Barriers and accessibility-improving strategies in mental health services for persons with hearing or vision impairments: Perspectives from professionals and clients—A qualitative interview study

Abstract

Objectives: Despite studies showing that persons with hearing impairments (HI) or vision impairments (VI) have an increased risk of developing mental health disorders, mental health services frequently are not accessible and suited to the specific needs of both populations. However, there is limited research addressing how mental health services can be improved to meet these needs. Design: This qualitative interview study explores barriers and strategies to improve accessibility in mental health services for persons with HI or VI in Germany, as viewed with a multi-perspective approach. Methods: Using problem-centred interviews, which combine a flexible interview guide with a focus on specific issues, we applied a participatory research approach to gather insights from 58 participants, including mental health professionals specialised in treating persons with HI or VI and persons with HI or VI with lived experience as clients in mental health services. Results: The qualitative content analysis yielded 44 inductive subcategories within a category system of seven deductive main categories. Key barriers included communication, limited visual accessibility and environmental challenges, while improvement strategies focused on tailored therapeutic adaptations as well as proactive and collaborative practices between therapists and clients. Conclusions: Our findings highlight the need for structural changes and expanded mental health services that cater to the specific needs of persons with sensory impairments. These insights should contribute to improving mental health services, training programs for professionals and emphasise the importance of including persons with HI or VI, both professionals and clients, in the participatory development of accessible care.