Besson Pascale, Gagné Lison, Bertulies-Esposito Bastian, Hudon Alexandre
Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada.
Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC H1N 3V2, Canada.
Eur J Investig Health Psychol Educ. 2025 Feb 28;15(3):30. doi: 10.3390/ejihpe15030030.
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.
边缘化人群在获得心理健康护理方面面临重大障碍，如耻辱感、贫困以及获得适配服务的机会有限，传统的精神病学方法往往难以满足需求。本研究旨在探讨如何调整精神病护理以更好地满足弱势群体的需求。在一门关于弱势群体的课程中，通过半结构化讨论从精神科住院医师、精神科医生和社区组织工作人员那里收集数据，并通过扎根理论和迭代编码进行分析。出现了七个主要主题：（1）弱势群体的障碍和需求，突出无家可归和耻辱感等挑战；（2）精神病学干预和灵活方法，强调量身定制的护理；（3）与社区组织的合作，侧重于改善护理可及性的伙伴关系；（4）道德方法和对权利的尊重，确保治疗中的尊严；（5）特定人群及其相关挑战，满足 LGBTQ+ 青年和移民等群体的需求；（6）干预和支持模式，如基于接近度的护理和出院后随访；（7）实践的创新和演变，侧重于研究和机构调整。本研究强调需要个性化的跨部门护理，建议加强合作、采用灵活模式并增加临床接触，未来研究探索精神病学教育如何更好地使临床医生为与边缘化群体合作做好准备。
