The education of deaf patients at Rampton Hospital

Rampton is one of the three maximum security psychiatric hospitals in England and Wales. Patients are send to a special hospital for treatment only if they would be a serious danger to themselves or other if they where free. Those patients who are profoundly or severely pre-lingually deaf are directed to Rampton rather than either of the other special hospitals and now there are no deaf patients in these hospitals. There are currently 494 patients in Rampton, only nine of whom are deaf. We do not have a special unit as such and deaf patients are nursed with hearing patients in four different wards within three different clinical teams. The development of services for deaf patients is relatively recent and we recognise that our experience is therefore limited and different from that of most other psychiatric services to deaf people. The Rampton working group concluded that there could be no treatment without communication. That’s why :

- an interpreter was appointed on a sessional basis

- a Deaf club was established, inviting volunteer visitors from the deaf community

- a Deaf person was appointed as Sign Language Demonstrator for twelve hours per week.

But to return to the title of this presentation, surely our patients are deaf already, and if so, what are we trying to teach them? Rampton hospital patients are in fact "four d" patients.

They are "d" for deaf, profoundly, pre-lingually deaf by audiological standards.

They are "d" for disordered, mentally disordered within the term of the 1983 Mental Health Act, and their behaviour has seriously offenced against normal codes of social and/or sexual behaviour, and they have committed serious offences.

They are "d" for dangerous in that their deviant behaviour has become so serious that society must be protected from them.

And lastly they are "d" for detained to receive treatment in maximum secure conditions.

The issue is one of HABILITATION not REHABILITATION because these people have never grown socially or intellectually to take their places as equal participants neither in the Deaf world than in the Hearing world.

In short, we try to create an environment which promote Deaf Language and Culture and which offers students an opportunity to develop a sense of identity and pride in themselves and other Deaf poeple. Whatever the medical treatment offered, it is vital that they have adequate language to learn the rules of the wider society and the intellectual skill to interpret them appropriately. Patients cannot leave Rampton untill they no longer need such a secure environment. Those who want to continue their education after leaving Rampton may need the experience of learning in an integrated classroom.