Interview, diagnostic, and legal aspects in the forensic psychiatric assessments of deaf persons

Forensic psychiatric assessments rely on many underlying presumptions concerning the language development and abilities of their subjects. Although these assumptions may apply across a culturally diverse group of hearing subjects, they probably do not apply to those who are prelingually deaf because such deaf persons never developed verbal language. In this article, a review of the range of literature focusing upon the unique aspects of interviews, diagnosis, and legal understanding of the deaf is conducted. An attempt to illuminate those features believed to be most relevant to forensic assessments of this unique population is made. The demands of interviews conducted in manual language are discussed and particular attention is paid to the impact of the interpreter upon confidentiality, privilege, agency, and the dynamics of the interview. It is also suggested that many of the baseline behaviors of the deaf may, at least partly, result from differences in communication style between the deaf and hearing. This article reports that many major mental disorders occur with the same frequency among the deaf and hearing and include many of the same symptoms. However, organic mental disorders may occur at a somewhat greater rate among the deaf because of the organic basis of deafness. Finally, the ways in which deafness and the use of an interpreter may influence the deaf person's ability to understand and relate to legal concepts and process are discussed. It is noted that many of these problems may arise from a deaf persons inexperience or undereducation about legal matters rather than psychopathology.