The purpose of this article is to report the findings of the mental health needs and community support systems for deaf and hard of hearing (HOH) adults in Nepal. Ninety-nine deaf Nepali adults completed a household-by-household, researcher-administered survey. The survey contained two World Health Organization instruments: the Self-Report Questionnaire and the Rapid Assessment of Mental Health Needs. The results indicated that 38 percent of the sample met the threshold score for the presence of mental health problems; 24 percent met the threshold for the presence of negative environmental influences. A multiple regression analysis indicated that the RAMH score was a significant predictor of SRQ-20 scores. Gender and age were not significant predictors. Respondents indicated that basic needs, assistive devices, such as hearing aids, job and educational opportunities, and supportive community programs are lacking. Several indicators also suggest that they are somewhat isolated from the surrounding community. Implications for social work and future research are noted.