The proposed research will utilize qualitative (focus groups;in-depth interviews) and quantitative (field testing;calculation of sensitivity and specificity) methods to develop a culturally and linguistically accessible depression screener on CD-ROM in American Sign Language. Depression is the most common mental health condition managed in primary care. Depressive illness results in considerable work time loss and functional status decline causing levels of disability comparable to that of major medical illness. Fortunately, early identification and proper treatment significantly decrease the negative impact of depression in most patients. Although several depression screening instruments are available for the general population of patients in primary care, for deaf patients who use American Sign Language as their first and most comfortable language, being screened for depression in primary care can be difficult, if not impossible. These deaf individuals often lack adequate English reading skills to answer the questions in written form. Furthermore, a pilot study has indicated that those who are culturally deaf do not share the same concept of depression as is held by the developers of screening instruments. Therefore even having a sign language interpreter available to interpret an English-language screener may not yield meaningful results. Deaf persons are further disadvantaged in having cultural barriers to seeking mental health screening and treatment. This depression screener which will be keyed to DSM-IV criteria, will meet the specific linguistic and cultural needs of deaf individuals. It will also meet the need for such a depression screener for primary care physicians, emergency room physicians and other health and service agency staff who care for deaf patients.
Depression is the most prevalent form of mental illness in the US, causing disability and loss of work time comparable to major physical illness. The identification of depression in underserved populations, such as the deaf population, at the time of visits to primary care is a public health priority. The proposed project will develop a culturally and linguistically specific depression screener in American Sign Language, for use in primary care and other health and service settings.
