Former patients are criticizing a plan by Fairview Health to close a substance-abuse treatment program for the deaf and hard of hearing, arguing that its unique approach to therapy and communication can help a vulnerable population that is at risk for binge drinking and drug abuse.

Joy Dalen, who is profoundly deaf, credits the Fairview program for succeeding where others failed two decades ago, because the counselors knew sign language and wouldn't let her use communication barriers as an excuse to withdraw and ignore addiction treatment. "Other programs had given up on me," said Dalen, 45, in an e-mail, "because I could isolate myself and outlast their attempts to communicate."

Closure of the inpatient program, which is located within the University of Minnesota Medical Center in Minneapolis, is part of a broader plan by Fairview to rein in costs and address a multimillion-dollar budget deficit. Other cuts include scaling down the Bethesda long-term care hospital and the potential closure of St. Joseph's Hospital, both in St. Paul.

In a written statement, Fairview said patients who are deaf or hard of hearing will still have access to inpatient substance abuse treatment, with support from interpreters. The program had also seen declining enrollment, serving only 16 patients this year.

"The decision … was made to ensure patients still have access to care they need while making best use of our resources," the statement said.

Deaf and hard of hearing patients aren't alone in opposing Fairview's downsizing, which is coming as the health system and the U launch their new M Health Fairview brand of hospital and clinic care.

A key component of that deal is Fairview's pledge to increase payments to the U for medical research, funds that must come either from increased clinical revenue or budget savings.

The Minnesota chapter of the National Alliance on Mental Illness issued a statement opposing any closure of St. Joseph's, which provides a substantial amount of inpatient mental health care.

And the Minnesota Nurses Association is leading a march Thursday at Mears Park in downtown St. Paul, demanding that Fairview be more open about its cuts and how they will affect patients.

Substance abuse can be a particular problem for people who are deaf — starting when they are teens and are grasping for ways to fit in with their peers, and later as adults when they self-medicate due to the stress and anxiety they experience in social settings and at work — said Debra Guthmann, a national advocate for people who are deaf or hard of hearing who was the program director for the U's specialized treatment program until 1995.

A University of Massachusetts study last year found that deaf and hard of hearing people start using alcohol and marijuana at similar ages to their peers, but are more likely to become heavy users.

The specialized program at the U hospital is staffed by people with sign-language skills and uses writing and artistic expression to help patients communicate their struggles with addiction, Guthmann said.

Treatment in a general program is harder, she said, because a key to recovery is intimate communication in group meetings and with other patients.

"It'd be like going to a Spanish-speaking [treatment] program and only being able to speak with your peers if there was an interpreter present."

Guthmann said the Fairview program is unique and that its loss will have a national impact even though it serves fewer than 100 people per year.

She also said Fairview had chances in the past year to save the program, but opted not to seek emergency state funding or federal grants. Enrollment declined in part because Fairview cut back on charity care payments, she added, which help patients cover out of pocket costs of treatment.