Doctoral Dissertations

Orcid ID


Date of Award


Degree Type


Degree Name

Doctor of Philosophy


Social Work

Major Professor

Theresa Abrams, Elizabeth Strand

Committee Members

Stephen McGarity, Patti Johnstone


Hearing loss, a communication disorder, is a global concern with approximately 20.3% of people around the world having some degree of hearing loss and is associated with chronic communication barriers. These barriers impact the mental health of individuals with hearing loss. This mixed method systematic review seeks to synthesize the communication barriers that contribute to negative mental health outcomes for adults. Databases searched include Pubmed, Cinahl, Scopus, Proquest, and Taylor and Francis. A total of 1215 articles were identified in August 2021. Through a systematic extraction, sixteen articles (ten quantitative, six qualitative) met the inclusion and exclusion criteria. Communication barriers were organized in the socio-ecological framework and included Intrapersonal barriers (e.g. active listening avoidance), Interpersonal barriers (e.g. lack of consideration from communication partner), Environmental barriers (e.g. reduced access to side conversations), and Systemic barriers (e.g. ableism). The mental health outcomes associated with these barriers were psychosocial factors (e.g. lower quality of life), mental health disorders (e.g., depression), and lack of access to integrated care (e.g., lack of sign language fluent providers). To help address these barriers, authors suggest integrating mental health and hearing health care. Clinicians can increase awareness of how chronic communication barriers contributes to poor mental health outcomes of their patients with hearing loss. Increasing mental health literacy can help individuals with hearing loss advocate for a decrease in communication barriers.

Available for download on Friday, May 15, 2026

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