Lisa Amstutz earned her Qualified Mental Health Interpreter Certification earlier this month, making her the second American Sign Language interpreter in Kentucky to do so. The credential is part of a crucial effort to bridge the gap between Deaf mental health care needs and barriers to access.
The certification is typically held by experienced interpreters who have already demonstrated particularly high competence in general interpreting. A progeny of Alabama’s Mental Health Interpreting Project, the certification is earned through practicum experience focused on broadening the interpreter’s knowledge of mental health conditions and treatments so that the most effective interpretation can be made in crisis and mental health care settings.
A common misconception about American Sign Language (ASL) is that it is simply English on the hands, when in fact, ASL is a full language with its own grammar, syntax, idioms and means of expression. A question asked in English may need to be altered to make conceptual sense in ASL, and likewise, a sentiment expressed in ASL may need to be altered from a direct translation to hold true to its intended tone in English. Because of this, a qualified ASL interpreter is a non-negotiable requisite to effective mental health care for those who use ASL as their primary language.
An estimated one in five adults in the United States is living with a mental illness, and research repeatedly shows that this rate is significantly higher among Deaf and hard-of-hearing individuals. A statement from the National Association of the Deaf cites that “mental health disorders for deaf signers, including depression and anxiety, occur at a much higher rate, usually in the magnitude of two times higher than what is typically seen in the hearing population.”
Amstutz explains that one cause of this is related to language deprivation, which occurs when a child is not given full access to language in the first few years of life. Language deprivation has long-term effects on neurological development, affecting the child’s ability to develop language skills needed for fluent communication later in life, oft in turn leading to emotional distress and behavioral health issues.
Over 90% of deaf children are born to hearing parents, and the vast majority of those parents do not learn sign language. Language deprivation research indicates that assistive hearing devices such (hearing aids and cochlear implants) are “insufficient as a stand-alone approach for language acquisition in deaf children,” sign language is scarcely proposed to parents as a solution for language acquisition.
According to a Boston University article, “The developing brain responds to language no matter how it is presented, so exposure to ASL is equivalent to exposure to a spoken language.” Still, the article goes on, “Perhaps as many as 70 percent [of deaf children] are deprived of language.”
Another major factor affecting the prevalence of mental health conditions among ASL users is the barrier to accessing mental health care at all, along with fears of communication barriers leading to undesirable outcomes such as misdiagnoses or involuntary admission to psychiatric units.
This Verywell Mind article illustrates an example of how a deaf person may pound on the floor to get another person’s attention, which is an accepted action within the Deaf community but may be perceived as aggressive by a hearing person.
According to Amstutz, ASL interpreters are trained to routinely “clean up” one language to make it make sense in the other. But what if, say, the patient is experiencing psychosis, and by cleaning up the language as the interpreter typically would, the clinician in turn misses key indicators of the condition? In mental health interpreting, Amstutz explains, interpreters have a unique role in ensuring the clinician has all information needed to make a diagnosis or set a treatment plan.
“We bear a great responsibility, because we are, a lot of times, the only person in the room that knows something here is not right,” Amstutz said.
Amstutz says her new certification will be helpful in establishing herself as a core part of the ASL user’s care team in settings with other professionals “who have long viewed us as ‘helpers.’”
Amstutz has long demonstrated her passion for mental health care access, even predating her work as an interpreter. When she first began college, she intended to become a child mental health therapist. Later, she realized her best fit as a crucial advocate in mental health as an ASL interpreter.
“Working on this credential has stretched me professionally and is helping me realize a lifelong dream, “Amstutz said. “I’ve worked in mental health settings for most of my 29 years of working as an ASL interpreter, and since my first mental health interpreter training experience in 2018, I knew pursuing the [certification] was something I wanted to do.”
Amstutz is a part of the Kentucky Office of Vocational Rehabilitation ASL Interpreting Team which is employed by the UK Human Development Institute to serve its Deaf and hard-of-hearing consumers.
Please join the Human Development Institute in congratulating Amstutz on her new credential as a Qualified Mental Health Interpreter.