Psychological well-being and mental health risks in deaf and hard of hearing youth: a systematic review

Abstract

Objective: This systematic review aimed to assess the mental health of children and adolescents who are Deaf or Hard of Hearing (DHH), including those with moderate to profound levels of hearing loss, exploring factors influencing their psychological well-being and social functioning.

Methods: Following PRISMA guidelines, a comprehensive search was conducted in nine databases (Medline, PubMed, PsycINFO, etc.) up to January 2025. Empirical qualitative, quantitative, and mixed-methods studies published in English were included, with 46 studies selected after screening. Study quality was assessed using a 14-criteria scoring system. Data extraction was performed by the first author and validated by co-authors.

Results: A total of 46 studies with 22,859 participants (ages 6-21) were included. Findings revealed that individuals who are DHH or moderate to profound hearing loss experience higher rates of internalizing disorders, such as anxiety and depression, compared to hearing peers. Social exclusion, communication barriers, and stigma were significant risk factors. Mainstream schools exacerbated mental health challenges, whereas specialized schools provided a supportive environment. Early diagnosis and intervention, especially cochlear implants, improved psychosocial development. Communication proficiency, especially sign language, positively impacted quality of life and mental health. Parental involvement and targeted interventions helped mitigate behavioral challenges and executive functioning deficits.

Conclusion: This review highlights the key factors affecting the mental health of DHH youth, including communication methods, educational setting, early intervention, and social relationships. Tailored interventions addressing these factors are essential for improving psychosocial development. Future research should focus on developing and testing interventions to enhance the mental health and well-being of individuals who are DHH or have moderate to profound hearing loss.

Keywords: Communication; Deaf; Early intervention; Educational environment; Mental health; Moderate to profound hearing loss; Quality of life; Social relationships; Stigma.