Better Mental-Health Care for Deaf and Hard-of-Hearing Patients Requires Greater Clinical Competence

Mental-health professionals may need to adapt routine psychiatric assessments when working with people who are Deaf or hard of hearing, according to a recent clinical viewpoint published in JAMA Psychiatry and discussed by Psychiatric Times. The authors highlight concerns that differences in communication, language and hearing can sometimes be mistaken for psychiatric symptoms.

The article distinguishes between Deaf people who use sign language and hard-of-hearing individuals who primarily communicate through speech, hearing devices or residual hearing. Both groups can encounter additional emotional, cognitive and practical difficulties when accessing mental-health services. The authors refer to these combined burdens as a “deaf tax”, which can also affect understanding of diagnoses, treatment plans and medication adherence.

Particular attention is given to the Mental Status Examination (MSE). For patients who communicate through American Sign Language (ASL), facial movements can carry both linguistic and emotional meaning. Consequently, clinicians unfamiliar with signed languages may incorrectly interpret normal linguistic features as changes in affect, thought processes or behaviour.

The authors also caution that people who have experienced limited language exposure may display unusual communication patterns that could be mistaken for disorganised speech or psychosis. For hard-of-hearing patients, listening fatigue, changes in speech patterns and difficulties following conversations may similarly complicate clinical assessment.

The viewpoint recommends specialised training for mental-health professionals, greater collaboration with qualified interpreters and wider availability of assistive technologies such as live captioning and frequency-modulated systems. In-person interpreters may be particularly helpful for patients who use sign language because they can better account for regional variations and communication nuances.

The authors argue that incorporating Deaf and hard-of-hearing considerations into psychiatric training could help clinicians make more accurate assessments and improve communication throughout treatment.

30-09-2026