The editors' preface to this interesting and informative book states that it “is intended to be an introductory text to mental health and deaf people for two main groups of people: those familiar with deaf people but not with mental health and those familiar with mental health but not with deaf people”. They have succeeded in the second of these aims, but deaf or hearing people completely new to the mental health field would probably benefit from reading a mainstream introductory text in the first instance.

The contributors, experienced deaf and hearing professionals from Britain and the USA, describe the epidemiology and assessment of deafness, the deaf cultural community and the assessment and management of mental health problems in this population. This is a difficult task, as many complex factors operate. Deafness is technically a disability measured by doctors and audiologists. For those with acquired loss it is a deficit and all too often a social stigma. However, for those people who are profoundly deaf from early life the issues are different. Although about 90% of them are born into hearing families and many have little or no access to sign language in childhood, many grow up to identify themselves as members of the deaf community, with its pride in deaf culture and language. Unfortunately, the limitations in age-appropriate language development and in educational and social opportunities that so often occur during a deaf person's childhood may leave a legacy of frustration, underachievement, dependency and low self-esteem that can lead to mental health problems in adult life. Deaf children are also more likely to be victims of abuse, emotional, physical or sexual. They may have additional difficulties, such as sight, neurological or learning problems, possibly associated with the cause of the deafness (e.g. meningitis and rubella).

Psychiatric illnesses such as affective disorder and schizophrenia occur with equal frequency in deaf and hearing people. However, delays and difficulties in diagnosis and lack of access to appropriate services have too often meant that deaf people have not received proper help, or that they have remained in institutional settings, sometimes without adequate communication, for long periods. This book addresses all of these issues from different professional perspectives.

There are several recurring themes, such as the importance of appropriate knowledge, attitudes and communication skills in the assessment and treatment of deaf people and how all of these are greatly enhanced by the involvement of deaf people themselves in service provision: Peter Hindley's chapter shows how risk factors in the childhood of deaf people can be tackled. Other excellent chapters include those on psychological therapies, the role of interpreters and rehabilitation.

As society develops a more positive attitude to minority groups, it is to be hoped that there will be a raised awareness of deaf people's rights to services as outlined by the Disability Discrimination Act, the National Service Framework (Department of Health, 1999) and the Health Advisory Service (1998) report Forging New Channels. Mental Health and Deafness is to be commended as a valuable contribution to this process.