I. Mission Statement

The mission of the SWVA Regional Deaf Services Program is to provide Deaf, Hard-of-Hearing, and DeafBlind persons living in Southwest Virginia access to mental health, substance abuse, and mental retardation services that are culturally sensitive and delivered in the preferred communication method of the consumer.

II. Program Philosophy

It is the program’s philosophy that the laws and regulations that require public entities to provide fully accessible services to person’s with a disability only provide a starting point for delivering truly equal human services. Although the involvement of a sign language interpreter in a therapy session with a deaf individual, for example, may meet the requirements of the law, it does not allow the person to communicate directly with the therapist, a benefit that is expected by persons who are hearing. The program desires to shift the focus of the consumer’s experience away from communication and towards assisting consumers in meeting their individual goals. The program will attempt to fulfill the mission statement by providing:

• Direct clinical services such as therapy, case management, psychiatric medication services, and crisis services.
• Consultation and education to the professional service community, particularly Community Services Boards in the region.
• Education to the community.

There are many controversial cultural issues within the deaf community. There are also controversies between the deaf community and the hearing community. The controversies are wide-ranging, and like many cultural issues, elicit strong emotions from persons involved. These issues include the best way to educate a deaf child, the option of receiving a cochlear implant, and the use of a person’s voice versus the use of sign language. The Deaf Services Program does not intend to represent a particular view on these types of issues. When providing education and consultation to the CSBs or to the community, the program intends to provide the many facets of a situation in a factual manner based on experience and professional literature. The program does, however, operate from the perspective that being deaf is not a pathology and staff will attempt to “de-pathologize” deafness when conducting education. The program recognizes that being deaf is commonly experienced as a cultural phenomenon and that this perspective can greatly promote self-esteem and healthy living.

III. Program Population

The Deaf Services Program is intended to serve persons with a hearing loss of all ages living in Southwest Virginia who have been assessed with a mental health, mental retardation and/or substance abuse need. To the greatest extent possible, the program will also serve persons assessed with a mental health, mental retardation and/or substance abuse need whose lives are impacted by a hearing loss. This may include, for example, a hearing child of deaf parents whose primary mode of communication is American Sign Language. The program does not intend to functionally define the terms deaf, hard of hearing or deafblind as these terms are used to describe both physical and cultural experiences. The phrase “persons who are deaf, hard of hearing, or deafblind” will be used throughout this program description to refer to the primary population served by this program. Although this program should be made known to persons who are deaf, hard of hearing, or deafblind, the use of the program should be based on consumer desire. A deaf woman who reads lips and uses her voice, for example, may desire to use local mental health, substance abuse, or mental retardation services in lieu of this program. For the purpose of this program, Southwest Virginia is defined as those living in the catchment areas of the following Community Services Boards:

• Cumberland Mountain CSB: Tazewell, Buchanan, and Russell County
• Dickenson County Behavioral Health: Dickenson County
• Highlands CSB: Washington County, City of Bristol
• Mt. Rogers CSB: Smyth, Wythe, Grayson, Carroll and Bland County, City of Galax
• Planning District One: Lee, Scott, Wise County, City of Norton

IV. Program Services

The long term goal of the Deaf Services Program is to provide persons who are deaf, hard of hearing or deafblind the same range of services offered to persons who hear. Because of the size of Southwest Virginia, the comprehensive nature of services currently provided to hearing persons, and limited program staff, this program must initially limit the extent of direct clinical services. The program currently provides outpatient counseling services, psychiatric services and medication clinic, crisis services, case management services, mental health support services (in the area of Lebanon, VA) and consultation.

Out-Patient Counseling

Providing individual mental health and substance abuse counseling services is a cornerstone of the Deaf Services Program. Program staff make every effort to communicate in the preferred communication mode of the consumer. Although program staff are fluent in American Sign Language, Signed English, spoken English, and can use different “simultaneous communication” methods, the program recognizes that some clients use home signs or other methods of communication in which the staff is not proficient. In these cases, staff will employ a certified interpreter, or a Certified Deaf Interpreter (CDI), to facilitate communication.

Psychiatric Evaluations and Medication Clinic

Those persons who are opened in the Deaf Services Program will have access to a psychiatrist who will provide the customary range of services that CMCS currently provides to hearing consumers. Regular times for medication clinic have been established for consumers of the Deaf Services Program. The program is proud to have a psychiatrist, Dr. Jana Dreyzehner, on the team who has experience working with persons with a hearing loss and is able to deliver services in sign language.

Case Management Services

Case Management services are designed to help persons with a mental health, mental retardation or substance abuse issues address problems of independence and daily living. Case management services include monitoring mental health symptoms, assisting with medications, coordinating medical and other service needs, advocating to make community resources accessible, problem solving relationship issues, assistance coping with mental health symptoms, supportive counseling, assistance with budgeting and daily living skills and other needs.

Crisis Services

Mental Health crisis services are available 24 hours a day, 7 days a week to persons who are deaf, hard of hearing and deafblind. The nature of the service provided is dependent upon the specific situation and the nature of the crisis. Crisis services after normal working hours and on weekends are accessed by following the local procedures established for a particular Community Services Board catchment area. The local CSB crisis worker when learner that the caller or individual in crisis is deaf will contact the on-call staff member from the Regional Deaf Services Program for clinical support. After hours crisis services are focused on assessing the individual’s capacity to take care of themselves and remain safe until an outpatient appointment can be sought during normal working hours. Where this is not possible the service focuses on assisting the individual in accessing an appropriate level of inpatient care.

Consultation and Education

The Deaf Services Program will provide consultation and education services to the professional service community and to Community Services Boards in Southwest Virginia. The extent of consultation and the range of this service will be determined on a case-by-case basis. The program will also provide education concerning deafness, deaf culture, sign language, and other topics to the staff of CSBs in Southwest Virginia.

V. Delivery of Services

This section of the program description is intended to provide a procedural foundation for the delivery of services. These procedures will be adapted and modified based on collective experience. Questions or suggestions for improving the delivery of services are welcome and may be directed to the Deaf Services Coordinator or to the Director of Mental Health Services at Cumberland Mountain Community Services.

Location of Services

Staff of the Deaf Services Program are based in the Lebanon, Virginia satellite office of Cumberland Mountain Community Services. Program staff providing therapy and case management are routinely available, however, to meet consumers in the Community Services Board office or facility closest to the location of the consumer. In many situations, case managers visit consumers in their homes, at school, or in other community locations. The only service that is exclusively available in Lebanon, VA is psychiatric evaluations and medication clinic. Program staff often assist consumers by arranging transportation or actually transporting them to Lebanon for this service, or in some cases by arranging for consumers to see the doctor through the Appal-Link Telepsychiatry Network. The “Appal-Link” is a high speed teleconferencing system available in over 10 locations in SWVA. Using this system, a person can go into their local Community Services Board office and still meet “face to face” with the doctor located in Lebanon.

Program Referals

Requests for services may come to the Deaf Services Program in different ways:

• Requests for services may come from an individual, family member, or professional service agency in the community.
• Community Services Boards may refer consumers to the program by contacting the Coordinator of Deaf Services.

Psychiatric Evaluations and Medication Clinic

• Requests for consultation may be made directly to the Deaf Services Coordinator.