Vulnerable Populations Introduction to Human Services, BSHS 302 June 21, 2010 Introduction Chronic illnesses are disorders that require ongoing care and treatment for much of the patients’ life to manage the illness. Examples of such illnesses are diabetes, high blood pressure, or heart disease. When discussing chronic mental illness, such diseases or disorders would be those that require ongoing treatment and care throughout much of the patients’ life. Examples would be schizophrenia, bipolar disorder, chronic anxiety disorder or attention deficit hyperactive disorder as well as many other specific forms of mental illness.
Individuals suffering from chronic mental illnesses are part of the vulnerable population because they exist within a social group consisting of individuals with high risk factors or are susceptible to health-related problems. Individuals with less access to quality health care, lower life-expectancy or higher mortality rates, and those in a lower social status not accepted in the general population may be a part of a vulnerable population (UCLA, 2010).
Those individuals with health disparities such as severe mental illness are vulnerable because they may not be able to provide for themselves or meet their own basic human needs as a result of their illness. Chronically Mentally Ill Population History of Mental Illness and Intervention Strategies Mental illness presumably has been present in all societies and cultures dating back to at least 5000 BCE. Up until the Middle Ages people with mental illness or those considered to have gone mad were accused as being possessed by evil spirits or demons.
The intervention strategy was to drill holes in the individuals head to allow the demons to escape. Mental illness and demonic possessions continued to be thought as connected well into the eighteenth century. The possessions were resolved by casting out the demons or going through witch trials resulted in either death or evidence of witchcraft such as living through the trials. In colonial America, intervention strategies were limited because mental defects were andled within each family as a private matter; however, the growth in populations made it difficult to maintain privacy and thereafter mental illness became an issue for the entire community. By the mid-eighteenth century the intervention strategy changed to separation, where communities began to build separate almshouses and hospitals for the insane members of the community. This allowed the clinically insane to be housed separately from those individuals with the inability to meet their own needs for reasons outside of mental illness.
Mistreatment and abuse have been common occurrences in mental health care and started with the earliest treatments or interventions being used. Individuals that did not follow the guidelines of socially appropriate or accepted behavior were thought to be mentally ill or to have gone mad. During the nineteenth century these behaviors continued and interventions were especially abusive and included public beating and humiliation, death, or incarceration. Interventions used were determined through behavior and whether the behavior was threatening to others.
Admittance to the insane asylum could be indefinite and the treatments for illness included severe beatings with chains, whips or rods and with patients chained or caged for years or until death. Residents of the community could pay money to enter the asylum and watch the public humiliation and abuse of patients. It was this behavior that led to the first true reform of mental health care at the end of the eighteenth century when chief physician Philippe Pinel from France began pushing for care to become more compassionate and for patients to be treated using moral methods.
Reform began in the nineteenth century in the United States when Dorothea Dix, a social activist, advocated for humane treatment of patients who lived in asylums. Dix, for much of the same reasons as Pinel, fought for patients’ rights that resulted in improved patient conditions in both hospitals, and asylums. Although these advocates led the way to vast improvements and the closure of almshouses and insane asylums there was still a significant amount of abuse reported.
The early twentieth century paved the way for new treatment options and methods when Clifford Beers book A Mind that Found Itself described his own encounters with abuse and cruel mistreatment within the several mental hospitals where he was placed. This publication led to a national committee dedicated to improving the conditions and treatment of those individuals with mental illness and in mental institutions, developing prevention methods and reducing the negativity toward those with mental illness.
Until the 1950s the most commonly used intervention method was putting those patients with mental illness into institutions. The 1950s marked a period in history in which mental health and national mental health institutes became a forefront in U. S. government legislations. The formation of the Joint Commission on Mental Health and Illness in 1955 lead to national changes and reform for mental health and wellness issues and was composed of professionals from several regions, backgrounds and organizations who took a collaborative approach to making positive changes (Martin, 2007).
Organizations such as these, for the past 60 years, have fought for change and reform and have made massive efforts to increase support from both the local and federal communities and to increase awareness and work toward prevention strategies. Social Problems and Clinical Issues Providing care for people with chronic mental illness has been a public problem for many years. Mental illness is nondiscriminatory, can affect any person and transcends all social boundaries.
As a result, the issues surrounding mental illness have become common discussion pints among policymakers dedicated or required to formulate solutions around providing the long-term care needed by many patients. Healthcare reforms and changes to the systems that provide services to those living with mental illness and funding for services to the facilities providing care have become major social issues (Goldman, Morrissey, Ridgley, Frank, Newman, & Kennedy, 1992). The reason for this is primarily how it can affect a market economy and how much of a burden diseases of the mind can be in a country such as the United States.
According to the 1991 Global Burden of Disease study conducted by the World Health Organization mental health burden accounted for “more than 15% in a market economy such as the U. S. ” (The Impact of Mental Illness on Society, 2001). The study also states that for individuals over the age of 5, varying forms of depression are the leading cause of disability. A more recent study indicates that mental illness in general is found in more than 26% of the United States adult population, of which 6% are severe and limit the patient’s ability to function (Martin, p. 63. 2007). Future Intervention Strategies Intervention strategies exist that recently are starting to be put into place to diagnose and treat mental illness of varying types and severity at much younger ages. Medical communities, social service agencies and support resources are striving to destigmatize the fear of mental illness as well as the diagnosis and treatment, so treatment intervention and acceptable alternatives to inpatient care are less likely to be the first response to crisis situations.
Communities are actively advertising treatment alternatives and healthcare resources that may be available to persons of all income levels and socioeconomic status (Goldman, Morrissey, Ridgley, Frank, Newman, & Kennedy, 1992). Many medications are leading to less severe patient disability as a result of medication and are often prescribed multiple treatment options and multiple medications to treat the different symptoms that may be present as a result of his or her illness.
The goals focus more on keeping patients functional and capable of being in control of their living situations, healthcare decisions and financial concerns. It is the goal of healthcare professionals to describe a patient as having a brain disorder undergoing treatment as a medical condition without the negative connotations or perceptions that often accompany those with mental illness. Just as an individual with diabetes receives insulin to control their illness, the hope would be that an individual with mental illness can receive his or her medication with the same perception toward his or her illness (Martin, 2007).
Conclusion Chronic mental illness affects millions of people across the globe and in major market societies has become a social problem with financial implications and a requirement of social responsibility. In America alone over 6% of the population suffers from a chronic or sever form of mental illness causing the inability to provide his or her own care consistently. The inability to provide for their own care and the need for assistance to manage their illness places them in the category of vulnerable populations.
Individuals with mental illness are vulnerable to discrimination, lower life expectancy and social status, and reduced access to receiving care for their illness, and as a result must rely on the resources provided by the society and government of which they live to ensure they receive the care they need. Ultimately, every society has a responsibility to treat those who belong to vulnerable groups, including those with mental illness.
Social involvement is necessary to empower patients to be as self sufficient as they possibly can; helping them to be productive members of society without spreading the negative connotations that go along with mental illness. Everyone has a right to access assistance, and as a society people must work to allow that in a nondiscriminatory fashion. References Goldman, H. , Morrissey, J. , Ridgley, S. , Frank, R. , Newman, S. , & Kennedy, C. (1992). Lessons from the Program on Chronic Mental Illness. Retrieved June 27, 2010, from Health Affairs: http://content. healthaffairs. org/cgi/reprint/11/3/51. pdf Martin, M. 2007). Introduction to Human Services: Through the Eyes of Practice Setting. Allyn & Bacon, Inc. Mental Health: A Report of the Surgeon General. (n. d. ). Retrieved June 28, 2010, from Public Health Service: http://www. surgeongeneral. gov/library/mentalhealth/chapter1/sec1. html The Impact of Mental Illness on Society . (2001, January 1). Retrieved June 28, 2010, from Healthier You: http://www. healthieryou. com/impact. html UCLA. (2010). Who are Vulnerable Populations? Retrieved June 27, 2010, from UCLA School of Nursing: http://www. nursing. ucla. edu/orgs/cvpr/who-are-vulnerable. html