Homeless population
Further information: Homelessness and mental health
Mental illness is thought to be highly prevalent among homeless populations, though access to proper diagnoses is limited. An article written by Lisa Goodman and her colleagues summarized Smith's research into PTSD in homeless single women and mothers in St. Louis, Missouri, which found that 53% of the respondents met diagnostic criteria, and which describes homelessness as a risk factor for mental illness.[59] At least two commonly reported symptoms of psychological trauma, social disaffiliation and learned helplessness are highly prevalent among homeless individuals and families.[60]
While mental illness is prevalent, people infrequently receive appropriate care.[59] Case management linked to other services is an effective care approach for improving symptoms in people experiencing homelessness.[60] Case management reduced admission to hospitals, and it reduced substance use by those with substance abuse problems more than typical care.[60]
Immigrants and refugees
See also: Mental health of refugees
States that produce refugees are sites of social upheaval, civil war, even genocide.[61] Most refugees experience trauma. It can be in the form of torture, sexual assault, family fragmentation, and death of loved ones.[61][62]
Refugees and immigrants experience psychosocial stressors after resettlement.[63] These include discrimination, lack of economic stability, and social isolation causing emotional distress. For example, Not far into the 1900s, campaigns targeting Japanese immigrants were being formed that inhibited their ability to participate in U.S life, painting them as a threat to the American working-class. They were subject to prejudice and slandered by American media as well as anti-Japanese legislation being implemented.[64] [61][62] For refugees family reunification can be one of the primary needs to improve quality of life.[61] Post-migration trauma is a cause of depressive disorders and psychological distress for immigrants.[61][62][63]
Cultural and religious considerations
Mental health is a socially constructed concept; different societies, groups, cultures (both ethnic and national/regional), institutions, and professions have very different ways of conceptualizing its nature and causes, determining what is mentally healthy, and deciding what interventions, if any, are appropriate.[65] Thus, different professionals will have different cultural, class, political and religious backgrounds, which will impact the methodology applied during treatment. In the context of deaf mental health care, it is necessary for professionals to have cultural competency of deaf and hard of hearing people and to understand how to properly rely on trained, qualified, and certified interpreters when working with culturally Deaf clients.
Research has shown that there is stigma attached to mental illness.[66] Due to such stigma, individuals may resist labeling and may be driven to respond to mental health diagnoses with denialism.[67] Family caregivers of individuals with mental disorders may also suffer discrimination or face stigma.[68]
Addressing and eliminating the social stigma and perceived stigma attached to mental illness has been recognized as crucial to education and awareness surrounding mental health issues. In the United Kingdom, the Royal College of Psychiatrists organized the campaign Changing Minds (1998–2003) to help reduce stigma,[69] while in the United States, efforts by entities such as the Born This Way Foundation and The Manic Monologues specifically focus on removing the stigma surrounding mental illness.[70][71] The National Alliance on Mental Illness (NAMI) is a U.S. institution founded in 1979 to represent and advocate for those struggling with mental health issues. NAMI helps to educate about mental illnesses and health issues, while also working to eliminate stigma[72] attached to these disorders.
Many mental health professionals are beginning to, or already understand, the importance of competency in religious diversity and spirituality, or the lack thereof. They are also partaking in cultural training to better understand which interventions work best for these different groups of people. The American Psychological Association explicitly states that religion must be respected. Education in spiritual and religious matters is also required by the American Psychiatric Association,[73] however, far less attention is paid to the damage that more rigid, fundamentalist faiths commonly practiced in the United States can cause.[74][unreliable source?] This theme has been widely politicized in 2018 such as with the creation of the Religious Liberty Task Force in July of that year.[75] Also, many providers and practitioners in the United States are only beginning to realize that the institution of mental healthcare lacks knowledge and competence of many non-Western cultures, leaving providers in the United States ill-equipped to treat patients from different cultures