HDI’s Lisa Amstutz is Second in Kentucky to Earn Special Credential for Mental Health ASL Interpreting

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.

HDI Celebrates Developmental Disabilities Awareness Month 2023 with Amanda Stahl

HDI Celebrates Developmental Disability Awareness Month

This month (March), HDI celebrates Developmental Disability Awareness Month. For some people, that may lead to questions about what defines a developmental disability. Developmental disabilities are conditions that begin during development and usually last throughout a person’s life.

For Amanda Stahl, LCSW, it’s a wide spectrum. 

“It’s a disability that happens before the age of 18,” Stahl said. “A disability that affects your daily life skills. It affects your development, how you become who you are as a person.” 

But at the same time, Stahl stresses that there is a human being behind every label and every diagnosis. 

“In my work, I don’t focus only on definitions. I focus on people’s stories,” she said. 

As part of her work with Merge, an HDI project focused on improving mental health access for individuals with mental health conditions and developmental disabilities, she’s helping ensure those stories are told. 

Merge seeks to improve the mental health systems that support people with co-occurring mental health conditions, and intellectual and developmental disabilities. Stahl is one of the researchers interviewing people with lived experience for Merge. 

“Some of the work that I’m doing is going around Louisville and going around to different parts of the state and collecting people’s stories around their experiences with mental health and disability,” she said. “What were the good experiences they had, what were the negative experiences they’ve had, what would they want to recommend to other direct support professionals and providers?” 

Stahl thinks that isolation, loneliness, and societal expectations placed onto some people with disabilities can have a tremendous negative impact on the mental health of individuals with disabilities. 

“It’s not done on purpose,” she said, adding that some have difficulty find more positive ways to think about themselves until they find ways of building community and experiencing inclusion. “People with disabilities may be isolated from other people with disabilities, including older people with disabilities,”

She also noted that she sees patterns in the interviews she’s completed. For example, she finds that even experienced mental health providers can have difficulty working with people with developmental disabilities, especially those who are in more controlled environments. Sometimes individuals, she says, may not feel like they have the space to feel or process their emotions. Another thing that she noted is that a lot of individuals with lived experience feel like outsiders. 

“Knowing my own story, a lot of their stories are very similar,” Stahl said. “I felt like I was the only one until I met this one person.” 

Stahl hopes soon to do more research on individuals in day programs to get an even wider view on what the community’s needs are. From there, the information will be used to develop training that will be designed for individuals and providers around the state. 

“I’m trying to get stories from the most impacted people,” she said. Ms. Stahl stressed that people often underestimate others due to disability – something she says is a mistake. 

“There may be limitations to what someone can do,” she said. “But always assume people can do more than you think they can.”

Amanda Stahl, LCSW, is a Disability and LGBTQ+ Activist from Louisville, Kentucky. Amanda is the lead organizer and director of a non-profit organization called the Independence Seekers Project (ISP), organized and developed by people with intellectual and developmental disabilities.

Merge Logo.

HDI introduces new mental health project: Merge

The University of Kentucky Human Development Institute introduces a new project: Merge. The project will strengthen the existing training framework serving Kentuckians with co-occurring mental health, and intellectual and developmental disabilities (MHIDD). By evolving current training, Merge aims to increase and improve the application of person-centered services and referral systems. 

Merge hopes to build stronger connections across systems in Kentucky, including state agencies, medical providers, medical service providers, LEND trainees, families, and individuals with MHIDD.

Merge will work with a team of state partners that includes people with lived experience. This team will identify existing resources, needs, gaps, and priorities. Existing resources will be strengthened and will address racial, health, and economic inequities in underserved communities. Once gaps and needs are identified, universally-designed supports will build a trauma-informed, and recovery-oriented framework for application. These efforts help fulfill Merge’s goal to increase understanding and improve the implementation of person-centered, culturally relevant services and referral systems.

For more information, contact Kristen Dahl at kristen.dahl@uky.edu.

Photo of Mineral Industries Building with UK blue overlay and UK HDI logo in white

HDI Receives Notice of Awards

The University of Kentucky Human Development Institute (HDI) received notice of award of a five-year grant from the Administration for Community Living to better serve Kentuckians who experience co-occurring mental health and intellectual and developmental disabilities. The Kentucky Mental Health, Intellectual and Developmental Disabilities (KY-MHIDD) Training Initiative will let us hone our work from the National Training Initiative that was co-lead with Utah State and Alaska. The goal is to increase understanding and improve implementation of person-centered, culturally relevant services and referral systems. Existing supports will be strengthened and integrated, addressing racial, health (including COVID-19 pandemic), and economic inequities in underserved communities. This is a partnership grant that includes people with disabilities, family members, state agencies, organizations and other stakeholders. Kristen Dahl, Dr. Chithra Adams and Dr. Kathy Sheppard-Jones will represent HDI in this important work.

The HDI is also working with the Child Neurology Foundation to review the materials they provide to help families and youth with intellectual and developmental disabilities navigate the transition from pediatric to adult healthcare system. Laura Butler, Bev Harp and contractors with HDI will review print and web-based content to identify accessibility issues and potentially ableist language or images. HDI will also conduct a training for Child Neurology Foundation staff and provide a resource guide for the development of new materials.

Kristen wearing a black and white gingham shirt smiling in front of a tree trunk. She has long, blonde hair and is wearing berry lipstick

Dahl to Co-Chair AUCD Special Interest Group

Kristen Dahl, LPCC, CHES, has been selected to co-Chair the Mental Health Aspects of I/DD Special Interest Group of the Association of University Centers on Disabilities (AUCD). This group provides information on critical issues related to mental health for people with intellectual and/or developmental disabilities (IDD). Their vision is to promote inclusion and belonging for all people with IDD and MH needs. Learn more about this group and their resources on AUCD’s website.  

Kristen is the Senior Program Manager for the Mental Health Developmental Disabilities (MHDD) National Training Center.  The MHDD National Training Center is a collaboration between the University Centers for Excellence in Developmental Disabilities at the University of Kentucky, University of Alaska Anchorage, and Utah State University. Established in 2018 through funding provided by the Administration for Community Living, they work to improve mental health services and supports for people with developmental disabilities. By serving as a national clearinghouse, we help provide access to the most current evidence-based, trauma-informed, culturally responsive practices that address the mental health needs of individuals with developmental disabilities.

Contact Kristen.Dahl@uky.edu for more information.