Masking and metacognition: depression and anxiety rates of individuals with hearing loss in the COVID- 19 pandemic

Individuals who are d/Deaf or hard of hearing (DHH) faced multiple challenges in the COVID- 19 pandemic. One of these challenges was navigating the significant increase of communication barriers that masking and social distancing brought. This study explored how masking and metacognition affected the mental health of DHH. A web-based cross-sectional survey was used. Of the 190 respondents, 122 participants were included in the descriptive statistics and regression analyses. Results indicate that communicating in masked environments decreased listening comprehension by 25%. As the number of hours in masked conversations increased, depression and anxiety scores also increased. Metacognition also had a relationship to the mental health of DHH during the pandemic. As metacognition scores increased, depression and anxiety scores increased. In interactions with clients with hearing loss, professionals should be aware that their masked communication could trigger a heightened vulnerability to mental health problems and decreased cognitive efficiency. Additionally, masking may contribute to further inequity and increase exclusion for DHH. These findings are important as they help to raise awareness of the ways that masking– a practice that has significant health benefits– can also have a deleterious impact on clients who are DHH. Beyond reporting on the findings, this article provides some suggestions for best practice to avoid contributing to further inequity and increased exclusion in clinical settings.