Deaf People in Germany: Mental Health Literacy and Perception of Mental Health Services - an Online Study

Background: Deaf people encounter numerous barriers as a linguistic minority in mental health services. Mental health literacy (MHL), which is essential for recognition, treatment, and help-seeking behavior in mental disorders, and shapes how people cope with stressors, has not yet been studied in deaf people. Material and Methods: Deaf people (n = 390) were surveyed online about MHL and perception of mental health services. A version of the Mental Health Literacy Questionnaire translated into German sign language was used for this purpose. The influence of the timepoint of language acquisition and sign language as a natural first language on MHL were investigated using Welch tests and Cohen's d. Results:The mean age of participants was 32.6 years (SD = 11.0) and a large proportion (69%) described themselves as female. In terms of time of deafness, 78.7% of participants were born deaf/hard of hearing and 14.1% became deaf before their fourth birthday. Early language acquisition (p > 0.001) and learning a sign language as a first language (p = 0.02) were associated with higher levels of MHL. Perception of the care system related to various aspects (e.g., involvement in treatment) was described. Discussion: MHL in deaf people is increased when early language acquisition is given, as well as when sign language was learned as a first language. Consequently, societal and health policy efforts are necessary to enable early language acquisition and access to sign language for deaf infants. As additional measures, possible deficits in MHL can be addressed with improved accessibility to mental health information. The availability of information materials in sign language and improved training for deaf staff and sign language interpreters could play an important role in this regard.