Mental Health Center program helps medical students understand deaf patients’ issues

(From left): Howard University medical students Ngozi Efobi and Anthony Gikonyo are shown at Gallaudet’s Mental Health Center with Houston Macintosh, M.D., MHC psychiatrist, and Mary Hufnell, Psy.D., MHC coordinator of training. For almost four years, third-year medical students at Howard have spent one day per week for six weeks at the MHC, learning survival signs and becoming informed about deaf culture.

For almost four years now, third-year medical students at Howard have spent one day per week for six weeks at the MHC, learning survival signs and becoming informed about deaf culture. They observe a psychiatrist conducting therapy sessions with deaf clients, and they join in on case conferences. An estimated 50 students have taken part in the program to date.

This effort in helping medical students become more informed about the deaf community is the result of a joint effort by Dr. Barbara Brauer, a psychologist and MHC executive director, and Dr. Luther Robinson, a psychiatrist, both pioneers in the field of mental health and deafness.

Robinson is credited with establishing a program for deaf patients in 1963 at St. Elizabeths Hospital, the city of Washington, D.C.’s, mental health facility. He is officially retired from Howard but continues to serve the university as associate professor emeritus.

When Robinson learned that Gallaudet was establishing its Mental Health Clinic in 1994, 'I felt it would be inconceivable for the training program to be there and our medical students or residents not to have some involvement in it,' he said. The following year he contacted Brauer and the idea for the collaboration was born.

When they enter the program, the medical students are tested on their knowledge of the deaf community. Then a regimen starts with an hour of basic sign language training and insights on deaf culture led by an MHC staff member or a graduate student in the program. They move on to issues that are unique to deaf patients: accessibility, use of an interpreter, the specific needs of various groups of people with hearing loss–culturally deaf, hard of hearing, or late deafened, for example.

The students also meet for several hours with Dr. Houston Macintosh, a psychiatrist with a private practice who for the past five years has worked with the MHC, diagnosing patients and prescribing medication. The students–usually only one at a time–observe, but do not interact, when Macintosh meets with patients, providing that the patients agree to be observed. They end their days at a case conference, where staff come together to discuss the week’s cases and specific clinical issues related to deaf patients.

At the end of the six-week rotation, the Howard medical students are tested again on their knowledge of deafness. 'They pick up quite a bit,' said Dr. Lauri Rush, director of clinical services for the MHC. 'Most of them are fascinated with the issues.'

According to Dr. Brauer, 'Because the MHC program is often the medical students’ first exposure to deafness and deaf people, the hope is that they will become better and more knowledgeable physicians for any future deaf patients they may have.' She added that another goal is to initiate a similar rotation program for psychiatric residents, not only from Howard University but also from Johns Hopkins and other local teaching hospitals. Brauer added that this fall, a psychiatric resident from the George Washington University Medical Center will join the MHC as part of her residency training.

'I feel that what we have our medical students doing with deaf patients is enhancing the students’ knowledge and skill working in the psychiatric field–deaf and hearing,' said Robinson. In particular, he added, 'I see the experience at Gallaudet to be quite beneficial in stimulating medical students’ interest in the psychiatric/mental health problems of deaf patients. Students who are assigned there express a great deal of interest in the program and indicate learning benefits.'