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Alison Aubrecht: Peer support program takes a deaf-centric approach to mental health

“Our program was officially launched in March 2014, with a total of four deaf certified peer support specialists (we now have seven),” says Aubrecht.

Minnesota's deaf certified peer support specialists offer free mental health counseling to members of the state's deaf community. Seated, left to right: Dori Richards, Melissa Forkner, Fern Nesvig, Angela Struzyk, Joyce Atchison, Linda Durand, and Jeff Lindstrom. Alison Albrecht, center, sitting on floor.
Photo courtesy of Alison Albrecht

It’s hard enough to find a qualified therapist, but imagine being deaf and looking for a mental health professional who: 1) speaks your language (ASL); and 2) understands the intricacies of deaf culture. Not an easy task.

With the help of interpreters, hearing therapists often work with deaf, deafblind or hard of hearing patients, but the presence of a stranger in the treatment room can be awkward, to say the least. In Minnesota, there only a few therapists who are either deaf or hearing but fluent in ASL. Waiting lists to see them can be months long.

In recognition of these concerns, two years ago the Minnesota Department of Human Services’ Deaf and Hard of Hearing Services Division established a Certified Peer Support Specialist Program. The program is like other peer support specialist programs around the state, except for one big difference: The peer support specialists on the team are all deaf or hard of hearing people who have experience with mental illness. They’ve been trained to provide support and guidance to their peers.

The program’s supervisor is Alison Aubrecht, a licensed professional clinical counselor who also happens to be deaf. Her primary language is ASL. Enthusiastic and committed about her work, Aubrecht oversees a group of busy peer support specialists.

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“At this time our seven peers meet with approximately 25-30 people per year,” Aubrecht said. “They have an average of 3-5 individuals on their caseloads at any given time.”

A Minnesota native and Gallaudet University graduate, Aubrecht lived and worked in other parts of the country before coming back to her home state.

“I returned to Minnesota,” she said, “in part because my family is here and in part because Minnesota has pretty amazing services and opportunities for deaf, deafblind, and hard of hearing people.”

This week, Aubrecht and I “talked” through a series of emails — our language barriers (I don’t speak ASL) made this the easiest way for us to communicate. She told me about Minnesota’s Deaf Peer Support Specialist Program, about mental health issues in the deaf community, and about her personal commitment to social justice.

MinnPost: Can you tell me more about the Deaf Certified Peer Support Specialist Program?

Alison Aubrecht: Certainly. Our program was officially launched in March 2014, with a total of four deaf certified peer support specialists (we now have seven). Our program is a state grant contracted with Consumer Directions, Inc., a contract that is managed by the Director of the Minnesota Deaf and Hard of Hearing Service Division Mental Health Program. Our specialists work with deaf, deafblind, and hard of hearing individuals across Minnesota. The certified peer support specialist group was trained using a modified (with permission) version of the Appalachian Consulting Group Peer Specialist Training curriculum. Modifications were made to ensure that the training would be culturally and linguistically affirmative, or accessible to American Sign Language (ASL) users.

MP: Tell me more about your peer support specialists. What kind of background do they have? What draws them to this work?

AA: All of our support specialists are deaf. They come from a variety of walks of life. All have struggled with mental health challenges and have agreed to share their experiences with folks who are currently struggling with mental health barriers. For the most part, they are drawn to the work out of a desire to use their own life challenges to help others.

MP: Are certified peer support specialists paid for their work?

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AA: Yes, our specialists are paid for their work through a state grant. They are paid an hourly rate, based on their time with their peers.

MP: How are team members trained?

AA: Trainings are provided by co-facilitators: myself and Dori Richards, who also works as a certified peer support specialist. We provide a weeklong, 40-hour training based on the Appalachian Consulting Group Peer Specialist Training curriculum. Trainings are generally hosted once or twice a year.

MP: Why is it important that deaf, deafblind and hard of hearing people have specially trained support specialists?

Alison Aubrecht
Alison Aubrecht

AA: One of the foundations of peer support is the belief that people benefit from working with others who have experienced similar challenges. There’s this gut-level connection and mutual understanding. The same is true for other layers of a person’s identity — deaf, deafblind, and hard of hearing people are more able to form that connection with one another because of their shared experiences and understanding, not only of deaf people and deaf culture, but beyond that — the experience of a deaf, deafblind, and hard of hearing person struggling to navigate the mental health system.

MP: What are some of the unique issues that arise when deaf people are seeking mental health care?

AA: The biggest issue is probably the availability of accessible support. We believe that direct communication access is ideal, but most providers across the board (i.e. therapists, social workers, group home staff, treatment center staff, psychiatrists, etc.) don’t use ASL. So the next challenge becomes: Are they willing to provide qualified interpreters? And working with interpreters comes with its own set of challenges, as some are not trained to work in mental health settings.

As a result of communication barriers, deaf people are sometimes misdiagnosed, or don’t receive adequate treatment. Other times they may not have support where they need it — an example would be accessible AA meetings following discharge from a treatment program. So that leads to higher risk of relapse, whether relating to substance abuse or mental health symptoms. That’s one of the reasons the Deaf Certified Peer Support Program is so beneficial—our specialists have the potential to become that bridge, to provide that support and supplement the work of providers or temporarily fill gaps in services.

MP: Is it important for a deaf person to be treated by a mental health professional who is also deaf?  Can a hearing mental health professional be trained to assist people who are deaf, deafblind and hard of hearing?

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AA: The National Association of the Deaf has a position statement on this topic. But if you’re asking me personally, my sense is that deaf people, like anyone else, should have options for mental health resources. Often deaf people relate more with deaf providers. This relates back to what I shared earlier regarding shared experiences. The larger issue, however, is ensuring that the provider is fluent in American Sign Language, if that’s how the person communicates. Hearing mental health professionals can be and are trained to work with deaf, deafblind, and hard of hearing individuals. Again, there needs to be emphasis placed on fluency and understanding of cultural nuances.

A short video explaining the Minnesota Deaf CPSS Program. Click on the “CC” icon to view with subtitles.

MP: Do deaf, deafblind and hard of hearing people have a hard time finding qualified mental health care?

AA: Absolutely yes. Minnesota is one of the better states in terms of providing quality mental health care to deaf, deafblind, and hard of hearing people. We have many wonderful programs and providers, including the Department of Human Services’ Deaf and Hard of Hearing Services Division Mental Health Program. Minnesota also has the only chemical dependency program tailored to this population: the MN Chemical Dependency Program for Deaf and Hard of Hearing Individuals. However, there are still challenges. Most services are specific to the Twin Cities and less accessible statewide. Most of these services are also specific to adults.

MP: How is mental illness acknowledged in the deaf community?

AA: There’s still quite a bit of a stigma. It isn’t discussed much, and there’s a level of insensitivity among community members at times, but that trend has been shifting in recent years. We are hoping that this program will contribute to removing stigma, and we have seen a really positive impact coming out of our peer specialists sharing openly their struggles and their accomplishments.

MP: What drew you to your work?

AA: I have a particular interest in social justice work. I see life through a social justice lens. Part of that lens is creating space for people to tell their own stories, because they often know best (lived experiences). As a trained therapist, I feel that same lens needs to be applied to people that I work with. I feel that people with mental health challenges have a wealth of wisdom and empathy beyond what many of us ever learn from books, and this program — for me — seemed like the perfect opportunity to combine my mental health training with creating space for people with lived experiences to work with others who have similar needs.