Adapting Psychiatric Approaches to the Needs of Vulnerable Populations: A Qualitative Analysis

Abstract

Marginalized populations face significant barriers to mental health care, such as stigma, poverty, and limited access to adapted services, with conventional psychiatric approaches often falling short. This study aimed to explore how psychiatric care can be adapted to better meet the needs of vulnerable populations. Data were collected from psychiatry residents, psychiatrists, and community organization staff during a course on vulnerable populations, using semi-structured discussions and analyzed through grounded theory with iterative coding. Seven main themes emerged: (1) barriers and needs of vulnerable populations, highlighting challenges like homelessness and stigma; (2) psychiatric interventions and flexible approaches, emphasizing tailored care; (3) collaboration with community organizations, focusing on partnerships to improve care access; (4) ethical approach and respect for rights, ensuring dignity in treatment; (5) specific populations and associated challenges, addressing the needs of groups like LGBTQ+ youth and migrants; (6) intervention and support models, such as proximity-based care and post-hospitalization follow-up; (7) innovation and evolution of practices, focusing on research and institutional adaptations. This study emphasizes the need for personalized, intersectoral care, recommending improved collaboration, flexible models, and greater clinical exposure, with future research exploring how psychiatric education can better prepare clinicians to work with marginalized groups.

Keywords: Housing First; clinical competence; intersectoral collaboration; mental health; needs assessment; psychiatry; social justice; vulnerable population.

Figure 1

Thematic codification of adaptations in psychiatric approaches to address the needs of vulnerable populations and specific clientele. The main themes are highlighted in dark blue, while the sub-themes are presented in light blue.