I am delighted to say that I am back on the NRCPD register. Happy Christmas to me! See my entry here, and for the time being (hopefully a month or two) take note of the restrictions - I will be not accepting work in the criminal justice system, mental health settings or social care with legal content. Feel free to consider me for anything, but I will not be accepting assignments that lie outside of my official competence for a while.
That said - I am back! Hooray!
I was forwarded this today:
New Family Court rules - Vulnerable persons: participation in proceedings and giving evidence
These new rules, The Family Procedure (Amendment No.3) Rules 2017, and Practice Direction 3AA, came into effect on Monday, 27 November 2017. They set out a court's duty to consider how a party can participate in the proceedings (other than by way of giving evidence) and how a party or a witness can best give evidence.
Previously, these matters were pretty much left to the discretion of individual judges and how much effort was made by the lawyers (on both sides) to identify vulnerability and to adapt procedures to enable the person to participate fully and to give their best evidence.
Now, all courts are required to think about these matters, so the lawyers (on both sides) will have to apply their minds to the issues at the earliest stage. The court can then make Participation Directions and adjust things such as the structure and timing of the hearing, the formality of the language to be used, the way in which cross-examination takes place etc. Good news!
The Rules and Practice Direction can be found here
http://www.legislation.gov.uk/uksi/2017/1033/made/data.pdf
The ruling applies to "vulnerable" people, but I think the ruling can be applied to Deaf BSL users in court - see the definitions in paragraph 3A.7. part b) i) - who might not consider themselves, or be considered to be "vulnerable" beyond the requirement for appropriate interpreter support.
Of course it definitely applies to vulnerable Deaf people for whom appropriate interpreter support may be necessary but not sufficient for true access to the proceedings.
I am not a lawyer, but this is definitely one to watch.
I run every Saturday at Parke parkrun in Bovey Tracey. Parkruns are entirely voluntary and so there is no budget for interpreters if they are needed. I am happy to run at Parke, Exeter Riverside, Killerton (Update: or Exmouth) parkruns and interpret the run briefing for free for any Deaf runners if that is needed.
If you are Deaf and require access to the run briefing at any of these Parkruns, just ask via this contact form.
Well, there's a lot more to this story in The Herald than the press would have you believe.
Derriford Hospital have been trialling iPads with which non-signing hospital staff and signing patients and their families can communicate using SignLive's video remote interpreting service. It has proven to be problematic in some ways. Internet connectivity across the hospital site appears to be patchy (though I wonder if issuing a powerline extender with each iPad could be a simple workable solution), some patients are not used to or comfortable with tablet technology or remote interpreting for various reasons, and - perhaps most importantly - Deaf patients (and perhaps some interpreters) have become suspicious that the cheaper and more immediate SignLive provision is a way to cut costs, thus removing from the Deaf person the choice to have a live interpreter in the room with them.
Not mentioned in the article is the separate issue that the hospital trust has agreed a contract with an interpreting agency that has become extremely slow to pay the interpreters for work done on their behalf at the hospital. Some interpreters remain unpaid and many interpreters in the area have taken the difficult decision to not accept assignments from that agency because they need to make a living. The hospital trust is unable to make interpreter bookings directly with the interpreters or via other agencies because of their contractual commitment to this particular agency. The consequence of this is that it is very difficult for the trust to use live interpreters, and they are left with just the iPad/SignLive solution, which the end users are unfamiliar with and continues to suffer from snags.
I understand that the hospital trust is looking into that contract in an effort to resolve this failure of interpreter provision.
I think the trust should be commended for embracing video remote interpreting (VRI). The issue of their being locked into a contract with a provider of live interpreting that cannot deliver has become mixed up with the separate issue of VRI. It is important that the use of live interpreters and the use of VRI be considered separately. Yes VRI might be preferentially used by financially constrained public services but are they? I hope that the trust has an open and publicly accessible policy for when they do and do not offer VRI or live interpretation. Historically, when only live interpretation was available, Deaf patients would be highly unlikely to have interpreted access to their care in A&E, at reception, or anywhere a wait of a few days to a few weeks for an interpreter to become available would be inevitable. VRI in principle puts a sign language interpreter into places they have never been, and this is a widening of accessibility, not a narrowing.
There is a net narrowing at present in that hospital because of the problems with their chosen interpreting agency. Hopefully by being open about their interpreting policy and consulting with the local Deaf Community patients will see that VRI provides more access, not less.
My sister is a really good trainer on social care, and particularly the Care Act 2014. She has a background in Deafness as a care home manager for the RNID and continues to be highly Deaf-aware.
She has been delivering Care Act training since it became law, and has found that when Deaf people are being trained, the material and the training process is not as accessible as she would like. This is the case even with a Deaf-aware trainer and good, experienced interpreters with lots of preparation opportunity.
Alex MacNeil
She and I are looking at running a Care Act training day for Deaf people, which will be created from the beginning with Deaf people and BSL in mind (rather than interpreting a hearing course.) At this stage we are just trying to find out if that is something that people want.
There is no obligation to take part or do anything - but if you can let us know your thoughts, if you think there are enough people interested to set this up, or if you have your own ideas about how to make the Care Act accessible, please let us know. Comment below, or email, or use the contact options here.
This is a moving article from Karen Sinnott in The Journal via @JeminaNapier in which she talks about the experience of mental health care as a Deaf person in Ireland.
When you start to work with Deaf people with psychosis, as I did in 1996, you learn very quickly that 'deaf people with psychosis often hear voices', and it takes a long time (well - it took me a long time) to ask what does that mean and how do you know?
Diagnosing psychiatric disorder is hard. It is exponentially harder with a Deaf patient - even if you are a Deaf clinician - because the definition of schizophrenia (for example) is based upon statistical analyses of symptoms described at interview by hearing patients to hearing researchers, and so the diagnostic criteria come from a fundamentally hearing phenomenology of psychosis. A clinician will ask "do you hear voices" and the patient will say yes (or no). For hearing clinicians and patients what they each mean by the English word "voice" likely has considerable overlap, and - arguably - that answer suffices.
For a Deaf person, in a signed clinical interview, you do not have that shared vocabulary. Signing clinicians, or interpreters, have to make an interpreting decision about how to ask that question in BSL/ISL. Do you sign voice with a mouth-like handshape, or a V-hand? Where do you sign it? At the throat? Near the ear? In a neutral space (if there is one)? Is your sign more akin to talk as opposed to speak? Given time and care, you need to ask a series of many specific questions about the language of the 'voice', the modality, the location, the patient's confidence in their own description and so on, and then base the diagnosis on that. If you are interviewing via an interpreter, that whole process becomes all the more complicated, and potentially also opaque. My friend, and genius, Jo Atkinson has researched this and published on it, for example here.
But to me it leads to more fundamental questions about the nature of communication and interaction. Is it sufficient to assume that the person means the same thing as you when you say "voice"? We naturally do this in conversation; we use highly familiar catch-all terms that, because we use them all the time, we assume that any pair of us means the same thing by that word. Only much later on in the conversation, if at all, do we realise we have been talking at cross-purposes.
What does your Deaf patient mean when they report 'hearing voices'?
And why, when we are super-cautious about taking as read the patient's claim of being followed at all times, or of being an African prince, are we so wiling to accept at face value their claim to be hearing voices?
NOTE: This post is in no way intended to doubt Karen's own account of her own particular experiences. Rather I thank her for her important and courageous article, and the opportunity it presents to me to raise broader questions.