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My Hero: Nick Kitson - The Quiet Revolutionary

A tribute to the man who transformed mental health care for the Deaf around the world

 

Note: In this article I use the term ‘Deaf’ (with a capital ‘D’) to refer to profoundly deaf people who were deafened before speech. Many Deaf people use British Sign Language (BSL) as their first language and consider themselves members of Deaf community and culture.

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Much as Sigmund Freud is seen as the seminal figure in the world of psychoanalysis, Nick Kitson (1950-2014) is widely considered a pioneer of the modern treatment of Deaf people with mental health issues. Many consider him a hero for this alone, but he’s also my hero because of his achievement in transforming psychoanalysis in the Deaf world, and it’s thanks to him that I’m a psychoanalytical psychotherapist today.

 

Until Nick began his quiet and total revolution in the treatment of Deaf people with mental health issues, a lack of treatment in their own language meant many were failed, often through misdiagnosis, and that their outcomes were far worse than their hearing counterparts'. Nick saw Deaf people were being severely failed by the system and he set about getting them the treatment they deserved.

 

Nick and I first met in 1989, when I took a job as an unqualified nursing assistant at Springfield Hospital, a specialist psychiatric centre in south London. I’m Deaf and at that time, like many in my community, my self confidence and ambitions were low. On top of this, I had no understanding of the world of mental health and thought psychiatrists could read minds.

 

Nick was tall, stern-looking and ran the Deaf unit. You can imagine I was a little over-awed by him, but as I got to know him better, it became clear there were different, more inspiring reasons for my awe.

 

Nick started working with Deaf people in 1984 when he became a consultant psychiatrist at Springfield. His clients were all profoundly Deaf with very specialised needs and often traumatic personal histories: most had never even heard speech, the majority had hearing parents with little idea of how to communicate with their children, and some had been sent to boarding school at the age of three with no understanding of what was happening to them or why.

 

Nick knew little about Deaf people and nothing about services for them but could see that they were being failed by the system. Funded by the British National Health Service, he spent the next nine months immersing himself in Deaf culture, learning British Sign Language and visiting facilities and services for Deaf people in the UK, Europe and USA.

 

The turning point was a visit, accompanied by his wife Karen, a former nurse, to Gallaudet University, a private university for the Deaf in Washington DC. “It was a completely signing environment and a real eye-opener,” Karen says. “We didn’t know sign language and everyone else was using it, whether Deaf or not. It wasn’t just students and lecturers: the cleaners, receptionists and catering staff all signed. We were rather lost and suddenly understood what being Deaf in a hearing world must be like.”

 

Common sense had told Nick that Deaf people would be the best providers of services for the Deaf (they’re more fluent at signing than hearing people because they use it to communicate themselves, they intuitively understand Deaf culture and they’d be able adapt to a patient's needs far more easily than their hearing counterparts) and his experiences at Gallaudet and elsewhere proved it. Back at Springfield, he pushed for changes to the recruitment system to ensure more Deaf and signing people were employed and fought for their access to training and qualifications. As he brought more such staff onto the ward he saw, as expected, that the patients’ rate of seclusion reduced and their overall mental state improved dramatically.

 

In the late 1980s, a charity helped Nick secure a grotty, gutted old church in Balham and he transformed it into a groundbreaking, specially-designed new home for the unit. Everything, from the decoration and lighting to phones and entry systems, was chosen in consideration of Deaf people’s needs and, from the minute you walked in, it was a signing environment: It employed Deaf people and required sign language at all times, including in conversations between hearing people. Deaf people, staff and patients alike, felt it was their space.

 

Nick’s revolution necessitated the development of clinical training for Deaf counsellors, and he campaigned long and hard for Deaf people, like myself, to have access to training. He negotiated the establishment of courses for Deaf people (through the Westminster Pastoral Foundation, a counselling organisation) that allowed sign language users access to counselling training in our own language - a world’s first. He also established new forums in the UK and Europe for professionals working in the field to learn about the unit’s work, exchange ideas and advocate change. Despite his many achievements, and I haven’t listed them all here, Nick was an incredibly humble person with a wonderful attitude to Deaf patients - and a great grasp of BSL.

 

On a typical morning, a few patients would be glancing between the clock and the door, waiting for him to arrive - they knew roughly what time he’d get into work. Then the door would open and Nick would enter, perhaps wet from the rain and always burdened with his large briefcase and files. The patients would rush over to him and immediately engage him on a range of subjects. He’d smile, put down his things, and give them all the time they needed. Whatever his own mood, he always behaved in a manner that had a soothing effect on those around him.

 

Just before 9am, Nick would join us for breakfast with the patients and they were frequently surprised by his honesty and openness. The fact that he could be ‘fed-up’ in just the same way as them seemed to boost their confidence and sense of wellbeing, leading them to seek him out, rather than fear and avoid him.

 

He had a real passion to improve the lives of Deaf people, including the Deaf staff he worked with, and constantly encouraged us to apply for training courses which had generally been inaccessible to Deaf people before then. In fact, he dedicated a large amount of time and energy to supporting all the Deaf staff who were trying to break down the barriers to higher learning and obtain clinical qualifications.

 

And this is why Nick’s my personal hero: Having encouraged me to start clinical training, he spent many hours with me revising the theories and practice of psychoanalytical psychotherapy. He would stay late after work to make sure I was supported in my learning and my clinical work, and as I became more experienced, he involved me in the training of other Deaf counsellors, delegating responsibilities to me that at first felt like falling in at the deep end, but actually helped me develop even further. His trademark was a shrug and, with a glint in his eye, these questions: "Why not?", "What’s stopping you?", and "Who said you can’t?" These questions had a profound impact on me – and on everyone else he asked.

 

With this training under my belt, I eventually became a qualified psychotherapist, gaining the same professional qualifications as my hearing counterparts. All these years later, I’m still thankful to Nick for starting me on this journey and, through his support and encouragement, enabling me to achieve so much. Many other Deaf practitioners and professionals will feel this gratitude too.

 

By campaigning for Deaf staff to be employed and trained, and fighting for Deaf people to have equal access to services, Nick not only played a pivotal role in transforming psychoanalysis for Deaf people (both as practitioners and patients); he influenced the wider world. And still he always refused to take any credit and remained humble to the end.

 

“All Nick wanted for Deaf people was the same access to psychiatric services and opportunities as hearing people,” said Karen Kitson, his wife. “To do that, the culture had to change.” Nick’s belief that Deaf people were just as capable of being mental health providers as their hearing counterparts had a profound impact on me; his stand for equal and proper treatment for his patients has transformed psychiatric care for the Deaf around the world. He’s widely and much missed, but his influence lives on.

 

With thanks to Herbert Klein - you can read his tribute to Nick here:

 

 

Further Reading:
Nick’s obituary in BJPysch, one of the world's leading psychiatric journals.

Jane Whitaker-Douglas

About the Writer

Jane is a psychoanalytical psychotherapist at Springfield Hospital in south London.

 

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