We now move to the short debate. Some of you may be leaving the meeting. I will pause briefly just to allow that to happen. I will now call the short debate, and Mark Isherwood is to move today's short debate. Over to you, Mark Isherwood.

Diolch, Llywydd. I've agreed to allow one minute for both Joel James and Jane Dodds to speak in this debate. Regrettably, I'm advised that it's not possible for this short debate to have live British Sign Language interpretation, not least due to the complexities of doing so under the current restrictions and in a fully virtual Plenary meeting. But it will be made available with British Sign Language interpretation after the debate in the same way as is done with First Minister's questions each week. 

The report 'Deaf People Wales: Hidden Inequality', compiled by the all-Wales deaf mental health and well-being group, was launched at the 21 October meeting of the Senedd's cross-party group on deaf issues by one of the report's authors, Dr Julia Terry, associate professor of mental health and nursing at Swansea University, highlighting the challenges faced by deaf people in Wales who experience mental health problems and calling on the Welsh Government to make significant changes.

As the Chair of the cross-party group, I pledged to raise this report in the Senedd and welcome this opportunity to do so, in the hope that it may generate a positive response from the Welsh Government and help drive the change required. The report reveals that deaf people in Wales are experiencing significant mental health inequalities because there is a lack of accessible services, no specialist deaf mental health service in Wales and limited training about deaf issues for health and care workers. Issues raised by the report include: limited implementation of the all-Wales accessible information standards, meaning that deaf people still don't get information in ways that they can understand and engage with; a need for an advice and signposting service for individuals, families, and staff; a knowledge gap because lots of health professionals do not know about deaf counselling services for deaf people that are provided by deaf people; and deaf people have to be admitted to Birmingham, London or Manchester specialist mental health wards for full access to communication in BSL for assessment and/or treatment. As Dr Julia Terry states,

'The mental health of Deaf people in Wales has been a neglected issue for decades. Deaf people are already at twice the risk of mental health problems and find it extremely difficult to get help as services rarely provide accessible information or culturally relevant services. If nothing changes, the mental health of Deaf people in Wales will continue to be at risk.'

The all-Wales deaf mental health and well-being group, which includes a wide range of experts working in this area and collaborated with deaf and hearing professionals to compile this report, aims to raise awareness within the Welsh Government and other relevant stakeholders and to recommend ways to improve mental health outcomes for deaf people in Wales.

A literature search was conducted, then data gathered from case studies from deaf people and British Sign Language interpreters, evaluations of mental health promotion initiatives involving deaf people, statistics from British Sign Language interpreting services and information from UK specialist deaf mental health services. Forty per cent of deaf people experience mental health problems—twice the level amongst people in hearing populations. Worryingly, the British Society for Mental Health and Deafness reported in 2020 that Wales is the only UK country that does not provide a clear pathway or service to meet the needs of deaf people experiencing poor mental health. The coronavirus pandemic has forced many people into poverty and mental health crisis, with the exclusions faced by deaf BSL users even more stark.

This report highlights findings that deaf people often experience limited access to healthcare, variations in access to education, negative societal attitudes and reduced opportunities regarding work and leisure. Many deaf people are not recorded as being deaf in their primary care records. If they're then referred to other health services, specific details that may impact on their health service experience are frequently not passed on and therefore unknown. In 2019, Public Health Wales commissioned a report to explore health behaviours and barriers experienced by deaf people in Wales and reported that access to health services is a major problem, and deaf people often avoid contact with health services due to poor past experiences. That was before the pandemic started. In 2010, the Welsh Government commissioned the RNID to investigate barriers to inclusion faced by deaf and hard-of-hearing people in Wales. Eighty-four per cent of deaf respondents highlighted that it was hard to use health services because there was limited provision for deaf people to use services in Wales, particularly health services. Despite the Assembly, as it then was, having recognised BSL as a language in its own right in 2006, there is still a shortage of BSL interpreters. On the national register of communication professionals working with deaf and deafblind people, only 48 individuals are registered as resident in Wales, with six at training level, below the target of 64 set by the Welsh Government.

The report highlights research showing that deaf children, particularly those born to hearing parents, are disadvantaged from birth, as they do not have access to the same education and health opportunities as their hearing peers; that potentially hearing parents might have had no experience of a visual language, such as BSL, nor have had any contact with deaf role models; that if parents and siblings can't use BSL, children are isolated and families struggle with communication; that there is little support or resource for the deaf child’s family to learn BSL; that deaf children do not have the opportunity for incidental learning opportunities, to ask questions, to pick up news, information or social capital that extends into education; that deaf people regularly experience isolation, discrimination and stress daily, which contributes to experiences of anxiety and depression; that deaf people persistently battle to access mental health services, with limited provision for them in Wales; that south Wales has no specialised deaf mental health network, and the service in north Wales has now been dissolved; that mostly deaf patients requiring in-patient care are referred to England, at great distance from their families and social networks, and at significant financial cost to the health service; that the secure anonymised information linkage databank, or SAIL, based at Swansea University, reports that systems in Wales are not able to provide accurate information about the number of deaf people or the number of deaf people with mental health problems, and that the NHS Wales Informatics Services support this view; that new patient forms at GP surgeries often do not ask about hearing, so this information is rarely collated on health databases or central systems; that many GP surgeries do not know local arrangements for booking BSL interpreters to enable deaf people to engage in meaningful discussions at health appointments; that, as over 2,500 children in Wales are deaf, around 1,000 children in Wales are likely to be at risk of mental health problems in the future; that, currently, there are no established links between deaf child and adolescent mental health services in Wales and deaf child and adolescent mental health services in the UK, unlike between hearing CAMHS services in Wales and other hearing CAMHS services in other UK areas; that there are four main providers of interpreting services for deaf people in Wales, but arrangements for booking BSL interpreters are patchy and not always known to deaf people. Frequently, health staff are unaware of how booking systems work and do not know how to help. Online interpreting can be an alternative, but uptake in Wales remains low due to procedural and technical issues.

Based upon its findings, the report makes a series of recommendations to address these issues and therefore to improve the positive mental health of deaf people in Wales. As Dr Julia Terry states,

'a conversation needs to start with Welsh Government to develop short- and long-term solutions to improve services in Wales for Deaf people experiencing poor mental health.'

In summary, the all-Wales deaf mental health and well-being group are keen to start a dialogue with the Welsh Government about the issues raised in this report. It is essential that progress is made towards immediate and short-term solutions, as well as effective long-term provision to improve mental health pathways for deaf people in Wales.

Last February, my motion proposing that the Senedd

'notes a proposal for a Bill that would make provision to encourage the use of British Sign Language (BSL) in Wales, and improve access to education and services in BSL' was passed here with cross-party support, no Member voting against, and Welsh Government Ministers routinely abstaining. My motion noted that my proposed Bill would

'ensure that the deaf community and people with hearing loss have a voice in the design and delivery of services to ensure they meet the needs of service users'.

Scores of deaf people and deaf-led groups across Wales contacted me in support of this, telling me that although the Welsh Government was developing a new BSL charter for Wales, my planned BSL Bill was an enormous step forward. Only one person wrote in opposition.

As I then stated,

'there is clearly an appetite for such BSL legislation across the Senedd chamber. We will continue to pursue this on behalf of the D/deaf community'.

Although I have continued to submit bids for a private Member's Bill in this Senedd accordingly and will continue to do so, I have not yet been successful. I therefore conclude by urging the Welsh Government to indicate its support for such a Bill during this Senedd term. Diolch yn fawr.

I'd like to start by thanking Mark for raising such an important topic for debate and allowing me to contribute to it. As some of you know, like Mark, I have hearing difficulties, and I wanted to use this opportunity to highlight my own experiences and to impress upon the Government the importance of this issue and the need for it to be seriously tackled.

As a child, I was diagnosed with otitis media with effusion, and I hope I've pronounced that correctly, or glue ear, and, sadly, after several hospital operations to try and alleviate this, my eardrums were left weak and badly scarred. A few years ago, they ultimately collapsed, and as a result my hearing, which was always terrible, was made substantially worse and I developed severe tinnitus as well, all of which will only get worse with age.

Poor hearing doesn't just affect one's ability to hear. From my own experience, it leads to feelings of isolation and loneliness, disorientation in noisy environments, nausea in quiet environments or when someone is speaking too quietly or softly, and an overall lack of confidence in social situations, with the painful irony being that I can hear people talking, I just can't understand what they are saying. Above all, I think people will never truly understand how embarrassing it is to continually ask someone to repeat themselves, the feelings you experience when they get annoyed with this and the impact it has on you when you are just dismissed as being thick or stupid.

You can also forget about learning another language, it took me years of speech therapy just to be able to learn English, and this has made me terribly self-conscious about the way I speak. I was very lucky that I had help and support from my parents, family and friends, but I know this is not the case for a great number of people who suffer hearing loss, particularly the elderly. These are the types of barriers that deaf people face that don't allow them to live to their full potential and don't allow them to maximise their physical and mental well-being. Despite the Well-being of Future Generations (Wales) Act becoming law in 2015, there's no recent comprehensive survey on the health and well-being of the deaf community in Wales. A detailed population-specific survey is therefore needed to assess how members of the Welsh deaf community specifically interact, as Mark said, with public and healthcare services within their respective communities and what the state of their well-being is. Thankfully, there is better public awareness of hearing loss. However, this is still a condition that limits so much of life that is available to others, and it could be made so much better if it was recognised more fully in society and by Government. Thank you, Mark, for raising this debate, and I also want to thank Jane as well for contributing to it. Thank you.

First of all, may I thank Mark Isherwood for tabling a debate on this topic, which is so very important, and I'm also very grateful for the opportunity to participate?

I have done a very small amount of work with children and their families who have hearing problems, and obviously in my work as a social worker have encountered children and young people who are deaf. As we've heard, the issue is one of figures. We're not clear how many people, children and young people across Wales actually are deaf, but around 3,200 children in Wales are deaf according to the National Deaf Children's Society in Wales, and they say, through their research, that around 60 per cent are more likely to experience mental health problems than other children.

I just want to touch very briefly on child protection issues in children and young people who are deaf. There is research to demonstrate that adverse childhood experiences, known as ACEs, are higher in children who are deaf. They are more likely to be abused for many reasons. For children who are deaf, signs of distress are often mistakenly assumed to be related to the child's impairment rather than recognised as an indication of abuse. There is a lack of awareness or agreement about what constitutes the abuse of deaf and disabled children, and this leads to ambiguity in the minds of both children and adults regarding the most appropriate course of action. Finally, the NSPCC tell us that deaf and disabled children are often invisible in terms of talking with them and consulting with them. In some cases, services were absent from their lives and for others provision was inadequate or inappropriate.

So, just to finish, in this very brief contribution, deaf children and young people in Wales and their families need additional support and help to be able to connect with their communities. There needs to be additional training and support to those working with them, particularly around their mental health, and our systems, such as our youth justice system, need to adjust their practice to ensure they meet their needs. Once again, I thank Mark for this debate. Thank you for allowing me to take part, and thank you to Joel as well. Diolch yn fawr iawn.

The Minister for Social Justice to reply to the debate. Jane Hutt. 

Diolch, Llywydd. Can I start by thanking Mark Isherwood for tabling this debate today and for ensuring this important matter is brought forward as part of this Senedd's evident commitment to advancing equality and human rights in Wales? And can I also thank Joel James for your contribution this evening? Joel, you've given such a powerful account of your personal lived experience as a result of hearing difficulties in your life, and that's such important evidence for us, not just tonight but in your role here as a Senedd Member and in all that you contribute to in terms of debates, questions and inquiries. So, thank you for telling us about your life today. Thank you very much, Joel. Thank you to Jane as well, Jane Dodds, for what you have described and the evidence you've given as part of this debate as a result of your work particularly with children and young people.

I do want to also just acknowledge and thank Mark for raising this important debate today, because it was, as you said, 24 February last year, nearly a year ago, in the last year of the fifth Senedd, that we debated your motion for a Bill that would make a provision to encourage the use of British Sign Language in Wales and improve access to education and services in BSL, and I was pleased to respond to that debate. And, of course, last week, we've had other statements and debates.

Last December we marked the international day of disabled people's rights, and I made a statement then, highlighting how the COVID-19 pandemic has had a devastating impact on disabled people, which has exasperated existing inequalities. This debate goes beyond that, and before the pandemic, in terms of policy actions that we want to take together.

I will say, in terms of the pandemic, there's no doubt that deaf people have been adversely affected by the pandemic, having to face COVID-19-related restrictions that have limited everyday use of BSL, and this has been acknowledged tonight, hasn't it, Mark, in terms of not being able to use BSL for this particular debate? But I'm really glad that it's going to be used following the debate.

In terms of our disability equality forum, which I chair: meeting very frequently during the course of the pandemic; trying to respond appropriately to the matters affecting disabled people as well; and meeting with the representatives from organisations that support deaf people. Deaf people themselves, crucially, are part of that forum. Some are also members of the steering group, which you brought forward in your questions to me this afternoon, Mark, which developed the report 'Locked Out: Liberating disabled people's lives and rights in Wales beyond Covid-19', which we commissioned as part of the forum's work, and it does focus, that report, on the stark inequities that disabled people face, but also highlights the barriers that affect deaf people and the use of BSL. We've got to acknowledge, alongside the use of BSL, of course, the impact this would have in relation to lip speakers and lip readers. It's a very sobering report. I'm glad you also brought it to the attention of other Senedd Members today and in this debate.

We have the disability rights taskforce, and they will—. Obviously, this debate, I'm sure, will be important evidence to feed into that, because it's going to take forward the recommendations of the report—the taskforce—and it does contain findings and recommendations in relation to the experiences of deaf people through the course of the pandemic.

Last year we did, as a Welsh Government, commission the British Deaf Association to undertake a BSL audit report. This has been acknowledged tonight. The report's findings and recommendations, which, clearly, I'll be sharing with you, will also provide a very useful framework in terms of responding as well to the 'Locked out' report, the specific support we need for deaf people, which we can build into the work programme of the disability rights taskforce. I've mentioned it's had its inaugural meeting. It's made up of people and organisations with lived experience, expertise and capacity to leave a long-lasting change from across Wales.

We would look to translate research reports into practical and sustainable actions, improving outcomes, changing things for the better for disabled and deaf people across Wales. Of course, this is all based and underpinned by the social model of disability, recognising that society's values, behaviours, structures, social and economic policies and built environments—they disable people, and the 'Locked out' report has laid this work bare in terms of the need to ensure long-term change.

BSL is an essential means of communication with deaf people that enables effective social inclusion and access to services. In 2004 the Welsh Government formally recognised BSL as a language in its own right. We recognise the importance of accessible communications. We're the first Government in the UK to ensure our COVID-19 press conferences include the presence of a BSL interpreter.

The accessible communications group was also established to overcome barriers and improve access to information, and that's been invaluable. We need much more to be done to co-ordinate an approach to promotion of support for BSL. We're committed to doing this, we're committed to the development of a BSL charter, and once the audit process is finalised, we anticipate signing up to the British Deaf Association's BSL charter. This would allow us to lead by example, and hopefully the Commission can come alongside Welsh Government in terms of signing up to this.

I want to just also say that we do recognise the mental health delivery, the all-Wales deaf mental health and well-being group, and recognise the report that Mark Isherwood has highlighted tonight, entitled 'Deaf People Wales: Hidden Inequality'. I have asked officials to consider the findings as part of the work towards the implementation of 'Together for Mental Health', and the framework of action for Wales, the integrated framework of care and support for people who are deaf or living with hearing loss. We have to mainstream this clearly into health and social care, and not just health and social care but across Welsh Government in terms of access to housing, transport, education—across the board.

There is a lot more that I could say tonight in terms of how we're moving this forward, but I would say the framework of action for 2017-20, the integrated framework of care and support for people who are deaf or living with hearing loss, has been extended to 2023. This is going to steer—not just guide but steer—the outcomes of provision in terms of care and support across Wales. And we work closely, particularly with health boards, to ensure communication of information on health needs for people with a sensory loss are being met in line with the Equality Act 2010, as set out in the all-Wales standards. 

So, can I just finally say we're committed as a Welsh Government to the advancement and strengthening of equality and human rights for people in Wales? I welcome the opportunity to debate today the inequalities faced by deaf people. We've heard what is under way to address these and how we can build on what's working, what more needs to be done to remove barriers that society puts in place, and we're also pleased that there's evidently a strong commitment here cross-party to tackle disability discrimination. As there is with all inequalities, it takes collective commitment and the energy of all leaders and communities across Wales to ensure sustained improvements and better outcomes for all the citizens of Wales. Diolch yn fawr i chi i gyd. Thank you to you all. 

Yes indeed, thank you to all of you who contributed to that important debate. With that, we'll close proceedings for today.

The meeting ended at 18:03.