First year with the complex disabilities, sight loss and blind Deep Engagement Partner

The complex disabilities, sight loss and blind Deep Engagement Partner (DEP) have completed the first year of their 3-year programme.

Complex disabilities

Focus group topic: oral health (all 4 focus groups had the same topic)

Objectives

• Explore how people with complex needs experience dental care and oral health
• Identify barriers to access, communication, and understanding
• Promote inclusive, person-centred approaches in dental services

Findings

• Many participants rely on carers for oral hygiene – few recognised floss or mouthwash
• Dental visits are often avoided because of fear, poor communication, or inaccessible environments
• Dentists rarely use communication aids like Makaton, picture cards, or social stories
• People with complex needs benefit from visual aids, hands-on learning, and tailored communication
• Preferences for communication vary — some prefer photos, symbols or emojis
• Social stories and models help reduce anxiety and improve understanding of dental procedures
• Focus groups were made accessible using adapted materials, physical adjustments, and safeguarding practices

Recommendations

• Use communication tools such as Makaton, Picture Exchange Communication System (PECS), Voice Output Communication Aids (VOCAs), and objects of reference in dental settings
• Provide visual aids and real objects to support learning and reduce anxiety
• Make sure dental environments are physically accessible and sensory-friendly
• Train dental staff in inclusive communication and disability awareness
• Offer social stories with clear visuals and simple language tailored to individual needs
• Engage people with complex needs in decision-making about their oral health
• Use inclusive focus group practices, such as plain language, flexible timing, easy-to-read materials, and consent protocols

Sight loss

Focus group topic: mental health (all 4 focus groups had the same topic)

Objectives

• Understand how sight loss affects mental health
• Identify what makes it hard to access mental health support
• Explore the role of peer support and lived experience
• Inform service development and policy in Birmingham

Findings

• Sight loss has a significant emotional impact, including grief, frustration, and suicidal thoughts
• The standard 6-week counselling model is not good enough for long-term conditions like sight loss
• Barriers include stigma, poor continuity of care, inaccessible communication, and transport challenges
• Peer support and community groups are highly valued and often preferred over formal counselling
• Lived experience among counsellors improves empathy and relevance of support
• Many participants do not identify their experiences as "mental health" issues, even though they feel low or overwhelmed
• Stigma around mental health prevents some from seeking help or disclosing struggles
• Participants expressed a need for personalised, flexible, and ongoing mental health support

Recommendations

• Train mental health professionals in sight loss awareness and inclusive communication
• Extend counselling beyond 6 weeks and improve follow-up
• Commission tailored mental health services for people with sight loss
• Invest in peer support and community-based initiatives to reduce isolation
• Improve transport options and train public transport staff in sighted guiding
• Offer accessible communication formats and support for navigating services
• Develop strategies for individualised support for long-term health conditions
• Address stigma through education and culturally sensitive outreach

Page last updated: 11 February 2026