association of America (HLAA) support groups: this organization offers in-person and virtual meetings across the nation for those with hearing loss.
- Helen Keller National Center for Deaf-Blind Youth and Adults (HKNC) support groups: groups for women, men, young adults, and more are offered through the HKNC.
- National Center on Deaf-Blindness(NCDB) Peer-Learning Communities: peer-learning communities help children who are deaf-blind and their families.
Barriers To Treatment For Those Who Are Deaf And Blind
A person who is deaf or blind must overcome certain barriers that peers who are not visually impaired, deaf, or HH might have when it comes to treatment for substance use disorders (SUD).
Research from the Substance Abuse and Mental Health Services Administration (SAMHSA) has identified three primary barriers to SUD treatment:
- negative attitudes and prejudices
- lack of staff training
- inaccessibility of treatment
Negative Attitudes And Prejudices
The SAMHSA report revealed that some vocational rehabilitation (VR) counselors who work with people who are hard of hearing or visually impaired express a negative point of view for those with SUDs.
These VR counselors have expressed that clients with disabilities are “not worthy” of SUD treatment, arguing that people with these co-occurring issues have poor outcomes.
With such a stigma in place, it’s then difficult for a person who is blind or deaf to express a need for addiction treatment or believe they need treatment at all.
This creates a negative cycle of prejudices and silent struggles with substances that keep these individuals from seeking help.
Lack Of Staff Training
Unfortunately, many treatment providers are not trained on how to effectively treat people who are deaf, hard of hearing, or visually impaired.
When this is the case at a rehab center, if a person who is blind or deaf does seek treatment, they’re still not getting the proper care they need to successfully overcome addiction.
For example, if a treatment center focuses heavily on group or individual counseling, but has no one to interpret with sign language for someone who’s hard of hearing or deaf, that person can’t benefit from the counseling session.
The report from SAMHSA communicated two important needs: VR counselors reported needing more training on SUD clients, and SUD providers need more training on clients with impairments.
Inaccessibility Of Treatment
Deaf, HH, blind, and visually impaired clients need extra support to reap the full benefits of their treatment program.
Depending on the person, this might include:
- sign language interpreters
- extra large font materials
- bright colors, different materials, and textures
- handrails for stairways
- more written materials for those who are deaf or HH
- transportation services
Oftentimes, facilities are built to fit the needs of those who can see and hear well. A person who doesn’t have the same level of ability will struggle to thrive in this type of environment.
Many treatment centers claim to be handicapped-accessible, providing ramps for those in wheelchairs, but don’t have many options for people who are visually impaired or HH.
There are an estimated 500,000 Americans who use ASL, yet there are very few medical and addiction treatment providers who use ASL to communicate with clients.
Unique Risk Factors For People Who Are Deaf Or Blind
In addition to the risk factors of substance abuse in any population — socioeconomic factors, trauma, mental illness — people who are hard of hearing or visually impaired have other risks to consider.
Mental Health Challenges
Mental illness poses a great risk to developing substance abuse across all populations. For those who are deaf, blind, HH, and visually impaired, this risk is intensified.
According to several studies, people who are deaf or hard of hearing see a higher prevalence of mental health problems than the general U.S. population.
And among the visually impaired community, research indicates a much higher rate of depression and anxiety than the general population.
The corroboration between mental illnesses and substance use disorders is significant: About 38% of adults with a SUD also have a mental illness.
As people who have hearing and visual impairments are seeing higher rates of mental illness, substance abuse is statistically likely to follow suit for many.
This presents an important understanding of this community and calls for a greater need for mental health treatment among people who are blind and deaf.
Lack Of Medical Insurance
According to 2018 data, one in 10 people who are deaf or HH did not have health insurance.
And according to research published by the National Council on Disability (NCD), people with disabilities have health disparities and problems in gaining access to appropriate health care.
Those who are deaf or hard of hearing are three times as likely to have health issues than those who are not hard of hearing. People who are visually impaired smoke more than the general population.
But the NCD argues that these issues are not seen or addressed by medical and mental health providers.
Issues include proper access to prevention and treatment services for substance abuse, as well as coverage of necessary prescriptions, long-term care, medical equipment, and more.
Those who are blind or deaf may need assistive technologies to help them live their daily lives and participate in addiction treatment programs.
If they’re unable to get health insurance that covers these necessities due to lack of employment, unaffordability, or another factor, they’re at a significant disadvantage for treatment.
Enabling From Family Members And Caregivers
Caregivers, treatment providers, friends, and loved ones often unintentionally enable people who are blind, visually impaired, deaf, or hard of hearing to continue abusing substances.
One study examining treatment issues for those with disabilities found that treatment providers often make the following assumptions:
- people with disabilities do not abuse substances
- a person with a disability will make other clients uncomfortable
- clients with disabilities deserve pity, and therefore need more leeway when it comes to substance use
Loved ones may also look the other way or make excuses for a person who’s visually impaired or hard of hearing when they’re abusing substances, enabling them to continue their addiction.
This type of attitude deters people who are deaf, HH, blind, and visually impaired from getting treatment, or from getting the full benefit of their program if they’re in treatment.
Financial Stress And Unemployment
Unemployment poses a significant risk to addiction, as it curbs morale, makes people feel as if they have no use or purpose, and offers no means to escape poor living conditions.
But for the blind and deaf community, this is a reality they’re faced with every day.
In 2017, 53% of people who are deaf were unemployed, as compared to 75.8% of the U.S. hearing population. In the same year, 44% of those with visual impairments were employed.
Researchers have concluded that financial stress and unemployment are directly linked to heavy alcohol consumption (particularly among older men and those with less education).
People who are blind or deaf experience lower quality education in school and medical facilities.
Not only do these groups have barriers to education in their school systems (only 51% of people who are deaf go to college), but they don’t get proper education from treatment providers.
In primary care offices, mental health clinics, substance abuse educational classes, and more, information is widely communicated via standard printed materials or videos without captions.
Those who are hearing and visually impaired are unable to reach the same level of education about their bodies, health care, treatment, and diseases as their non-impaired counterparts.
This lack of education can lead to low socioeconomic standing, employment issues, knowledge about substance abuse and mental health, life skills, vocational training, and much more.
Increasing The Accessibility Of Treatment Facilities
The first step to increasing the accessibility of addiction treatment for those who are blind, visually impaired, deaf, or HH is raising awareness.
Individuals with hearing or visual impairments, family members, treatment providers, and others need to be educated on the reality of addiction and how to offer accessible treatment.
If staff is not trained on how to offer programs that meet the needs of their deaf, HH, blind, or visually impaired clients, these individuals are at a major disadvantage to achieving long-term sobriety.
There are many small and big changes that facilities can implement to make their programs more accessible for these individuals, and it all starts with conversations to ignite change.Article Sources
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- National Council on Disability — The Current State of Health Care for People with Disabilities
- National Deaf Center on Postsecondary Outcomes — Deaf People and Educational Attainment in the United States: 2017
- National Deaf Center on Postsecondary Outcomes – DEAF PEOPLE AND EMPLOYMENT IN THE UNITED STATES: 2019
- National Institute on Drug Abuse — Comorbidity: Substance Use and Other Mental Disorders
- Substance Abuse and Mental Health Services Administration — Substance Use Disorders in People With Physical and Sensory Disabilities
- U.S. National Library of Medicine — Addiction Treatment with Deaf and Hard of Hearing People: An Application of the CENAPS Model
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