ObjectiveTo investigate the determinants of mental health among severe hearing-impaired adults in the Netherlands, separately by prelingual and postlingual age of onset.MethodsFive hundred twenty-three face-to-face interviews were carried out by persons with practical skills in communication with hearing-impaired people.ResultsOf prelingually and postlingually deaf men, 27.1% and 27.7%, respectively, reported mental distress (scores on the General Health Questionnaire ≥ 2), and among women these figures were 32.4% and 43.2%. These rates are higher than in the general population (men: 22.0%; women: 26.6%). Among the prelingual category, none of the demographic or hearing loss-related characteristics was associated with mental health status as measured by the General Health Questionnaire (GHQ). Of these variables, only additional impairment or serious illness was associated with the brief Symptom Checklist (SCL-8D). Among the postlingual category, female gender and equilibrium disturbance was associated with both the GHQ and SCL-8D, and additional impairment or serious illness with the SCL-8D. For both categories, the risk of mental distress also was higher in those with more communication problems, lower levels of self-esteem, and poorer acceptance of the hearing loss. Opportunities for identification in youth and social support were not associated with mental health.ConclusionsMental health status differs between the hearing-impaired and the general population, but not as much as is sometimes suggested. Mental distress is greater in those in certain categories of the hearing-impaired.