Abstract

Background. The evidence base that has been established for hearing persons has demonstrated that experiences of hallucinations and delusions are shaped by the individual’s context and the culture of their local community (e.g., Kent & Wahass, 1996; Stompe et al., 2006;Yamada, Barrio, Morrison, Sewell, & Jeste, 2006). The Deaf community has a distinct culture to the general British population, carrying with it different beliefs and social rules for living. However there is no research exploring the specific content and themes of hallucinations and delusions for deaf persons despite an understanding that; a) the content of these experiences reflect individual context and culture for hearing persons; and b) the personal meaning ascribed to these experiences (i.e., content reflecting their local culture and community) is necessary to understand the individual’s feelings, distress and associated behaviours (Chadwick, Birchwood, & Trower, 1996; Strauss, 1991).

Study Aims. The aim of the current study was to explore d/Deaf adults’ experiences of hallucinations and/or delusions within the context of unique experiences of being d/Deaf and Deaf culture.

Method. Multiple Sequential Functional Analysis (MSFA), a structured case study approach was used to track the developmental nature of hallucinations and/or delusions in a sample of three d/Deaf men from a secure specialist Deaf service. Multiple data sources were collected for each individual; participant interviews, file reviews and interviews with a professional. The data was triangulated to develop MSFA sequences of the individual case histories. An across-case analysis was also conducted of the MSFA sequences that intended to identify common themes that were shared across the participants. Thematic analysis was used as a structured approach to identifying shared themes in the across case analysis.

Results. The analysis identified two key findings. Firstly, unique experiences of being deaf and Deaf culture appeared to shape the content and themes of delusions with regards to delusions of grandeur. The second important finding was that there was a lack of information regarding the content of hallucinations for all the participants despite access to 113 documents in the file review process. It was therefore not possible to analyse how the content and themes of hallucinations were shaped based on the individuals learning history and unique experiences of being d/Deaf.

Conclusions. The lack of content specificity indicates a clear clinical implication that we need to better understand how to support d/Deaf individuals in psychiatric services to understand and communicate their inner experiences. The significance in understanding the personal meaning of hallucinations for clinical interventions is acknowledged within hearing mental health (e.g. Chadwick et al., 1996) yet there appears to be barriers in accessing this information for d/Deaf persons in secure psychiatric services.