About two weeks ago, we received an unsettling text from Miranda Meyers, who regularly shares with us her experiences as a college student with cochlear implants. That post was written out of the pain aroused by the tragic death of another college student who, like Miranda, was a CI user. Although she pointed out that she didn’t know her personally, the incident caused Miranda deep sorrow and provoked thoughts about difficulties among young people and specifically within the deaf population. Miranda wrote candidly and boldly, from her own life experience, about feelings of loneliness, alienation, and difficulty arising from the challenges faced by people with hearing loss who cope every day in a world of people with typical hearing.

Miranda’s post is a call to rehabilitation and hearing healthcare professionals to consider this aspect of the patient's well-being as an inseparable part of the rehabilitation of people with hearing loss. This call is consistent with the position of the World Health Organization (WHO), as well as to other organizations and individual clinicians. There are already cochlear implant programs that are guided by a holistic approach towards rehabilitation. Yet, there is great importance in discussing this topic, which needs to be more widely explored in research and in the clinical setting so that people with hearing loss receive the comprehensive support and enjoy the best possible quality of life.

Thank you, Miranda.
Naama Tsach
naama@acialliance.org

A few weeks ago I woke up and checked Facebook like I always do. I saw a friend had posted an obituary, but I didn’t think much of it. Then a day later, I saw another friend post about their friend’s death, and the pictures looked eerily familiar. I put two and two together and realized both of those friends were talking about the same person. After reading the obituary, I realized this young woman had killed herself. And on top of that, I realized my two friends knew her because she had cochlear implants just like them. Whew. Reading about a suicide is hard enough, but learning that someone who is just like me decided to take her own life is devastating. I felt numb after realizing how she went.

This death has thrown me. I did not even know Melissa (the young woman who died) but it has hit me in a way I never knew possible. Melissa was deaf and had cochlear implants like me. She grew up with listening and spoken language just like me. She was my age, and she was just starting her life. She was just like me, and she decided she couldn’t suffer anymore. Unfortunately, these thoughts and actions are not uncommon in our community. Depression is a common secondary condition in people with disabilities. There are reports of higher rates of depression among deaf and hard of hearing people compared to the typical hearing population but accurate counts of suicidal behavior are not known.

Life is harder for us, and we live in a world that is not built for us. We do feel left out sometimes, and the pain that comes with being different can be too much to handle.

Awareness Among CI Professionals Should be a Priority
I think it is essential that professionals of all types in this field be aware of these higher rates of depression and that people with hearing loss should be taken care by multidisciplinary rehabilitation teams that include accessible mental health services as part of the medical care. Parents who pursue cochlear implants for their young children do so because they feel it will give them the best quality of life; as such, quality of life should include psychosocial health. These issues are not consistently considered as part of cochlear implantation as far as I know; they certainly were never brought up to me or to my parents. Audiologists, speech therapists, and even surgeons tend to focus on their own aspect of care. I understand that, they were trained in a specific aspect of care, and that’s what they are expert in. But, all medical practitioners in this field should also understand that this aspect of care is also essential. Parents need to be made aware of the possibility of mental health issues and what to look for in their deaf child who receives cochlear implants.

Inclusion of Psychologists in CI Practice
It would be absolutely wonderful if more psychologists and psychiatrists studied the effect of hearing loss on individuals including the long-term mental health outcomes of those who are implanted at a young age. It would also be wonderful if more therapists knew how to better care for deaf and hard of hearing individuals. Life is hard and being different sure can make it a lot harder. We have to adapt to this world since it is not built for us. That can be tiring and defeating, and everyone in the field needs to understand that. One idea is to have CI centers provide information on recommended psychologists for patients to call if they feel the need to talk to a professional. Or, they could even have psychologist(s) on staff. Another idea is to encourage periodic sessions with recommended psychologists when patients come in for programming. This way the psychologist can keep an eye on the patient, and treat that patient if needed. Many people might benefit from participating in therapy regularly to just talk, even if they aren’t struggling with thoughts like Melissa had.

Support Groups Can Help
It is also so important that everyone in this community knows they are not alone. Many people in this community, including myself, have gone through periods where they feel they have nowhere to turn. They feel that no one truly understands, but that is simply not true. There are many thousands of us in the United States, and more around the world. Official and unofficial support groups are necessary. I am so thankful to have friends who have cochlear implants as well; we can just talk about things only we understand. I know that I am not alone in this world since I have them. Parents also need support. CI centers could play an integral part in organizing these, or even just introducing two kids of similar age so that they could meet. We often are the only kids in our school with cochlear implants so our activities after school typically don’t have kids with cochlear implants either. We do not necessarily know where to meet people similar to us, so professionals in this field have a responsibility to help organize those connections.

In the wake of Melissa’s death, it is so important that we never let anyone slip through the cracks like this again. This is a gap in our medical care that sorely needs to be filled. I am not a doctor or mental health professional, but I am sure some of these ideas are a good starting point. I hope to become a fierce advocate for these ideas. There must be other ways to help those with hearing loss of all ages maintain good mental health. Melissa’s death will not be in vain. Her memory will live on in the cochlear implant community.

Please check up on your friends, let everyone you love know you love them, and reach out if you’re struggling. Your life matters.

Comment

I attended high school with Melissa. Miranda raised the very important topic of potential loneliness and depression among young adult CI users, and greater awareness of these mental health issues among professionals working with this population is necessary. However, I want to clarify that this is not what pushed Melissa to suicide. During high school, she was diagnosed with another medical condition that significantly impacted her life. Throughout her time in high school, Melissa continued to take on all her battles with courage. Her parents were well aware of Melissa’s issues and made sure she received the necessary help and care.

Jessica Chaikof