Staff, Students Team to Highlight Health Care Gaps Facing the Deaf Community

Brianna Dominguez-Barnes ’23, a child of Deaf adults, had no idea of the intersection of health care and Deaf people until she was told the story of her birth.

“It’s a scary situation when someone is coming into your personal space and doing things medically,” said Dominguez-Barnes, noting that her mother shared how an interpreter was not available when she was in labor. “Patients want to be aware of what is going on with their own body. Not being able to communicate heightened her anxiety. Giving Deaf people equitable access to what’s happening to their own lives is essential.”

A current position paper from the National Association of the Deaf notes the “health care system has largely failed to both ensure and provide accessible language services and health information for many deaf individuals.” This, despite federal law requiring that means of effective communication is made available.

“There isn’t a lot of Deaf awareness in the hearing community. This leads to Deaf patients being ostracized,” said Trinity Offutt Decker '23, who works in human services with Deaf and hard of hearing individuals in Providence.

Dominguez-Barnes and Offutt Decker, now alumnae, and several current Holy Cross students sought to address this and in 2022 worked with Stephanie Clark, lecturer and program director of Deaf Studies and Sign Languages, on a film that teaches hearing health care professionals and students how to effectively communicate with Deaf, DeafBlind and hard of hearing patients. The students participated in the project through their intermediate American Sign Language course and the Donelan Office of Community-Based Learning, Teaching and Engaged Scholarship.

“Access to health care is so critical, it’s so foundational, it’s so basic… how could this have not existed before?” said Melissa L. Anderson, associate professor of psychiatry at UMass Chan Medical School and co-director of the DeafYES! Center for Empowerment and Recovery, a center that researches and develops health resources tailored to the Deaf community. Clark, who served as the “Vital Signs” film director, and her students, as interns and film extras, collaborated with film producer Bryan Horch on the effort spearheaded by DeafYES! and Brown University. The film was released in January 2024 and has since been shared with medical schools and professionals throughout the U.S.

Deaf community members have a right to qualified interpreters of their choice, whether in person or remote, and it’s taxing for the Deaf community to have to continue to self-advocate for services that are equitable, Clark said.

Interpreter agencies often contact medical providers directly and establish a private contract, according to Clark. This does not allow Deaf community members the opportunity to have interpreters of their choosing and who best match their individual needs. The risk is that the interpreters available through the private agencies might not be qualified or meet ethical standards.

Aarya Rumde '25, a biology major and Deaf studies minor, said priorities throughout filming were to highlight the challenges Deaf community members encounter in clinical settings and training medical professionals and students how to ask patients how they identify themselves and then arrange accommodations for them. In addition, the film also sought to reinforce that the Deaf community is diverse and to encourage the hearing community to listen and learn from their experiences and become allies, Rumde said.

“It’s vital that medical professionals and students recognize this and can provide whatever is necessary to let their patients know they are here for them,” she said.

Anderson and Alexander Wilkins, co-director of DeafYES! and a Deaf assistant professor of psychiatry at UMass Chan, credit Clark with ensuring different perspectives of the Deaf community, including those of Black, indigenous and people of color, were represented into the film as consultants, actors, interpreters, cast and crew. By collaborating with the larger Deaf community, the team was able to create an authentic film that reflects their needs, they said.

“It’s vital that medical professionals and students recognize this and can provide whatever is necessary to let their patients know they are here for them,” she said.

“That we were able to encompass everyone is testament to the importance of community engagement research. It speaks to the power of collaboration with community members and how we can use research to benefit most people,” Wilkins said.

One item emphasized as key in the video is the importance of having an interpreter with medical vocabulary and relevant content-specific knowledge available as soon as possible after a Deaf patient arrives for an appointment or in the emergency department. Whether the interpreter is in-person or online should be based on the patient’s preference.

“A lot of people are under the assumption that one size fits all when it comes to interpreters,” Offutt Decker said. “Having an appropriate interpreter should feel personal. You’re sharing your private health information. If they don’t have an interpreter, you can’t have your doctor’s appointment.”

Dominguez-Barnes acknowledges that this process might be easier said than done, but ensuring that there is no barrier to communication should be as routine as taking a patient’s vitals: “There’s always an opportunity to learn how to be more equitable.”