Vera Institute of Justice Culture, Language, and Access: Key Considerations for Serving Deaf Survivors Center on Victimization and Safety Culture, Language, and Access: Key Considerations for Serving Deaf Survivors of Domestic and Sexual Violence Sheri Ann Farinha, Deaf leader and advocate, standing in front of a brick wall, signing Ôadvocacy'. January 2015 Nancy Smith and Charity Hope From the Director The Vera Institute of Justice is committed to enhancing victim services and justice responses to better meet the needs of all crime victims, especially those from marginalized communities. Vera was introduced to the Deaf community in 2005 after launching a new project to improve access to services for crime victims with disabilities. Despite the fact that Deaf women and girls experience higher rates of violence than their hearing counterparts and face unique barriers to support, we found few efforts within the field of victimization and disability that specifically focused on this community. We interviewed leaders from the Deaf community to find out why, and quickly learned that many Deaf people do not view themselves as having a disability, but as members of a cultural and linguistic community, defined by a language other than English and a unique set of cultural norms, values, and expectations. As such, in the aftermath of domestic and sexual violence, the experiences and needs of members of the Deaf community are different from people with disabilities in important ways that have unique policy and practice implications. We went on to review the literature, conduct more interviews, and host three national roundtables involving Deaf and hearing experts on domestic and sexual violence in the Deaf community. Our goal was to better understand the unmet needs and experiences of Deaf survivors, and what is happeningÑor needs to happenÑto address them. This policy and practice brief summarizes the findings from our work with the Deaf community and offers practical suggestions for increasing Deaf survivorsÕ access to victim services and other supports, including those offered by the criminal justice and medical systems. This information will provide a framework for meeting the needs of Deaf survivors that is grounded in the cultural and linguistic needs of this community. It will also ground policymakers, practitioners, and first responders in the victim services field in the realities of this often-overlooked community. It is our hope that they and others will join us in becoming hearing allies to the Deaf community and Deaf survivors of domestic and sexual violence across the country. Nancy Smith, Director Center on Victimization and Safety Vera Institute of Justice Contents 4 Foreword by Erin Esposito 5 Introduction 6 The Deaf community in the United States 10 Research on victimization is limited 11 Higher rates of domestic and sexual violence 13 Unique experiences of violence 14 Barriers to services and justice 21 Services for Deaf, by Deaf: a promising strategy 25 Enhancing the capacity of hearing service providers and systems 27 Collaboration between Deaf and hearing programs 29 Recommendations 31 Conclusion Foreword: The Story of Ruth Ruth is a Deaf woman who is fluent in American Sign Language (ASL) and married to a hearing man who knows sign language.1 He is physically, emotionally, and verbally abusive, and has total control over RuthÕs finances. RuthÕs friends have been encouraging her to leave her husband for years. Finally, after her husband comes home one night and threatens to kill her, Ruth flees in fear for her life with only her purse and iPhone. Terrified and sobbing, Ruth video chats with her Deaf friend and explains what happened. Her friend tells her about a domestic violence shelter she can go to. Ruth is reluctant and hesitates, telling her friend, ÒBut the people there donÕt know ASL!Ó The friend reassures her, ÒProbably not, but I am sure the staff will get an interpreter. And at least you will be safe and that is what is most important right now!Ó Ruth places a Video Relay Service (VRS) call through her iPhone to reach the shelter. Following protocol, the VRS operator proceeds to announce that a Deaf person is calling using the relay service, only to have shelter staff hang up the phone. Confused, Ruth advises the VRS operator to call again, and they get the same results. Frustrated and tired, Ruth instructs the VRS operator to simply say ÒHi. My name is Ruth and I need shelter from my abusive husband.Ó The operator calls back and follows RuthÕs direction, and she is finally able to obtain directions to the shelter. Upon arriving at the shelter, Ruth struggles to get in. There is a speaker out.side of the locked door but she cannot hear whether someone is trying to speak to her after she rings the doorbell. She rings again and knocks on the door, which has no window or open space to be able to communicate with the shelter staff. After 10 minutes, the door opens and Ruth is escorted to a small, poorly-lit office space where a staff member asks her questions as part of intake. Ruth does not understand anything being said to her and motions for paper and pen. The staff member continues to try to talk to Ruth, mouthing dramatically ÒCan you read my lips?Ó Ruth fiercely shakes her head and again asks for paper and pen. The woman ignores Ruth and picks up the phone and starts talking. Ruth grabs a pen and finds a piece of paper and scribbles, ÒI am Deaf and need interpreter,Ó to which the staff person writes back, ÒWe donÕt have money for interpreters. We can write back and forth instead.Ó Ruth writes a note asking if the shelter serves Deaf women. The staff person writes back, ÒOnce before, but she didnÕt stay long. DonÕt worry though, you can stay for as long as you need.Ó An hour into the tedious process of writing back and forth, frustrated and exhausted, Ruth writes one final note, gets up, and walks out the door. ÒIÕd rather go home than be stuck here with no one I can talk to.Ó Erin Esposito, Executive Director, Advocacy Services for Abused Deaf Victims Introduction Deaf women in the United States experience rates of domestic and/or sexual violence equal to or higher than their hearing counterparts, with emerging research pointing to rates twice that of hearing women.2 Yet, as ÒRuthÕsÓ story illustrates, Deaf survivors routinely face barriers when reaching out for help. From 911 systems that only take phone-based calls to domestic violence programs and rape crisis centers that do not provide bilingual and bicultural services in ASL, to prosecutors who question the credibility of Deaf witnesses, the services and systems designed to respond to domestic and sexual violence are not equipped to meet the unique language and cultural needs of the Deaf community. As a result, Deaf survivors are often shut off from services and supports that could help them safely flee from abuse, heal from trauma, and seek justice after they have been harmed. In 2005, the Vera Institute of JusticeÕs (Vera) Center on Victimization and Safety partnered with the U.S. Department of Justice, Office on Violence Against Women to better understand the experiences of Deaf survivors and the barriers they face. Vera staff conducted a literature review and quickly learned that research on domestic and sexual violence in the Deaf community was severely lacking. We turned to Deaf advocates who were working to address the issue to learn more. During the next three years, we convened three national roundtable discussions with more than 40 experts in this area, including Deaf advocates and hearing allies. At the first roundtable in March 2006, we sought to better understand Deaf survivorsÕ experiencesÑboth with domestic and sexual violence and reaching out for helpÑand to identify promising approaches for meeting their needs. For the second roundtable in August 2007, we explored culturally and linguistically competent community-based services for Deaf survivors in more detail, including their characteristics, promising models for delivering such services, and barriers to doing so. Our final roundtable in August 2008 focused on enhancing criminal justice responses for Deaf survivors. Additionally, since 2006, we have been supporting communities across the country to improve services for survivors with disabilities and Deaf survivors. To date, we have fostered more than 60 collaborations between organizations that serve survivors of domestic and sexual violence and those that serve people with disabilities and/or Deaf people. After an intensive planning phase to strengthen and formalize their collaboration, organizations identify strengths and gaps in their capacities to serve these survivors, determine how best to address the gaps they have identified, and then implement those solutions. This policy and practice brief summarizes the findings from the Deaf-specific roundtables we conducted and reflect the lessons learned from our work with and observations of collaborations aimed at addressing domestic and sexual violence in the Deaf community from 2006 to 2014. The brief offers a framework for understanding and addressing the unmet needs of Deaf survivors that is rooted in a cultural and linguistic perspective. As such, it includes information on the Deaf community and culture in the United States, provides foundational information on what is known about the incidence and prevalence of domestic and sexual violence against Deaf people, and explores the cultural and linguistic barriers that prevent Deaf survivors from accessing services and other supports that generally exist. It discusses several promising approaches to delivering culturally and linguistically competent services to Deaf survivors and the challenges faced by those delivering these services. Finally, it concludes with a set of recommendations for policymakers and practitioners in the victim services field aimed at creating equal access to services and the criminal justice system for Deaf survivors in every community. Deaf culture in the U.S. is defined by its unique language, values, behavioral norms, and traditions. The Deaf community in the United States Instead of viewing themselves as lacking hearing (or as having a disability), many Deaf and hard of hearing people identify as members of a distinct cultural group in the United States. Like any culture, Deaf culture in the U.S. is defined by its unique language, values, behavioral norms, and traditions. Language: ASLÑthe primary and preferred language of the American Deaf communityÑis a visual-gestural language with its own syntax and grammatical structure. It employs signs made by moving the hands combined with facial expressions and postures of the body. It does not have a vocal or written component. Many Deaf people in the United States learn written English as a second language. ASL even has geographic variations akin to accents in spoken languages, as well as slang. ASL is not universal; there are distinct signed languages in other countries, including but not limited to Spanish Sign Language and Chinese Sign Language. Values: Individualism is a widely-held American value, however, Deaf culture values collectivism. Deaf people are often deeply connected to one another and regularly function as one close-knit group despite being spread across the country. Deaf people work hard to stay informed about what is happening in other Deaf communities and in the individual lives of Deaf people they may only know tangentially. Deaf culture commonly places a premium on transparency and honesty, as keeping secrets or being too private may conflict with the cultureÕs collective spirit. Deaf culture also strongly values the visual, especially because this is how communication takes place. Behavioral norms: Personal interaction among Deaf people can differ from that of their hearing counterparts. While making eye contact is valued in many cultures, it is imperative in the Deaf community for communication and allows Deaf individuals to read facial expressions and body language for additional information. Conversations tend to be incredibly direct; it is not uncommon, for example, for a Deaf person to inquire about how much money someone spent on an item or to comment about a change in a personÕs appearance. There are also established behaviors to get the attention of a Deaf individual who is not in oneÕs line of sight: flicking a light switch, gently tapping a person on the shoulder, tapping a table, or stomping on the floor. Traditions: Because most Deaf people are born to hearing parents, the Deaf community relies upon Deaf-specific institutions like Schools for the Deaf and Deaf clubs to pass down its culture from one generation to the next.3 Deaf schools and clubs are strongly supported by many Deaf people for this reason. Deaf events like social outings, fundraisers, or conferences create opportunities for Deaf people to come together to socialize and networkÑopportunities that are rare for Deaf people in a society dominated in number by hearing people, leading many Deaf people to go out of their way to attend them. The Deaf community is also known for its widespread adoption and innovative use of communication technologies ranging from the tele.typewriter in the 1960s to videophones and videoconferencing in the early 2000s to social media today. Woman signing ÔoppressionÕ. oppression Members of the Deaf community coalesce around and celebrate their shared language and culture. An uppercase ÒDÓ in ÒDeafÓ is used to reflect identification with Deaf culture, whereas a lowercase ÒdÓ in ÒdeafÓ reflects an audiological perspective defined by a loss of hearing. The Deaf community in the United States is considerably diverse and comprised of people who self-identify in a multitude of ways depending on a number of factors including the cause and degree of hearing loss, age of onset, educational background, communication methods, and their personal experiences and journey. While identity is very personal and varied from individual to individual, it is helpful to understand some of the common ways people within the Deaf community identify. Many people identify as ÒDeaf,Ó reflecting their identification with Deaf culture. Others who consider themselves members of the Deaf community include individuals who may identify as Òhard of hearing,Ó indicating that they have hearing loss, but some degree of residual hearing. Other Deaf community members include those who lost their hearing later in life and may call themselves Òlate-deafened,Ó and still others with some degree of hearing and sight loss who may identify as ÒDeafBlind.Ó Some members of the Deaf community are hearing, most commonly family members of a Deaf person, including children of Deaf adults (CODAs), and ASL interpreters. Hearing members of the community embrace and identify with Deaf culture as well. Legacy of fear and mistrust AudismÑthe belief that one is superior based on oneÕs ability to hearÑis engrained in our society, shaping our world around the idea that hearing people are the norm and contributing to the dis.crimination and disparities d/Deaf people face in our country. Examples of audism in society at large include medical efforts to ÒfixÓ or ÒrepairÓ d/Deaf people; the devaluation of signed languages in favor of spoken English in education and other settings; systematic failures to accommodate d/Deaf people, including refusal to provide ASL interpreters; and enduring stereotypes, such as d/Deaf people being less intelligent or unfit parents simply because they are d/Deaf. The collective experiences of discrimination and exclusion d/Deaf people have experienced as a result of audism has created a legacy of fear and mistrust of hearing people, organizations, and systems that must be taken into account and overcome by hearing professionals in the crime victims field. According to data from the 2010 Survey of Income and Program Participation (SIPP), approximately 7.6 million people ages 15 and older in the United States have difficulty hearing, while approximately 1.1 million of these individuals define their hearing difficulty as severe.4 In the SIPP questionnaire, difficulty hearing was defined as experiencing deafness or having difficulty hearing a normal conversation, even when wearing a hearing aid. Those who were deaf or unable to hear a normal conversation were described as having a severe difficulty.5 These numbers, however, do not distinguish between those who identify with Deaf culture and those who do not, making an accurate estimate of the Deaf population impossible. The unavailability of current, accurate information on ASL users highlights how Deaf and hard of hearing individuals have often been overlooked in existing research, including studies on victimization of Deaf individuals. A review of existing estimates for the number of ASL users found estimates as low as 100,000 and as high as 15,000,000 users.6 Even the commonly-cited estimate of 500,000 users was found to be largely derived from reports published in the 1970s.7 Research on victimization is limited Emerging research indicates rates of sexual and domestic violence are higher in the Deaf community, but a dearth of Deaf-specific research on victimization make it difficult to determine how much higher. For example, there is little ongoing data collection that provides national, state, or local information on crime victimization of Deaf people. The Federal Bureau of Justice StatisticsÕ National Crime Victimization Survey does report rates of nonfatal violent victimizations for Deaf and hard of hearing individuals, and includes data on the following crimes: rape/sexual assault, robbery, aggravated assault, and simple assault. However, these numbers only reflect broad victimization rates at the national level, which fail to provide any insight as to when and where victimization is likely to occur. The Uniform Crime Report, on the other hand, only reviews hate crimes against victims with disabilities, and does not distinguish Deaf and hard of hearing individuals from those with dis.abilities. While there is a growing body of research on victimization and disability, for the most part, the research that makes up this knowledge base has not made this distinction either. There is little ongoing data collection that provides national, state, or local information on crime victimization of Deaf people. There are efforts underway to address this gap, with researchers at Deaf institutions such as the National Technical Institute for the Deaf and Gallaudet University designing research projects that are culturally and linguistically competent. They are using a number of strategies to achieve this competency, including broadening the descriptions of domestic and sexual violence that guide the studies to include Deaf-specific examples of abuse and common experiences of Deaf survivors, and conduct.ing the research using ASL. One of the largest challenges to research within the Deaf community is the difficulty in building a representative sample of the population. The Deaf community is small and spread across the country, so study participants are often gathered from Deaf schools or members of a Deaf community organization out of convenience due to time and budgetary restrictions. While the findings of these studies offer important insight into the victimization of Deaf individuals, these samples are not representative of the entire community and the findings should be interpreted with caution and not generalized to the larger Deaf population. Higher rates of domestic and sexual violence While limited in number and methodology, research on victimization within the Deaf community suggests that Deaf and hard of hearing individuals living in the United States have higher rates of domestic and sexual victimizationÑintimate partner violence, psychological aggression and abuse, forced sexual experiences, and sexual assaultÑthan their hearing counterparts.8 While limited in number and methodology, research on victimizing within the Deaf community suggests that Deaf and hard of hearing individuals living in the U.S. have higher rates of domestic and sexual victimizationÉthan their hearing counterparts. Using survey data comparing almost 1,900 students at the Rochester Institute of Technology and the National Technical Institute for the Deaf, researchers found that Deaf and hard of hearing individuals were 1.5 times more likely to be victims of sexual harassment, sexual assault, psychological abuse, and physical abuse than their hearing counterparts.9 According to a 2011 study examining intimate partner violence among 100 Deaf female undergraduates, approximately twice as many deaf respondents report.ed experiencing intimate partner violence in the past year than their hearing counterparts.10 A 2014 study found that Deaf adults were more likely to experience forced sexual experiences than hearing adults. Deaf survey respondents experienced forced sexual incidents at rates that were at least twice those reported by hearing respondents in other surveys.11 Prevalence rates of lifetime forced sexual experiences. One in every ten hearing women will experience a forced sexual experience in their lifetime. One in every four Deaf women will experience a forced sexual experience in their lifetime. Children who are Deaf or hard of hearing also experienced higher rates of physical and sexual abuse than their hear.ing counterparts.12 A 1998 study using a sample of 312 Deaf and hard of hearing children found that these children were 1.4 times more likely to be neglected and twice as likely to be physically abused.13 A 2000 study using records of school children enrolled in Omaha, Nebraska schools during the 1994Ð1995 school year found that children who were Deaf or hard of hearing were twice as likely to experience neglect and emotional abuse, and almost four times as likely to be physically abused than their hearing counterparts.14 Unique experiences of violence Deaf survivors of domestic violence experience many of the same tactics of abuse as their hearing counterparts from abusers attempting to gain power and control (e.g., isolation; intimidation; blame; and financial, emotional, physical, and sexual abuse), but they also face unique tactics that must be understood and accounted for to effectively support Deaf survivors. For example, abusers might: injure a victimsÕ hands to prevent effective communication in ASL or by using assistive equipment; destroy devices used for communication, including smartphones used for texting, videophones, and teletypewriters (TTYs); monitor electronic communication by accessing saved text messages, emails, instant messenger communication logs, and TTY records; erase or falsely reply to emails, text messages, or TTY calls; threaten or abuse hearing dogs (specially trained dogs that alert Deaf individuals to important sounds such as fire alarms and lead the person to the source of the sound); threaten to or actually move away from the victimÕs established Deaf community or to an area with very few Deaf people to further isolate the victim; spread lies and rumors about the victim within the deeply-connected Deaf community to damage the victimÕs credibility, good standing in the community, and ability to obtain financial independence; and deny abuse tactics by saying the tactics are culturally appropriate behaviors within the Deaf community. For example, an abuser might throw objects at a person and then claim itÕs a culturally accepted way to get a Deaf individualÕs attention. Similarly, an abuser might intimidate by using body language and being in close physical proximity while signing and later claim both are features of ASL. In addition, hearing abusers commonly use their hearing privilege to maintain control over Deaf individuals. ÒHearing privilegeÓ is a term coined by the Deaf community to describe the advantages and entitlements one receives by being able to hear in our society. For example, an abuser might play off commonly held societal values that view d/Deaf people as incompetent by saying the victim is not good enough, in general, or an unfit parent, specifically, because the victim is d/Deaf. An abuser might refuse to use sign language with the victim to further isolate or punish her or him. An abuser might take advantage of institutions that are inaccessible, like child protective services or job and family services, by interpreting falsely or inaccurately for the victim. Barriers to services and justice When Deaf survivors reach out for services and support and their needs are not met, their experience of trauma is compounded by the very systems and services that are intended to help. Despite higher rates of domestic and sexual violence within the Deaf community, Deaf survivors face barriers that prevent them from getting help. When Deaf survivors reach out for services and support and their needs are not met, their experience of trauma is compounded by the very systems and services that are intended to help.15 The challenges that underlay these barriers include: Invisibility Despite high rates of domestic and sexual violence within the Deaf community, it is largely invisible to victim service providers. Most providers have limited to no exposure to the Deaf community and havenÕt received specialized train.ing on Deaf culture or domestic and sexual violence within the community. Without an awareness of Deaf peopleÕs unique needs and experiences, victim service providers do not commonly recognize this community as underserved or marginalized. Such recognition is what typically spurs communities and programs into action to remove barriers and enhance services for survivors from recognized communities. Lack of specialized outreach by victim service providers Few victim service providers tailor their outreach and education efforts to meet the needs of the Deaf community. Deaf peopleÕs unique experiences with domestic and sexual violence are rarely reflected in educational curriculum and outreach brochures. For example, it is common for domestic violence awareness trainings to include a list of abusive behaviors so potential victims can determine if they are in an abusive relationship. The behaviors listed, however, rarely include those such as destroying video.phones and channeling physical abuse towards the victimÕs hands. Similarly, victim services outreach brochures rarely include Deaf-specific language or information, including the unique dynamics of abuse specific to the community and important information regarding accessibility, such as information on the availability of interpreters. Additionally, programs rarely conduct educational activities or leave outreach brochures where Deaf people are likely to congregate, such as Deaf schools, clubs, and Deaf community events. Phone-based emergency hotlines Those Deaf survivors who do reach out for assistance are often met with barriers that prevent a connection from being made. In most communities, for example, helpÑwhether from an advocate or law enforcement officerÑis only accessible by phone. For Deaf individuals, this means using a TTY to communicate by typing messages back and forth, but these methods are cumbersome, slow, and ineffective in an emergency. Moreover, many Deaf individuals no longer use or own TTYs because of advances in technologies such as email, instant message, and videophones. Having a call relayed is also an option for Deaf individuals, but most law enforcement and victim services agencies are not prepared to receive relay calls (or TTY calls) and Deaf survivors commonly report being hung up on or never having their call answered at all.16 Lack of language access It is difficult to exchange information in a personÕs non-native language in the best circumstances, and it becomes even more difficult if that person has experienced trauma, is in crisis, or if the information being conveyed is complexÑall of which apply to Deaf survivors. It is difficult to exchange information in a personÕs non-native language in the best circumstances, and it becomes even more difficult if that person has experienced trauma, is in crisis, or if the information being conveyed is complexÑall of which apply to Deaf survivors. Language access presents a significant barrier to Deaf survivors. Qualified ASL interpreters are rarely used to facilitate communication between Deaf survivors and law enforcement officers, advocates, and medical professionals. More commonly, Deaf survivors are forced to use ad hoc and often ineffective communication measures that present their own challenges: writing notes back and forth requires a level of fluency in and comfort with written English that many Deaf survivors do not possess; speech or lip reading is difficult for most Deaf survivors, imprecise, and can lead to confusion; and family members acting as interpreters can present problems, especially since they often lack the skills and fluency to interpret the information being conveyed accurately. These ad hoc measures lead to miscommunication, missed information, and frustration in any circumstance, but they are particularly problematic in the context of domestic and sexual violence. In the rare instances when certified interpreters are used, they often do not have the proper qualifications or preparation to work in the context of domestic and sexual violence, which presents unique linguistic needs, practice considerations, and safety concerns for interpreters. Residential programs, such as domestic violence shelters, canÕt afford interpreters around the clock. Instead, they reserve them for high-priority events such as program orientations and case management meetings, making it difficult for advocates and Deaf survivors to have impromptu conversations as issues come up or for Deaf survivors to interact with other residents who often provide invaluable support. The practices of law enforcement and service providers contribute to the challenges Deaf survivors face around access to interpreters: Unfamiliarity with legal obligations: The Americans with Disabilities Act of 1990 requires service providers and law enforcement agencies to provide auxiliary aids to ensure effective communication so Deaf people have an equal opportunity to participate in and benefit from their services.17 For many Deaf people, this means ASL interpreters. Many providers and law enforcement officers are unfamiliar with their obligations under the law and often donÕt meet their legal obligations. Lack of qualified interpreters: A qualified interpreter is one who can interpret accurately, effectively, and impartially, and use specialized vocabulary, as needed. ASL interpreters require specialized training to effectively interpret in courtrooms and domestic and sexual violence contexts. This training covers vocabulary specific to domestic and sexual violence, trauma and communication, ethics, safety planning, and self-care. Few interpreters have this specialized training. Lack of funds allocated for interpreters: Most domes.tic violence programs and rape crisis centers do not have money set aside in their budget to cover costs associated with ASL interpreters. While rates vary from community to community, the average cost for an ASL interpreter is between $55 and $65 per hour. ASL interpreters are required to work in two-person teams and many agencies have a two-hour minimum for each interpreting assignment. However, most funding sourcesÑespecially local, state, and federal governmentsÑallow their funds to cover the costs associated with accommodations for access. Lack of ability to secure ASL interpreters: Program staff and law enforcement officers often have little knowledge of the world of sign language interpreting, including how to locate interpreters, how to contract with them for these services, and how to determine if interpreters are qualified for a given assignment. It is critical that interpreters be vetted for language fluency, interpreting skills, specialized training (as described below), and to determine whether they have pre-exist.ing relationships with the parties involvedÑespecially the person responsible for the abuseÑgiven the small, tight-knit nature of the community. Interpreters must also be prepared for the potentially difficult nature of the subject matter being discussed and to plan for their own safety, as there have been instances of abusers harassing or physically assaulting interpreters for their role in legal proceedings. Challenges in securing interpreters in a crisis: Securing interpreters for a scheduled appointment can take up to three weeks, but emergency engagements, such as Deaf survivorsÕ initial calls for help, or impromptu meetings, such as conversations with staff at residential programs as new issues arise, present challenges. Aside from court proceedings, few interactions surrounding domestic and sexual violence can be scheduled. Victim service professionals struggle to quickly secure qualified interpreters during times of crisis, such as fleeing domestic violence to an emergency shelter, calling the police for help, and going to the hospital for a sexual assault forensic examÑinteractions when communication access is arguably most critical for survivors. interpreter Image of hands showing the sign for Ôinterpreter.Õ Consequences of miscommunication The consequences of miscommunication can be dire when survivors are navigating life or death situations, complex systems, and their healing or the healing of their children. Inaccurate or ineffective communication can have far-reaching and negative ramifications in criminal proceedings, which require a high degree of accuracy throughout, from the initial police report to testifying in court. For example, survivors are often denied protection orders and their abusersÕ criminal cases are often dismissed due to insufficient evidence or conflicting testimony. Without communication access, itÕs difficult for advocates working in domestic violence programs or rape crisis centers and Deaf survivors to connect with one another, develop understanding, and build trust, which is the foundation for any relationship and essential when supporting survivors in the after.math of trauma. It also limits an advocateÕs ability to tailor potential services and supports to meet the unique needs of Deaf survivors and to build on their strengths, especially those related to Deaf survivorsÕ often rich cultural heritage. Lack of cultural competency in victim services and advocacy Without a deep understanding of Deaf culture and the unique cultural context of domestic and sexual violence, it is difficult for advocates and counselors to effectively safety plan with Deaf survivors, support Deaf survivors through the criminal or civil legal system, facilitate sup.port groups involving Deaf survivors, and provide many of the other critical services Deaf survivors need in crisis and healing. These advocates also play an important role in advancing justice for survivors by advocating to close gaps and address troubling trends in the responses of key systemsÑcivil, criminal, medicalÑto domestic and sexual violence. Domestic violence programs and rape crisis centers cannot eliminate communication and cultural barriers without gaining expertise on the Deaf community, leaving Deaf survivors alone to navigate the systems involved in victimsÕ lives on top of the trauma they have experienced. Audism in mainstream services and systems Services and supports designed for survivors of domestic and sexual violence are not immune to audism, which can influence how these services are designed and implement.ed, as well as the culture and attitudes that define them. Many professionals in the crime victims field construct their work through an anti-oppression framework, but most are unfamiliar with audism. Awareness is a necessary first step toward understanding how it contributes to disparities Deaf survivors experience and identifying strategies to eradicate it in our responses to survivors. Lack of capacity among Deaf service providers to address violence Deaf organizations and groups within the Deaf community werenÕt designed to address domestic and sexual violence and, thus, usually are not sources of support for Deaf survivors. Their staff or volunteers lack specialized knowledge about domestic and sexual violence, best practices, and protocols to guide services to survivors, and other resources necessary to safely and effectively support survivors at all stages in their journey. Without specialized capacity, these programs cannot address complex and critical issues that have dire consequences for survivors, including confidentiality and how information is quickly shared from person to person in the Deaf community (often referred to as the Deaf grapevine). Additionally, these programs often struggle to navigate relationships and interactions with perpetrators who are members of the community and may be clients of their programs. As a result, these programs run the risk of contributing to safety concerns for survivors rather than mitigating them. Additionally, the lack of attention and misinformation about domestic and sexual violence within the Deaf community coupled with the invisibility of the Deaf community within domestic violence programs and rape crisis centers creates a double code of silence for many Deaf survivors. Services for Deaf, by Deaf: a promising strategy In 1986, in response to the lack of accessible services for Deaf survivors in Seattle, a small group of Deaf women and their allies founded Abused Deaf WomenÕs Advocacy Services (ADWAS). They sought to fill these gaps by providing Deaf survivors with services that were rooted in the culture and language of the Deaf community. To achieve their goal, they created ADWAS to be run by and for Deaf people, making it the first victim services organization of its kind in the world. Since then, ADWAS has provided thousands of people in the Deaf community in the Seattle area and beyond with an array of Deaf-centered services, including education and outreach, crisis intervention, advocacy, and housing. Its success was recognized in the mid-1990s when it received federal funding to replicate its victim services model in 15 cities across the country. Today, thanks to this and other replication efforts, there are a small number of agencies that provide Deaf-centered services to Deaf survivors in the United States. The majority of these agencies are stand-alone Deaf-specific victim services organizations like ADWAS. To a lesser extent, some programs are run out of general Deaf social service organizations and, in a few rare instances, administratively housed in a hearing victim services organization (such as a domestic violence shelter or a rape crisis center). Regardless of the configuration, these Deaf-specific programs provide the Deaf community with emergency hotlines, crisis intervention, medical and legal advocacy, counseling and other supportive services, peer support opportunities, and community outreach and education. The design and delivery of these standard victim services is tailored to meet the needs of the Deaf community. For example, many offer email, text, and video-based emergency hotlines and routinely use social media to educate the community about domestic and sexual violence, which better meets the technology and communication norms of the community. Woman signing ÔhelpÕ. advocacy Map showing the 15 agencies providing Deaf-specific services to Deaf survivors in the United States. Services as located in Washington state, California, Utah, Colorado, Minnesota, Iowa, Wisconsin, Illinois, Ohio, Washington D.C., New York, and Vermont. Agencies providing Deaf-specific services to Deaf survivors in the United States Information provided by: ADWAS, Seattle, WA 1. Abused Deaf WomenÕs Advocacy Services, Seattle, WA 2. Deaf Survivor Advocacy for Empowerment, North Highlands, CA 3. DeafHope, Oakland, CA 4. Peace Over Violence, Los Angeles, CA 5. Salt Lake City Sego Lily Center for the Abused Deaf, Salt Lake City, UT 6. Deaf Overcoming Violence Through Empowerment, Denver, CO 7. Communication Service for the Deaf, Saint Paul, MN 8. Deaf Iowans Against Abuse, Cedar Rapids, IA 9. Deaf Unity, Madison, WI 10. Chicago Hearing Society, Chicago, IL 11. Deaf Women Against Violence Everywhere, Worthington, OH 12. Deaf Abused WomenÕs Network, Washington, DC 13. Barrier Free Living, New York, NY 14. Advocacy Services for Abused Deaf Victims, Rochester, NY 15. Deaf Victims Advocacy Services, South Barre, VT These programs also provide services unique to the Deaf community. For example, Deaf Hope in the Bay Area and a few other Deaf-specific programs are developing non-criminal justice based approaches to holding abusers account.able and curbing their abusive behavior, such as limiting their access to Deaf cultural events or boycotting their businesses. Developing these approaches is more possible in a small, close-knit community that often values collectivism, such as the Deaf community, but the lessons learned can be instrumental for the crime victims field as a whole. Additionally, these programs have expanded services that include advocacy and training efforts aimed at hearing programs to help them better understand the needs of the Deaf community and increase their ability to provide accommodations and other cultural needs of Deaf survivors seeking their services. The provision of services to survivors by specially trained advocates who themselves are Deaf is perhaps the most promising model for serving Deaf survivors. The provision of services to survivors by specially trained advocates who themselves are Deaf is perhaps the most promising model for serving Deaf survivors. Because services are delivered by Deaf staff members and volunteers, survivors are able to communicate to advocates and other professionals directlyÑwithout an interpreterÑin their native language. Using oneÕs native language makes communication easier, especially when individuals may be experiencing trauma or discussing particularly sensitive and difficult topics. It is also easier for Deaf survivors to connect with one another and provide valuable peer support in Deaf-specific programs because they are not the only Deaf survivors being served. The result is victim services that not only account for Deaf culture, but also are defined by it. Challenges facing Deaf programs Despite the progress made, there continues to be a severe lack of Deaf-specific services in the United States. Accord.ing to Abused Deaf WomenÕs Advocacy Services, there are only 15 programs nationwide designed to serve Deaf survivors, with a few others in the early stages of development.18 By contrast, there are more than 1,905 programs that address domestic violence, according to the National Network to End Domestic Violence, and 1,100 that address sexual assault in general listed on the U.S. Department of JusticeÕs Directory of Crime Victim Services.19 To expand and sustain their work into the future, Deaf-specific victim service providers will have to overcome unique funding and staffing challenges that limit their ability to deliver more resource-intensive essential services, such as emergency shelter or transitional housing for survivors fleeing abuse. Funding: Like most victim services organizations, many Deaf-specific programs struggle to secure funding to support their operationsÑespecially from public sources, which are arguably the largest source of fund.ing in the victim services field. But Deaf programs face unique barriers, as well. Graphic pie chart showing the number of programs addressing domestic and sexual violence in the United States. 1,100 Sexual violence programs. 1,905 Domestic violence programs. 15 Deaf-specific domestic and sexual violence programs. Number of programs addressing domestic and sexual violence in the United States 1,100 Sexual violence programs 15 Deaf-specific domestic and sexual violence programs 1,905 Domestic violence programs ¥ Many of these programs are small startups that have yet to build the internal capacity necessary to apply for or manage public funding, including grant writing experience. ¥ Funders often place a premium on programs being able to serve large numbers of survivors and Deaf programs canÕt compete with the numbers promised by hearing programs. ¥ Specialized grant programs focusing on under.served victim groups are emerging that donÕt emphasize quantity in service provision, but not all of them specifically identify the Deaf community as an underserved or priority population. ¥ Having a relationship with a potential funder often plays a key role in whether or not funds are secured, but many Deaf victim services providers do not have ready access to funders to build those relationships due to communication barriers. With.out readily available interpreters, for example, it is difficult for Deaf professionals to network with or have in-person informational meetings with funders. Staffing: With minimal to no financial support, most Deaf programs operate with a small number of paid staff, if lucky, or a cadre of specially trained volunteers. They are often tasked with serving Deaf survivors from across an entire state or even multiple states because their program is likely to be the only one of its kind in the area, spreading these programsÕ limited resources even thinner. Staff are also less likely than their hearing counterparts to access training opportunities, either because hosts do not have the resources for on-site interpreters or to caption virtual trainings. Enhancing the capacity of hearing service providers and systems Given the lack of Deaf-specific services and the resources needed to develop them, enhancing the capacity of exist.ing mainstream service providers and systems to better meet the needs of Deaf survivors has emerged as an interim step. Several national efforts, like VeraÕs, have emerged in recent years to build capacity within existing domestic violence programs, rape crisis centers, and allied systems (criminal justice, medical, etc.).20 This not only ensures that Deaf survivors have greater access to services and sup.port in their community, but also increases the number of options Deaf survivors have when deciding where to go for support. A small but growing number of organizations have answered the challenge, enhancing their capacity by: Building relationships with Deaf organizations and the Deaf community in their service area. Working with members of the Deaf community to edu.cate staff on the local Deaf community and culture, and domestic and sexual violence against Deaf people. Developing an understanding of audism, exploring its role in the barriers Deaf survivors face, and engaging in a process of becoming hearing allies to the Deaf community. Reviewing the accessibility of their physical, communication, information, policy, and attitudinal environments to identify barriers for Deaf people and creating plans to remove them. Establishing agreements with interpreter agencies to ensure qualified, trauma-informed interpreters are avail.able, especially during nights and weekends. Finding money (often by including costs related to accommodations in grant proposal budgets) to cover the costs of auxiliary aids or other accommodations, such as sign language interpreters, that create equal access for Deaf survivors, staff and volunteers, and community partners. Recruiting staff and volunteers who are fluent in ASL or teaching existing staff basic sign language. Creating captioned videos to communicate critical information about their services that has previously only been available in writing. College-age women standing outside communicating in American Sign Language. Adopting policies on effective communication that outline a law enforcement agencyÕs responsibilities for creating communication access, procedures for secuing auxiliary aids (such as interpreters), and tips for communicating effectively with Deaf and hard of hearing people. None of these initiatives can occur, however, without the buy-in from hearing programs, financial resources, and participation from the Deaf community. Collaboration between Deaf and hearing programs Collaboration between the Deaf community, hearing victim service providers, and allied systems (such as criminal justice and medical) is essential in every community so Deaf survivors can access services and supports that arenÕt provided by Deaf-specific programs, such as transitional housing, forensic exams, and protection orders. The degree and nature of the collaboration depends on whether Deaf-specific victim services are already in place and, if so, what they offer. In communities without Deaf-specific services, for example, a more intensive and structured process is necessary to bring representatives from the Deaf and victim services communities together on equal footing to determine how to best meet the needs of the community. Communities with a more defined strategy for serving Deaf survivors might center their collaborative efforts on cross-training to build the baseline capacity of both Deaf and hearing programs, developing protocols for how the organizations can work together to support a Deaf survivor, and strategizing for removing barriers Deaf survivors routinely face in the community. Despite their benefits, collaborations of this nature are rare. As discussed earlier, the invisibility of Deaf survivors in most communities, the communication and cultural barriers they face, the Deaf communityÕs frequent mistrust of mainstream services and systems, and the lack of accessibility to most mainstream interventions can impede relationship building and meaningful participation. Without a foundation to build from, it is difficult for hearing professionals to make in-roads into the Deaf community and for Deaf providers to advocate for changes within hearing victim service organizations and allied systems without leading to strained relationships and challenging dynamics at the collaboration table. Developing Deaf-allied services Vera House, a comprehensive domestic and sexual violence service agency, and the local Deaf community in Syracuse, New York built a strong collaboration to develop Deaf-allied services for Deaf survivors of domestic and sexual violence using the following ingredients for success.21 After uncovering the unmet needs of Deaf survivors in its community through a series of focus groups with service providers and Deaf community members, Vera House committed itself to address.ing the gaps and working to ensure Deaf survivors have equal access to services and supports. The staff embarked on a journey that begin with building their own capacity and stressed ongoing relationship and trust building with the Deaf community. They created opportunities to build their knowledge of Deaf culture; developed policies and protocols that support communication access for Deaf survivors; brought on Deaf and signing advocates; supported training of American Sign Language interpreters; and began having their events interpreted. Alongside these efforts, they met with leaders in the Deaf community; convened open forums with Deaf community members; held an open house for the Deaf community; invited Deaf survivors to serve on advisory groups; and attend Deaf events and meetings in the community. This multi-pronged approach has led to strong connections, mutual understanding, and trust between Vera House and the Deaf community in Syracuse that serves as a strong foundation as they develop and implement Deaf-allied services. ÒCollaboration between hearing service providers and the Deaf community is crucial in ensuring culturally and linguistically competent services are being provided to Deaf survivors of domestic and sexual violence. Vera House in Syracuse is a fabulous model for others to consider emulating.ÓErin Esposito, Advocacy Services for Abused Deaf Victims Successful collaborations require commitment, financial resources, time, and mutual understanding, among other things. All participants must embark on the hard work of developing a joint vision for serving Deaf survivors in a community. This requires intentional conversation, deliberate planning, and execution. It also requires skilled leadership to help create a work process that is culturally and linguistically appropriate, to facilitate that process, and to help the group find common ground and have an impact. Financial resourc.es are also needed for ASL interpreters and other accommodations members need to participate. Recommendations What follows is a list of initial recommendations for improving Deaf survivorsÕ access to and experiences with victim services and criminal justice system interventions. Recognize Deaf as a distinct cultural and linguistic group. Specifically naming the Deaf community is a powerful way for policymakers and practitioners to communicate an understanding of the communityÕs uniqueness; build trust; and, subsequently, more effectively appeal to and reach Deaf individuals, whether they are survivors in need of services and support or practitioners in the victim services field. This recognition can take many forms, such as mentioning the Deaf community in outreach brochures, referencing the experiences of Deaf survivors in annual reports and other publications, and including the Deaf community as an underserved or priority community in strategic plans and funding solicitations. Woman signing ÔhelpÕ. help Dedicate resources to address domestic and sexual violence in the Deaf community. Effectively address.ing violence in the Deaf community requires services and supports that are built on a high degree of cultural and linguistic competence. Funders, state-level administrators and advocacy groups, and practitioners should consider how best to dedicate resources to ensure that Deaf survivors have access to such services. This includes financial resources to support the development and ongoing operations of Deaf-specific programs, as well as the enhancement of hearing programs and systems so they can effectively work in tandem with Deaf-specific programs. It also includes staff time, meet.ing space, and the cost of accommodations, like ASL interpreters, to support a community-based planning effort to determine how to achieve culturally competent services in communities where they currently donÕt exist. Prioritize Deaf expertise. Deaf people with expertise in domestic and sexual violence should not only be included in any Deaf-specific efforts in the victim services field, but should be engaged as leaders or co-leaders. In addition to understanding the unique needs of Deaf survivors, Deaf experts bring an under.standing of the culture, dynamics, and needs of the Deaf community in the jurisdiction in question. If engaged in meaningful ways, Deaf leaders can increase the credibility of the effort, which is likely to increase support for the effort in the broader Deaf community. Fill research gaps. Fundamental questions about domestic and sexual violence in the Deaf community remain unanswered, making it difficult for policymakers and practitioners to craft effective prevention and intervention approaches. More research in the following three priority areas is required: (1) incidence and prevalence of domestic and sexual violence against Deaf individuals; (2) utilization of victim services and criminal justice system interventions; and (3) evaluations of Deaf-specific programs and other promising approach.es to serving Deaf survivors. Collect data on Deaf cultural status. Domestic violence programs and rape crisis centers routinely collect basic information about the people who contact them for help and the people they ultimately serve, and similar information is collected on the victims and offenders involved at various points in the criminal justice system. Few entities across the country, though, collect information on Deaf cultural affiliation. Gathering data about Deaf cultural status, like other diversity data, is essential to understanding these survivorsÕ needs and planning services to meet them. In addition, this information can be used to identify disparities in service use and justice system experiences and to develop benchmarks for reducing those disparities. ÒTo be accountable, each member of the community has to engage in healthy dialogue and ask themselves how we perpetuate violence or create safety. When a survivor speaks out, what is our reaction? How do we provide support?Ó Amber Hodson, DeafHope Conclusion No one should have to choose between their culture and language and their safety and healing. Yet, in the absence of cultural and linguistic services, Deaf survivors of domes.tic and sexual violence are forced to make that choice every day. They are faced with impossible dilemmas such as, ÒShould I flee to safety in a shelter where I canÕt communicate with anyone and no one understands my culture? Or should I stay in my home where my safety and well-being is at risk, but I can freely communicate and be part of a culture that brings me pride and strength?Ó By recognizing the Deaf community as a cultural and linguistic minority and supporting services tailored to this community, the victim services field can take the critical first steps toward a time when Deaf survivors donÕt have to make that choice, and can easily obtain the services and support they need to live safe and fulfilling lives. Endnotes 1 Ruth is a fictitious character whose story is a composite of several Deaf survivors of domestic violence. 2 Melissa L. Anderson and Irene W. Leigh, ÒIntimate partner violence against deaf female college students,Ó Violence Against Women 17 (2013): 822Ð834. 3 Ross Mitchell and Michael Karchmer, ÒChasing the mythical ten percent: Parental hearing status of deaf and hard of hearing students in the United States,Ó Sign Language Studies, 4 (2004): 138Ð163. 4 TheÊSurvey of Income and Program ParticipationÊ(SIPP) is a statistical survey conducted by the United States Census Bureau. Matthew W. Brault, Americans With Disabilities: 2010, Current Population Re.ports, (Washington, DC: U.S. Census Bureau, 2012); http://www.census.gov/prod/2012pubs/p70-131.pdf (accessed November 21, 2014). 5 Ibid, p. 8. 6 Ross E. Mitchell, Travas A. Young, Bellamie Bachleda, and Michael A. Karchmer, ÒHow many people use ASL in the United States? Why estimates need updating.Ó Sign Language Studies 6, no. 3 (2006): 306.335. 7 Ibid. 8 According to Vaughn I. Rickert et al., ÒRates and risk factors for sexual violence among an ethnically diverse sample of adolescents,Ó Archives of Pediatrics & Adolescent Medicine 158, no. 12 (2004): 1132Ð1139, forced sexual experiences can include Òverbal sexual coercion (being talked or pressured into having unwanted intercourse),Ó while sexual assault includes Òunwanted sexual contact (touching or kissing without permission)Ó and Òrape/attempted rape (use of physical force, alcohol, or other drugs or position of power).Ó 9 Laverne McQuiller Williams and Judy L. Porter, ÒAn Examination of the Incidence of Sexual, Physical, and Psychological Abuse and Sexual Harassment on a College Campus Among Under.represented PopulationsÓ (paper presented at the Western Society of Criminology Conference, Honolulu, Hawaii, February 2010). 10 Melissa L. Anderson and Irene W. Leigh, ÒIntimate partner violence against deaf female college students,Ó Violence Against Women 17 (2011): 822Ð834. 11 Robert Q. Pollard, Erika Sutter, and Catherine Cerulli, ÒIntimate Partner Violence Reported by Two Samples of Deaf Adults via a Computerized American Sign Language Survey,Ó Journal of Interpersonal Violence, (2014): 948Ð965. 12 Patricia M. Sullivan and John F. Knutson, ÒMaltreatment and behavioral characteristics of youth who are deaf and hard of hearing,Ó Sexuality and Disability 16, no. 4, (1998): 295Ð319. 13 Ibid. 14 Patricia M. Sullivan and John F. Knutson ÒMaltreatment and disabilities: A population-based epidemiological study.Ó Child Abuse & Neglect 24, no. 10, (2000): 1257Ð1273. 15 Candice Tate, Trauma in the Deaf Population: Definition, experience, and services (Alexandria, VA: National Association of State Mental Health Program Directors, 2012). 16 When making a relay call, a Deaf individual contacts the national Telecommunications Relay Service using a TTY or computer. The caller is connected to a communications assistant who relays communication between the caller and the recipient. A Deaf caller, for example, types the message to the assistant, who speaks and relays it to the hearing recipient. The recipient responds with a spoken message, which the assistant types to the Deaf caller who reads it on their TTY or computer screen. 17 ADA: Americans With Disabilities Act of 1990. Public Law 101Ð336. ¤ 35.160 and 36.303. 108th Congress, 2nd session (July 26, 1990). 18 Abused Deaf WomenÕs Advocacy Services, http://www.adwas.org/, (accessed November 21, 2014). 19 National Network to End Domestic Violence, Domestic Violence Counts: Census 2013 Report, http://nnedv.org/projects/census/4225-domestic-violence-counts-census-2013-report.html (accessed June 2, 2014); U.S. Department of Justice, Office for Victims of Crime, ÒDirectory of Crime Victim Services.Ó http://ovc.ncjrs.org/findvictimservices/search.asp (accessed June 2, 2014). 20 The name of VeraÕs project is Increasing Culturally and Linguistically Competent Services Initiative. To learn more about this initiative, visit VeraÕs website. 21 Vera House is not affiliated with the Vera Institute of Justice. Acknowledgments A special thanks to those who have contributed their expertise, time, and perspective to this policy and practice brief through participation in a focus group, reviewing the publication, or helping us to better understand the needs of Deaf survivors: Keri Darling, director, Deaf Vermonters Advocacy Services; Ashley Demyan, research associate, Vera Institute of Justice; Erin Esposito, executive director, Advocacy Services for Abused Deaf Victims; Amy Loder, senior program specialist, U.S. Department of Justice, Office on Violence Against Women; Libby Stanley, program director, Abused Deaf WomenÕs Advocacy Services; and Deaf advocates and hearing allies Wendie Abramson, Vonnie Basham, Martina ÒMJÓ Bienvenu, Sheri Farinha, Jessalyn Frank, Amber Hodson, Tara Holcomb, Cathy Hoog, Amy Judy, Soon Sun Kim, Damara Paris, Kim Parra, Jennifer Pfau, Sasha Ponappa, Cheryl Prusinski, Julie Rems-Smario, Peggie Reyna, Lindsay Ryan Anthony, Amy Rousseau, Tess Sakolsky, Marilyn Smith, Alice Sykora, Gretchen Waech, and Aimee Whyte. © Vera Institute of Justice 2015. All rights reserved. The Vera Institute of Justice is an independent nonprofit organization that combines expertise in research, demonstration projects, and technical assistance to help leaders in government and civil society improve the systems people rely on for justice and safety. For more information, visit www.vera.org. The Center on Victimization and Safety works with communities around the country to fashion services that reach, appeal to, and benefit all victims. Our work focuses on communities of people who are at elevated risk of harm but often marginalized from victim services and the criminal justice system. We combine research, technical assistance, and training to equip policymakers and practitioners with the information, skills, and resources needed to effectively serve all victims. For more information on the Center on Victimization and Safety, please contact cvs@vera.org or 212.376.3096. This project was supported by Grant No. 2011-TA-AX-K124 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women. Cover image used with permission of ASL4DeafKids. Photographer: Clare Cassidy. Layout and infographic design by Stephanie Grey Design. Suggested citation Nancy Smith and Charity Hope. Culture, Language, and Access: Key Considerations for Serving Deaf Survivors of Domestic and Sexual Violence. New York: Vera Institute of Justice, 2015. 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