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Vulnerable Populations Essay

All communities contain a mentally ill population. Their behavior is considered to be inappropriate and abnormal. Every society has cultivated solutions in which to treat the mentally ill in order to prevent disruption of the strong civil function. Normal behavior varies through generations and societies. When deciding if a person is mentally ill, the generation and culture must be taken into consideration. Approximately 26 percent of the U.S. population suffers from mental illness, with six percent of that percentage suffering from such debilitating mental afflictions that their ability to function is limited.

The History of Mental Illness

In ancient times, mental illness was thought to be madness caused by demonic possession. Skulls of the “mad” were drilled to allow the demon to escape. During the middle ages, mental illness was believed to be the result of witchcraft and demonic control. The tormented were treated as criminals and subject to torturous acts. They were often tied up and thrown into bitterly cold waters. If the person floated, they were considered to be a witch and were murdered in an inhumane and heinous manner. If the suspected sunk, they were found not guilty of witchcraft. The freezing water was accepted as a cure for “madness.” By the mid 1700’s, mental illness was considered an issue for the afflicted’s family. As the American colonies grew, the mentally ill began to negatively impact the society. Almshouses were used to board the mentally ill. Specialized hospitals were constructed for the “insane.” Mistreatment and abuse of the mentally ill were common and continued through the 19th century.

“Moral treatment” of the mentally ill began in the 18th century when Phillipe Pinel discovered 5,000 patients chained to walls and released them. Dorthea Dix was a U.S. social activist who made an appeal to the Massachusetts State Legislature for more humane and benevolent care of the mentally ill in asylums. Dix’s plea accrued regulated conditions in asylums. Most asylums and almshouses were obsolete by the beginning of the 20th century. State psychiatric institutions became the chief means of serving the mentally ill. However, reports of abuse and neglect in state hospitals were prevalent. In 1900, Clifford Beers, a privileged businessman, suffered a nervous breakdown after a family catastrophe. He was admitted to numerous mental hospitals and each was abusive and defamatory. In 1908, Beers penned his autobiography A Mind that Found Itself. The book discusses his mental deterioration as well as the mental and physical abuse he endured in the hospitals.

Beers’ book was the catalyst for the founding of the National Committee for Mental Hygiene (Presently the National Mental Health Association) which created mission goals, such as improved doctoring, advocacy, and minimizing the negative stereotypes of the mentally ill. The Community Mental Health Centers Act was passed in 1963. This act focused on the maintenance and issue prevention through outpatient care. Patients were released from state hospitals and treated by community facilities. This act began the process of deinstitutionalization in the United States.

The Nature of the Social Problems or Issues Experienced

Deinstitutionalization released thousands of mentally ill patients from psychiatric hospitals into the streets. The majority of these hospitals were shut down, which led to the difficult transition from long-term care to short-term hospital visits. Those with no family or support system were left with nowhere to go and forced to live on the streets. The government approximates that 20 to 30 percent of the United States homeless population suffer from severe mental illness. If this estimate were to include clinical depression and substance abusers, the numbers would climb to a staggering 50 to 80 percent. There are many problems trying to get the mentally ill and homeless of the streets. They have the right to refuse treatment and unfortunately many of them do. Other obstacles that prevent the mentally ill and homeless population from receiving adequate care is the lack of government assistance, such as Medicaid and Medicare, to help pay for treatment.

Many severely mentally ill men and women are so disoriented, paranoid, and confused that they are unable to participate in client/psychologist services. Another barrier is the firm participation requirements administered by mental health facilities. Severely mentally ill clients may find it difficult to abide by the rules. In order to remain in housing assistance programs, participants must remain sober which also poses a problem for many of the mentally ill who are plagued with substance abuse disorders. The criminalization of the mentally ill has become a large issue in the United States. The U.S. Department of Justice reports that 8 to 17 percent of the prison population suffers from mental illness. The National Alliance on Mental Illness reports that 40 percent of the mentally ill population will commit a crime at some point.

Demographics, Common Clinical Issues, and Intervention Strategies Mental illness does not discriminate. It affects all races, social classes and religions. The only difference is that those in a higher social class are able to receive better care. Studies show that minorities receive poor mental health treatment because of the underrepresentation of certain ethnicities in the mental health field and the refusal of mental health care by certain cultures. People suffering from mental illness may seek help by directly going to a specialist or by seeking assistance from a mental health agency. Mental health experts must be able to diagnose the frequent symptoms and evidence of mental illness in a client. The method for diagnosing mental illness in the United States is the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR).

This method is disputed by many professionals because it treats mental illness as a diagnosis of a disease rather than focusing on a person’s strengths to obtain wellness. Axis I of the DSM-IV-TR includes clinical disorders such as bipolar, clinical depression, substance abuse issues. They are treated with psychotropic medications and psychotherapy. Axis II consists of personality disorders and mental retardation. Many professionals feel that people suffering from Axis II illnesses are resistant to treatment. Many mental health professional view those suffering from mental illness as “broken” and ill. These beliefs can limit the potential of the mentally afflicted.

A different strategy some mental health professionals are taking is using the Strength Perspective. This plan of action requires the practitioner to focus on a client’s successes and advantages rather than promoting their shortcomings. Other intervention strategies include insight counseling which allows clients to create coping skills to help them deal with their mental health issues. Group counseling allows clients to gain support and friendship from those suffering from the same mental afflictions. Psychotropic medication can alleviate mentally crippling symptoms and Psychiatric rehabilitation aides low functioning clients in obtaining the basic living skills.

Future Interventions

The United States has encountered many modifications throughout the last 50 years. The mental health profession will undoubtedly undergo many more changes in the years to come. Human Service Professionals are the future of mental health. They continuously crusade for augmented funding and strive to develop new intervention and counseling strategies tailored to the intricate and complex needs of the mentally ill population. Experts and scientists continuously work to create advancements in medications that will remove all debilitating effects of severe mental illness.

Martin, M.C. (2011). Introduction to Human Services: Through the Eyes of Practice Settings (2nd ed.). Boston, MA: Allyn and Bacon Publishing.

A future vision of mental health. (n.d.). Retrieved from


Leupo, K. (n.d.). The history of mental illness. Retrieved from


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