**3. Mental health, and professional and social participation in deaf adults**

Given the reported psychosocial challenges experienced by young deaf participants, attempts to attain and maintain quality of life in adulthood are perhaps more difficult for deaf individuals than for individuals without a disability. Chronic unemployment, underemployment, and maintaining employment are problems for many deaf adults (Hogan et al., 2009a; Punch, Hyde, & Creed, 2004; Rosengreen, Saladin, & Hansmann, 2009). For example, a disproportionately high 45 percent of unemployed deaf Australians were deaf before 20 years old (Hogan, O'Loughlin, Davis, A., & Kendig, 2009a). Moreover, deaf Australians with just one disability (i.e., deafness) are currently nine times less likely to be employed than average Australian (Access Economics, 2006). Individuals with additional disabilities to deafness are also proportionately less likely to be employed per additional disability (Australian Safety & Compensation Council, 2007).

Career difficulties for deaf people can include physical or structural impediments such as excessive background noise, the workplace requirement of using telephones, the nonprovision of assistive auditory devices (e.g., FM systems), and auditory rather than visual alerting signals (e.g., colleagues announcing departure) (DeCaro, Mudgett-DeCaro, & Dowaliby, 2001; Scherich, 1996). Other difficult workplace circumstances include group situations such as departmental, staff meetings, work-related social functions, in-service training sessions, and informal social interactions (e.g., lunch breaks) (Hyde & Punch, 2009; Scherich & Mowry, 1997; Scherich, 1996; Steinberg, Sullivan, & Montoya, 1999). Additional barriers are the discriminatory practices of being refused workplace promotion on merit, being bullied, and being denied necessary and reasonable deafness-related accommodations (e.g., a note taker for meetings) (Scherich, 1996; Scherich & Mowry, 1997; Wheeler-Scruggs, 2002). Many deaf people are also significantly disadvantaged because they have not

Deafness-Specific Tactic Knowledge:

may be best answered by a focus shift.

(Hintermair, 2006).

**4. Shifting focus: A strength-based understanding** 

challenges.

A New Understanding of Mental Health, and Social and Professional Participation 293

appear to have two primary characteristics: external and internal (Glickman, 2008). External challenges are outward social and professional pressures encountered by the individual. Internal challenges are the individual's cognitive capacity to deal with these external

The previous survey of the literature runs the risk of portraying a dire picture of living life with deafness. However, when viewed from another angle, positives also appear. For example, studies show that a majority of deaf participants are achieving workplace participation and a healthy mental well-being. An additional finding is that the attainment of tertiary qualifications is an indicator of deaf people achieving near identical incomes to similarly qualified hearing peers (Jones, D.D., 2004). But what are these deaf people actually doing in their daily lives to maximize their social and professional potential? This question

According to Hintermair (2006), there is a need for a "capabilities-resources" perspective of understanding deaf people. This focuses on 'what works' as opposed to describing the dimensions of deafness-related problems. In 1998, the then president of the American Psychological Association Martin Seligman stressed the need for substantial strength-based research into psychosocial attributes and tactics for coping with day-to-day life (Hintermair, 2006). Seligman also argued that research focusing on personal weaknesses has contributed to mental health professionals being ill-equipped to conduct or devise effective interventions (Hintermair, 2006). Similarly, describing the dimensions of deaf people's social isolation, employment disadvantages, and mental health problems may not actually benefit deaf people, their peers, or family. This is a deficit mode of thinking because it focuses on what deaf people cannot do, or have difficulties with. Descriptions of problems can have little or no practical value for everyday living. Oppositely, strength-based research seeking to understand what deaf people can do – or how their healthy personalities are operationalized – can uncover knowledge of their capabilities and utilization of resources. This practical knowledge also has a prescriptive value. The specialized tactics gleaned from the research can thereafter be used to inform educational or intervention practices designed to assist deaf people who, in turn, will use these skills. That is not to dismiss that challenges do and will continue to exist – or underestimate the importance of research identifying these challenges - but to emphasize a shift in focus toward deaf people's strengths and capabilities

Three examples of studies seeking to understand strength-based psychosocial attributes in deaf participants are as follows. Powers (2011) studied factors influencing the success of high achieving English deaf adolescents. Interviews were conducted with the deaf students themselves (n = 27), their parents (n = 27), teachers of the deaf (n = 27), and professionals other than teachers of the deaf (n = 21). The methodology was similar to Luckner and Muir's (2001) American study and also produced remarkably similar findings. In both studies, each of the participant groups attributed success to 1) the child's own personal attributes and character over other factors in order of importance: 2) the influence of parents, 3) the support of teachers of the deaf and teaching assistants, and 4) skills in language, communication, and reading. In addition to the crucial finding that attributes and character are key aspects to success in deaf people, studies by Powers and Luckner and Muir also

developed strong social skills necessary for effective workplace relationships before entering the workforce (Rosengreen et al., 2009).

Unemployment and living alone have been found to be significant indicators of mental distress in deaf adults (de Graff & Bijl, 2002). Social isolation or unsatisfactory social participation has been linked with loneliness, exhaustion, lethargy, anxiety, apathy, despondence, social dissatisfaction, and severe self-doubting (Backenroth-Ohsako, Wennberg, & af Klinteberg, 2003; Heydebrand et al., 2005; Steinberg, Sullivan, & Montoya, 1999; Wheeler-Scruggs, 2002). Cited problems include communication difficulties in group situations, understanding conversational nuances, and learned helplessness (Heydebrand et al., 2005; Hyde, Punch, & Komesaroff, 2010). Studies have also reported higher levels of mental distress, depression, interpersonal sensitivity, phobic anxiety, substance abuse, and hostility in deaf individuals compared with population norms (Brunnberg, Boström, & Berglund, 2007; de Graaf & Bijl, 2002; Fellinger et al., 2007; Jones, E.G., Ouellette, & Kang, 2006; Monzani et al., 2008). Irritability, feelings of inferiority, and phobias can create a mutually impacting cycle of social rejection and psychological dejection, and deliberate selfseclusion from social and professional activities (Heydebrand et al., 2005). Kvam, Loeb, and Tambs (2007) further found that negative childhood experiences (e.g., parental abuse, bullying, and sexual abuse) increased the probability of mental health problems in deaf adults. Hearing spouses of people with acquired deafness have additionally reported comparatively poorer psychological, physical, and social wellbeing when measured with population norms (Fellinger et al., 2005; Hogan et al., 2001; Hogan, O'Loughlin, Davis, A., & Kendig, 2009b).

The aforementioned studies mostly had small sample sizes and were conducted in Western nations. Larger studies by Hintermair (2008) and Hogan et al. (2009b) suggested that many themes in the smaller studies are prevalent across the broader population of deaf people. When interacting with hearing peers, deaf individuals are often required to make sense of and to concurrently act upon - the social situation with less-than-ideal hearing. Another important finding is that stress and anxiety tends to occur when the environmental demands exceed a deaf individual's resources for coping with events (Hogan et al., 2009b; Jones, E.G., et al., 2006). As such, it is not deafness per se that contributes to psychiatric problems. Rather, maladaptive communication and coping strategies appear to be the chief problems for deaf individuals in their quest to gain and sustain social and workplace participation and a healthy mental well-being (Fellinger, Holzinger, Sattel et al., 2009; Hintermair, 2008; Monzani et al., 2008; van Gent et al., 2007). Ineffective communicative abilities can also retard the development of emotional and social skills vital to social participation (Leigh et al., 1996).

It is speculated that the deafness-related difficulties are associated with 1) an individual being a member of a minority that can encounter considerable and consistent ostracism – whether subtle or overt (Hogan, 2001); 2) the cognitive demands deriving from learning and executing deafness-specific proactive psychosocial skills, and; 3) difficulties deriving from real-time interaction with less-than-ideal hearing. Deaf individuals therefore appear to encounter more psychosocial challenges than do nondisabled individuals (Kvam et al., 2007; Lukomski, 2007). These extra and unique psychosocial difficulties for deaf individuals – or disability-related psychological, social, and professional challenges - may negatively impact on their mental health (Jones, E.G., Ouellette, & Kang, 2006). In addition, these challenges appear to have two primary characteristics: external and internal (Glickman, 2008). External challenges are outward social and professional pressures encountered by the individual. Internal challenges are the individual's cognitive capacity to deal with these external challenges.
