Abstract

Digital mental health screening systems are used to identify psychological needs, guide referrals, and determine access to behavioral health services. As their use continues to expand, these systems are typically designed around standardized language-based communication that may not align with the communication modalities of Deaf and hard-of-hearing (DHH) individuals. This paper, informed by the authors’ prior qualitative research as well as interdisciplinary literature, proposes a stage-based framework for understanding how communication barriers may influence assessment validity throughout digital mental health screening. The framework identifies three communication-dependent processes that shape assessment outcomes: interpretation of screening prompts, construction of responses, and comprehension of system-generated feedback. Rather than viewing digital screening technologies as neutral instruments, the proposed framework conceptualizes them as structured assessment environments in which communication conditions directly influence psychological assessment. This perspective extends existing work on accessibility and clinical assessment by providing a process-oriented framework for examining how communication accessibility may affect interpretation accuracy, clinical decision-making, and access to mental health services among DHH individuals.

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