Giving voice to the Deaf community: co-designing a Bangla Mental Health Sign Language Bank in Bangladesh.

Deaf communities worldwide face systemic barriers in accessing mental health care because of social exclusion and marginalisation. In Bangladesh, these challenges are compounded by a historical neglect of mental health among the Deaf. This study explored mental health understanding and experiences within the Bangladeshi Deaf community, aiming to co-develop culturally and linguistically appropriate digital mental health tools. Two exploratory workshops facilitated by sign language interpreters (n=4) were conducted with Deaf individuals (n=12) and their caregivers (n=4), revealing a substantial gap in Bangla Sign Language vocabulary related to mental health. To address this, the research team developed the first digital Bangla Mental Health Sign Language Bank using an adapted Delphi and workshop approach. The three-phase Delphi process involved mental health professionals (n=9), Deaf individuals (n=5), and interpreters (n=3), who identified and prioritised key mental health terms. This was followed by three consensus workshops with Deaf participants (n=6) and interpreters (n=4) to collaboratively develop the final sign language bank. Qualitative findings revealed six key themes: stigmatisation, isolation, denial of care, difficulty expressing emotions, inadequate mental health support, and the positive role of family awareness. This participatory process led to the creation of an inclusive digital resource to support mental health communication among Deaf individuals in Bangladesh and similar contexts.