Connecticut State Department of Mental Health and Addiction Services

Glossary of DHOH Terms 


Three people in discussion. A woman is using ASL to communicate with another woman while a man wearing a stethoscope looks on.


Disability and DHOH related terms include:

Accessible Mental Health and Substance Use Services includes the full continuum of mental health and substance use disorder services with the use of auxiliary aids and services for a deaf or hard of hearing individual to communicate with licensed mental health professionals who are not fluent in the primary mode, style, or language of the individual requiring such services.

Americans with Disabilities Act (ADA) is civil rights law which prohibits discrimination due to disabilities and ensures that persons with disabilities have equal access to programs, goods and services as other individuals. 

There are five Titles to the ADA:

  • Title I, Employment
  • Title II, State and Local Governments
  • Title III, Places of Public Accommodation including businesses and non-profits which provide goods and services
  • Title IV, Telecommunications
  • Title V, Miscellaneous

DMHAS is a Title II entity which provides persons with disabilities equal access and equally effective services as those provided to persons who do not have disabilities. Title II entities are prohibited from denying people an opportunity to participate in programs services or activities or give them an opportunity that is less effective than the opportunity given to others.

Title II and Title III entities are responsible for providing persons with disabilities effective communication on request. 

The ADA requires both Title II and Title III entities to provide qualified interpreting services at no cost to DMHAS clients, visitors, guests or their companions.

Auxiliary aids refer to the methods of communicating with persons who are Deaf, Deafblind, Hard of Hearing or have other communication disabilities. Auxiliary aids are reasonable modifications which are provide on request of the person with disabilities. They can include assistive listening devices, audio recordings, Captioning (open, closed and realtime) Communication Access Realtime Transmission (CART), communication boards, qualified note takers, Qualified Sign Language Interpreters (including but not limited to: American Sign Language, Cued Speech, Certified Deaf Interpreters), screen readers, speech to speech transliterator, Video Relay, written communication. Auxiliary aids and services do not include hearing aids and devices for personal use.

Communication Mode, Style, and Language, DMHAS offers one or more of the following interpreting services: Certified Deaf Interpreting (CDI), Tactile, Pro-Tactile & Haptics Interpreting, Low Vision Interpreting, Communication Access Real-time Translations (CART), Signed English Interpreting, Foreign Sign Language Interpreting, Oral Interpreting, Remote Captions, Cued Speech, Video Remote Interpreting (VRI).  

Companion: The term “companion” includes a family member, friend, or associate of a person seeking or receiving DMHAS’ services with whom DMHAS is authorized to communicate with.

Computer Access Realtime Translation (CART), also known as “real-time captioning” allows to instant translation of spoke word into English text which can be displayed on an individual’s computer monitor, phone or tablet, or projected on a screen to appear as captions. 

Culturally and Linguistically Affirmative Services: “Culturally and linguistically affirmative mental health and substance use services” includes providing the full continuum of mental health and substance use disorder services to deaf or hard of hearing individual through licensed mental health professionals fluent in the primary communication mode, style, and language as well as the cultural needs of the individual requiring such services.

These services are provided directly between the individual being served and the service provider. Such services are to be distinguished from “accessible mental health and substance use services” which involves the use of interpreters or other auxiliary aids and services that provide access to mental health and substance use services.

Deaf, Deafblind, Hard of Hearing (DHOH), describe hearing impairments. 

  • Deafness and ‘Deaf’, deafness is described as a hearing impairment. ‘Deaf’ with a capital ‘D’ often refers to people who may have been deaf all of their lives or since before they started to learn to talk and who may communicate in sign language as their first language.
  • Deafblindness, is a condition where an individual has combined hearing and vision impairments which limit their access to both auditory and visual information.
  • Hard of Hearing refers to a hearing impairment where there may be enough residual hearing that an auxiliary device or hearing aid provides adequate assistance to process sound.

Disability Etiquette, is defined as respectful ways to communicate with and about persons with disabilities. For communicating with someone who is Deaf, Deafblind, Hard of Hearing, etiquette includes:

  1. Get the person’s attention respectfully.
  2. Honoring the person’s preferences for communicating with them.
  3. Avoid a lot of distractions when speaking to someone.
  4. Make sure the person can see you well. Lighting is important as well as speaking directly to the person without covering your mouth.
  5. DO NOT SHOUT! Speak clearly and rephrase instead of repeating something a person doesn’t understand.
  6. If the person uses sign language remember American Sign Language and other forms of sign language have their own syntax.
  7. Talk directly to the person and not the interpreter.

Effective Communication ensures a person with disabilities who is Deaf, Deafblind, Hard of Hearing or who has a vision or speech disability can communicate with and receive information in a way that is equal to persons who do not have disabilities. The key to effective communication is the nature, length, complexity and context of the communication and the person’s usual method(s) of communication. 

State and local governments and places of public accommodation must provide auxiliary aids and services when needed. ADA Requirements: Effective Communication | ADA.gov

Legal Requirements: “People who are Deaf, DeafBlind, or Hard of Hearing are entitled to effective communication with state and local government agencies. Title II of the Americans with Disabilities Act (ADA), 42 U.S.C. §§12131-12134, forbids discrimination by any public entity.”

Qualified Interpreters: DMHAS contracts with DHOH vendors for interpreting Services approved by the Department of Administrative Services (DAS). These services are arranged on request by DMHAS state-operated facilities at no cost to DMHAS clients, visitors or guests or their companions. 

TTY Relay Services involve the use of Text Telephones (TTYs) and communication assistants. A person using a TTY calls a relay service and the communication assistant connects the person to the number they want to dial. The communication assistant then relays the call between the parties. A voice caller can use the TTY Relay Service to speak to a TTY user.

TTY Relay Services effective as a TTY user can contact anyone they need to speak with rather than calling a dedicated line that may or may not be monitored. TTY Relay Services allow anyone contact a TTY user as well. However, Emergency Services are required to maintain a TTY number. 

For more information go to: RelayCT 

Video Relay Service (VRS), is a free, subscriber-based service for people who use sign language and have videophones, smart phones, or computers with video communication capabilities.

Video remote interpreting (VRI) is a fee-based service that uses video conferencing technology to access an off-site interpreter to provide real-time sign language or oral interpreting services for conversations between hearing people and people who are deaf or have hearing loss.

This page was prepared by William Pierce, ADA Title II Coordinator, (William.Pierce@ct.gov) Department of Mental Health and Addiction Services Office of the Commissioner, 860-418-7000 (TTY Relay 711)

ACA Notice: DMHAS and other federally funded healthcare providers complies with federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (Patient Protection and Affordable Care Act Section 1557).

DMHAS DHOH Services Glossary Revised: December 2023


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