Aim: The aim of this study was to elucidate factors related to the high rate of mental health disorders seen in those with impaired hearing, including social factors and audiological measures. Method: A representative sample of 95 pupils (47 females, 48 males; mean age 11y 1mo, range 6y 5mo to 16y, SD 2y 7mo) with hearing impairments of at least 40dB and normal non-verbal intelligence (IQ 97.5, SD 19.5), was assessed audiologically and with a structured clinical interview giving both current and lifetime diagnoses, and the Strengths and Difficulties Questionnaire. Detailed social information was gathered from parents and teachers. Results: Point and lifetime prevalence rates for any psychiatric disorder (32.6%; 45.3%) and depression (7.4%; 26.3%) were higher than in general population samples and not related to the degree of hearing loss. There was a relation between having a lifetime diagnosis and the child's ability to be understood within the family (25.6% vs 7.7%, odds ratio 4.12 [1.2-14.1], p = 0.02). Internalizing mental health disorders were between three and six times more likely in those who had been teased, maltreated by classmates, or isolated. Interpretation: We conclude that the increased risk of depression in those who have been teased, isolated, or maltreated is not peculiar to deafness, but the ability to make oneself understood is, and is modestly related (r=0.22-0.34) to the probability of these adverse experiences.