Populations Affected by Mental Illness

Chapter 24 Vulnerability in Community Populations: An Overview Basic Concepts • Risk • Vulnerability • Special needs – At risk • Vulnerable populations – Vulnerable families Web of Causation • Schematic model – Shows

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interrelationship among multiple factors that contribute to choices made by individuals, families, and communities that affect their health status – Factors commonly associated with vulnerability: • • • • • Disadvantaged socioeconomic status Lifestyle behaviors Low self-esteem Feelings of powerlessness Disenfranchisement Poverty and Historical Perspectives • Society’s attitude • Two common themes – Strong work ethic – Religious/moral beliefs • Industrial Revolution • Public assistance programs • Shift from federal government to state to private sector Cultural and Policy Perspectives • Cultural perspectives – Meaning of poverty • • • • Impoverished Persistent poverty Neighborhood poverty Underclass poverty • Policy perspectives – Poverty index – Near poor Health-Related Perspectives • • • • High rate of infant mortality High morbidity and mortality Complex health problems Physical limitations secondary to chronic illness • Trauma-induced injuries • Death by violence Community Perspectives • High proportion of underrepresented ethnic groups • Single mothers • High rate of unemployment • Low level of education • Low wages • Violence • Discrimination • Communicable diseases • Premature death Vulnerable Populations with Special Needs • Disenfranchised • Uninsured and underinsured – Medically indigent/working poor • • • • Children and adolescents Elders Underrepresented ethnic groups Women Nursing Considerations • Access to care • Acceptable services for vulnerable patients in diverse settings – Know the community – Schedule clinic visits at convenient times – Have bilingual nurses available – Staff members who reflect cultural, racial, ethnic background of persons who use the facility – Sensitivity – Nonjudgmental attitude Considerations • Ethical and legal • Patients’ strengths and resources – Hardiness – Support networks • Nursing roles – Advocate and activist – Case manager – Educator and counselor – Collaborator and partner – Researcher
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