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

Uzair Khalid¹, Nida Majeed², Cathy J Chovaz^{3

4

5

6}, Fahad Riaz Choudhary^{7

8}, Khadeeja Munawa⁹

Affiliations

¹ Department of Psychiatry, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, Punjab, Pakistan.
² Department of Psychology, Government College University, Lahore, Punjab, Pakistan.
³ King's University College at, Western University CA, London, Ontario, Canada.
⁴ Department of Psychology and Co-Director, Research Institute with Children, London, Ontario, Canada.
⁵ CDEAF King's University College, 35 Rainforest, London, Ontario, Canada.
⁶ Adjunct Research Professor, Dept. of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
⁷ Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, Canada.
⁸ Department of Psychology, Turner Institute for Brain and Mental Health, Monash University Clayton Campus, 35 Rainforest Walk, Clayton VIC 3800, Australia.
⁹ Department of Psychology, Turner Institute for Brain and Mental Health, Monash University Clayton Campus, 35 Rainforest Walk, Clayton VIC 3800, Australia. khadeeja.munawar14@gmail.com.

PMID: 40569433
DOI: 10.1007/s00787-025-02795-6

Review

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

Uzair Khalid et al. Eur Child Adolesc Psychiatry. 2025.

. 2025 Jun 26.

doi: 10.1007/s00787-025-02795-6. Online ahead of print.

Authors

Uzair Khalid¹, Nida Majeed², Cathy J Chovaz^{3

4

5

6}, Fahad Riaz Choudhary^{7

8}, Khadeeja Munawa⁹

Affiliations

¹ Department of Psychiatry, Bahawal Victoria Hospital, Quaid-E-Azam Medical College, Bahawalpur, Punjab, Pakistan.
² Department of Psychology, Government College University, Lahore, Punjab, Pakistan.
³ King's University College at, Western University CA, London, Ontario, Canada.
⁴ Department of Psychology and Co-Director, Research Institute with Children, London, Ontario, Canada.
⁵ CDEAF King's University College, 35 Rainforest, London, Ontario, Canada.
⁶ Adjunct Research Professor, Dept. of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
⁷ Faculty of Health and Behavioural Sciences, Lakehead University, Thunder Bay, Canada.
⁸ Department of Psychology, Turner Institute for Brain and Mental Health, Monash University Clayton Campus, 35 Rainforest Walk, Clayton VIC 3800, Australia.
⁹ Department of Psychology, Turner Institute for Brain and Mental Health, Monash University Clayton Campus, 35 Rainforest Walk, Clayton VIC 3800, Australia. khadeeja.munawar14@gmail.com.

PMID: 40569433
DOI: 10.1007/s00787-025-02795-6

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.

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Conflict of interest statement

Declarations. Disclosure: statement: Nothing to disclose. Ethics approval: This article does not contain any studies of human participants or animals performed by any of the authors. Patient consent: Not applicable. Public health significance: This article explores the mental health outcomes of children and adolescents with moderate to profound hearing loss, including those who are Deaf. It highlights how factors like communication methods, educational settings, early interventions, and social relationships impact their psychological well-being and social functioning. The review stresses the need for tailored interventions focused on communication and education to address the unique challenges faced by this population. These insights can guide public health policies to support their psychosocial development and reduce mental health disparities. It also calls for future research to inform evidence-based practices and improve the health and well-being of this underserved population. Competing interests: The authors declare no competing interests.

References

1. Newsted D et al (2020) Approach to hearing loss. Can Fam Physician 66(11):803–809 - PubMed - PMC
1. WHO. Deafness and hearing loss (2021); Available from: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
1. Rogers KD et al (2024) Health outcomes in deaf signing populations: A systematic review. PLoS ONE 19(4):e0298479 - PubMed - PMC - DOI
1. Sutton-Spence R, Woll B (1999) The linguistics of British sign language: an introduction. Cambridge University Press, Cambridge - DOI
1. Stefánsdóttir H et al (2023) Measuring speech intelligibility with deaf and hard-of-hearing children: A systematic review. J Deaf Stud Deaf Educ 29(2):265–277 - PMC - DOI

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

Full Text Sources