Prevalence of Suicide Attempts in a Deaf Population with Co-Occurring Substance Use Disorder

The Deaf Off Drugs & Alcohol (DODA) Program provides culturally appropriate recovery services via e-therapy to Deaf and hard of hearing (HH) individuals with substance use disorder (SUD). In the first three years DODA was providing services,149 consumers (107 Deaf, 42 HH) received treatment. A retrospective secondary data analysis sought to examine the lifetime prevalence of suicidal behavior in Deaf individuals receiving alcohol and drug treatment services from the DODA program. The prevalence of self-reported lifetime suicide attempts in the Deaf sample was 42.1%, higher than rates reported for other subgroups with coexisting conditions. Suicidal ideation was reported by 50.5% of Deaf consumers and by 65.1% of Deaf women. Variables significantly associated with suicide attempts included past mental health diagnosis. Possible explanations and future study are discussed

Translation and Validation of an Online Suite of Assessments in American Sign Language

Abstract This article reports on a National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Disability and Rehabilitation Research Project (DRRP; Federal Grant # 90DP0067). The project is being conducted by investigators in the Substance Abuse Resources and Disability Issues (SARDI) Program in the Boonshoft School of Medicine at Wright State University (WSU), in collaboration with nationally recognized experts on Deaf culture and substance abuse/mental health. The goal of this DRRP is to develop and test an online suite of instruments in American Sign Language (ASL), validated for deaf consumers, assessing substance use, mental health, and occupational interests. The translation process used to validate these assessments in ASL is discussed along with the current project status

Comparing Outcomes from an Online Substance Abuse Treatment Program and Residential Treatment Programs for Consumers who are Deaf: A Pilot Study

Numerous barriers exist when attempting to provide culturally appropriate substance use disorder (SUD) treatment to persons who are Deaf, including a lack of accessible community-based treatment providers. To address these barriers, the Deaf Off Drugs and Alcohol (DODA) Program has provided culturally and linguistically appropriate cessation and recovery support services via a telemedicine program to Deaf individuals who are clinically diagnosed with a SUD. This study was conducted to assess whether an online SUD treatment program, such as DODA, is an effective way to serve the Deaf population, which is underserved due to communication and other cultural barriers. DODA’s effectiveness was analyzed using five outcome measures: the Substance Abuse Screener in American Sign Language, substance use items from the Addiction Severity Index, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, and Beck Depression Inventory, which were administered before SUD treatment and six months after SUD treatment began. The intake and 6-month follow-up scores on the five selected outcome measures were compared between 8 Deaf individuals enrolled in the DODA program and 87 Deaf individuals receiving SUD services in specialized residential treatment settings for deaf individuals. The outcomes for Deaf consumers who receive online SUD treatment from DODA were compared to the outcomes for Deaf individuals who receive culturally appropriate residential SUD treatment. Significant differences between pre- and 6-month follow-up scores for all five outcome measures were found for both the online and residential treatment programs. In contrast, no significant differences were observed between outcome measures for the online and residential treatment programs, suggesting that the online treatment program may be as effective as the residential treatment programs

Effects of Telehealth on Dropout and Retention in Care among Treatment-Seeking Individuals with Substance Use Disorder: A Retrospective Cohort Study

Background: During the COVID-19 pandemic, telehealth became a widely used method of delivering treatment for substance use disorders (SUD), but its impact upon treatment engagement and dropout remains unknown. Methods: We conducted a retrospective analysis of adult SUD patients (n = 544) between October 2020 and June 2022 among a cohort of treatment-seeking patients at a nonprofit community behavioral health center in Southwestern Ohio. We estimated the likelihood of treatment dropout using survival curves and Cox proportional hazard models, comparing patients who used telehealth with video, telephone, or solely in-person services within the first 14 days of diagnosis. We also compared the likelihood of early treatment engagement. Results: Patients who received services through telehealth with video in the initial 14 days of diagnosis had a lower hazard of dropout, compared to patients receiving solely in-person services (0.64, 95% CI [0.46, 0.90]), while there was no difference in hazards of dropout between patients who received telephone and in-person services. Early use of telehealth, both via video (5.40, 95% CI [1.92, 15.20]) and telephone (2.12, 95% CI [1.05, 4.28]), was associated with greater odds of treatment engagement compared to in-person care. Conclusion: This study adds to the existing literature related to telehealth utilization and engagement in care and supports the inclusion of telehealth in SUD treatment programs for treatment-seeking individuals

Suicidal Behavior, Language Acquisition, and Deafness: Evaluating the Potential Relationship Between Age of Language Acquisition and Prevalence of Suicidal Behavior in a Deaf Population with Co-Occurring Substance Use Disorder

Since 2008, the Deaf Off Drugs and Alcohol (DODA) Program has provided culturally appropriate cessation and recovery support services via e-therapy to Deaf/HH individuals with a clinically diagnosed substance use disorder (SUD). The information collected by the DODA program presented an opportunity to study the relationship between delayed language acquisition and suicidal ideation and attempts in a population that has historically been understudied, yet has increased prevalence in both suicidal behavior and significantly delayed language acquisition compared to the general population. Of the 107 prelingually Deaf consumers in the program, 18 reported language acquisition later than age ten. This study proposed that manifestations of this delay may contribute to known risk factors for suicidal behavior as well as adaptive communication in the form of suicidal gestures and parasuicide. As hypothesized, the lifetime prevalence of suicide attempts increased with substance use disorder or mental illness. Suicide attempts were also higher in this sample than studies suggest with comorbidity of substance use disorder and co-occurring mental illness. Each of these factors was amplified among those participants with significantly delayed language acquisition. Although caution should be exercised when comparing these results with the hearing population, they underscore the need for increased attention and further inquiry

Prevalence of Suicide Attempts in a Deaf Population with Co-Occurring Substance Use Disorder

The Deaf Off Drugs & Alcohol (DODA) Program provides culturally appropriate recovery services via e-therapy to Deaf and hard of hearing (HH) individuals with substance use disorder (SUD). In the first three years DODA was providing services,149 consumers (107 Deaf, 42 HH) received treatment. A retrospective secondary data analysis sought to examine the lifetime prevalence of suicidal behavior in Deaf individuals receiving alcohol and drug treatment services from the DODA program. The prevalence of self-reported lifetime suicide attempts in the Deaf sample was 42.1%, higher than rates reported for other subgroups with coexisting conditions. Suicidal ideation was reported by 50.5% of Deaf consumers and by 65.1% of Deaf women. Variables significantly associated with suicide attempts included past mental health diagnosis. Possible explanations and future study are discussed

Translation and Validation of an Online Suite of Assessments in American Sign Language

Abstract This article reports on a National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Disability and Rehabilitation Research Project (DRRP; Federal Grant # 90DP0067). The project is being conducted by investigators in the Substance Abuse Resources and Disability Issues (SARDI) Program in the Boonshoft School of Medicine at Wright State University (WSU), in collaboration with nationally recognized experts on Deaf culture and substance abuse/mental health. The goal of this DRRP is to develop and test an online suite of instruments in American Sign Language (ASL), validated for deaf consumers, assessing substance use, mental health, and occupational interests. The translation process used to validate these assessments in ASL is discussed along with the current project status

Suicide Rates in Rural Ohio: The Role of Population Density, Social Association, and Healthcare Access

Background: This study explores differences between adult suicide rates in counties in Ohio from 2007-2016, specifically differences between urban and rural counties. Nationally, the least densely populated states in the nation have the highest rates of completed suicide, and that same trend was hypothesized to exist in the least densely populated counties in Ohio. Methods: Simple demographics and rates for sub-populations and counties were retrieved for adults over 18 years of age, and separated by rural and urban counties. A random effects meta-regression model was developed to assess the association among suicide death rate, rate of emergency rooms, rate of mental health providers, rate of social associations, and rural or urban counties. Results: There were differences in suicide rate between urban and rural counties. Suicide death rates were significantly associated with rate of mental health facilities, rate of social associations, and type of county (e.g., rural versus urban). As the rate of mental health providers increased, there was a significant decrease in the rate of suicide deaths. Conclusions: This study illustrates the positive effect that access to mental health service providers can have on decreasing suicides in rural areas. More studies are needed focusing on unmet needs in rural areas, specifically those looking at individual level predictors of suicide. Key words: Suicide, Population Density, Social Association, Mental Health, and Rura

Suicide Rates in Rural Ohio: The Role of Population Density, Social Association, and Healthcare Access

Background: This study explores differences between adult suicide rates in counties in Ohio from 2007-2016, specifically differences between urban and rural counties. Nationally, the least densely populated states in the nation have the highest rates of completed suicide, and that same trend was hypothesized to exist in the least densely populated counties in Ohio. Methods: Simple demographics and rates for sub-populations and counties were retrieved for adults over 18 years of age, and separated by rural and urban counties. A random effects meta-regression model was developed to assess the association among suicide death rate, rate of emergency rooms, rate of mental health providers, rate of social associations, and rural or urban counties. Results: There were differences in suicide rate between urban and rural counties. Suicide death rates were significantly associated with rate of mental health facilities, rate of social associations, and type of county (e.g., rural versus urban). As the rate of mental health providers increased, there was a significant decrease in the rate of suicide deaths. Conclusions: This study illustrates the positive effect that access to mental health service providers can have on decreasing suicides in rural areas. More studies are needed focusing on unmet needs in rural areas, specifically those looking at individual level predictors of suicide. Key words: Suicide, Population Density, Social Association, Mental Health, and Rura