{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T11:09:49Z","timestamp":1778238589539,"version":"3.51.4"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Fondation de l\u2019Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3390\/ejihpe15030030","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T04:28:18Z","timestamp":1740716898000},"page":"30","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adapting Psychiatric Approaches to the Needs of Vulnerable Populations: A Qualitative Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Pascale","family":"Besson","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lison","family":"Gagn\u00e9","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7285-0181","authenticated-orcid":false,"given":"Bastian","family":"Bertulies-Esposito","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montreal, QC H3T 1J4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-0928","authenticated-orcid":false,"given":"Alexandre","family":"Hudon","sequence":"additional","affiliation":[{"name":"Centre de Recherche de l\u2018Institut Universitaire en Sant\u00e9 Mentale de Montr\u00e9al, Montreal, QC H1N 3V2, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24095\/hpcdp.41.1.01","article-title":"Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: A scoping review with gender and equity analysis","volume":"41","author":"Andermann","year":"2021","journal-title":"Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1176\/appi.ps.201400587","article-title":"A multiple-city RCT of Housing first with assertive community treatment for homeless Canadians with serious mental illness","volume":"67","author":"Aubry","year":"2016","journal-title":"Psychiatric Services"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Barker, L. C., Lee-Evoy, J., Butt, A., Wijayasinghe, S., Nakouz, D., Hutcheson, T., McCarney, K., Kaloty, R., and Vigod, S. N. (2022). Delivering collaborative mental health care within supportive housing: Implementation evaluation of a community-hospital partnership. BMC Psychiatry, 22, (1).","DOI":"10.1186\/s12888-021-03668-3"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1136\/jech-2018-210981","article-title":"Effects of Housing First approaches on health and well-being of adults who are homeless or at risk of homelessness: Systematic review and meta-analysis of randomised controlled trials","volume":"73","author":"Baxter","year":"2019","journal-title":"Journal of Epidemiology and Community Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1192\/apt.bp.106.002295","article-title":"Effective psychotherapy in a racially and culturally diverse society","volume":"13","author":"Bhui","year":"2007","journal-title":"Advances in Psychiatric Treatment"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1017\/S1474746419000423","article-title":"Women\u2019s experiences of homelessness: A longitudinal study","volume":"19","author":"Bretherton","year":"2020","journal-title":"Social Policy and Society"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s11920-019-1017-0","article-title":"Community interventions to promote mental health and social equity","volume":"21","author":"Castillo","year":"2019","journal-title":"Current Psychiatry Reports"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bhugra, D., Bhui, K., Wong, S. Y. S., and Gilman, S. E. (2018). Early intervention in psychiatry. Oxford textbook of public mental health, Oxford University Press.","DOI":"10.1093\/med\/9780198792994.001.0001"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"126","DOI":"10.18778\/1733-8077.4.2.06","article-title":"QDA MINER\u2014The mixed method solution for qualitative analysis by provalis research","volume":"4","author":"Chomczynski","year":"2008","journal-title":"Qualitative Sociology Review"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2050312118822927","DOI":"10.1177\/2050312118822927","article-title":"Grounded theory research: A design framework for novice researchers","volume":"7","author":"Birks","year":"2019","journal-title":"SAGE Open Medicine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1176\/appi.ap.12040082","article-title":"Trends in performance on the psychiatry resident-in-training examination (PRITE\u00ae): 10 years of data from a single institution","volume":"37","author":"Cooke","year":"2013","journal-title":"Academic Psychiatry: The Journal of the American Association of Directors of Psychiatric Residency Training and the Association for Academic Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/prj0000277","article-title":"Three agendas for changing the public stigma of mental illness","volume":"41","author":"Corrigan","year":"2018","journal-title":"Psychiatric Rehabilitation Journal"},{"key":"ref_13","first-page":"180","article-title":"\u2018I didn\u2019t want to be noticed\u2019: Discrimination and violence among LGBTQ+ youth experiencing homelessness","volume":"21","author":"Blais","year":"2023","journal-title":"Journal of LGBT Youth"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1093\/tbm\/ibac025","article-title":"A scoping review of implementation of health-focused interventions in vulnerable populations","volume":"12","author":"Daniels","year":"2022","journal-title":"Translational Behavioral Medicine"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Messich, J., Botbol, M., Christodolou, G., Cloninger, R., and Salloum, I. (2016). Person-centered psychiatric rehabilitation. Person-centered psychiatry, Springer International.","DOI":"10.1007\/978-3-319-39724-5"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1093\/bjsw\/bcaa024","article-title":"Cultural adaptations of evidence-based mental health interventions for refugees: Implications for clinical social work","volume":"51","author":"Fennig","year":"2021","journal-title":"The British Journal of Social Work"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.2105\/AJPH.2010.300086","article-title":"Estimated deaths attributable to social factors in the United States","volume":"101","author":"Galea","year":"2011","journal-title":"American Journal of Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.socscimed.2017.11.043","article-title":"Corrigendum to \u201cStructural stigma and all-cause mortality in sexual minority populations\u201d [Soc. Sci. Med. 103 (2014) 33\u201341]","volume":"200","author":"Hatzenbuehler","year":"2018","journal-title":"Social Science & Medicine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s00038-011-0283-3","article-title":"The health and housing in transition study: A longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities","volume":"56","author":"Hwang","year":"2011","journal-title":"International Journal of Public Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1192\/apt.bp.114.013409","article-title":"Human rights in psychiatric practice: An overview for clinicians","volume":"21","author":"Kelly","year":"2015","journal-title":"BJPsych Advances"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1177\/1363461514557202","article-title":"Toward a new architecture for global mental health","volume":"51","author":"Kirmayer","year":"2014","journal-title":"Transcultural Psychiatry"},{"key":"ref_22","unstructured":"Kloos, B., Hill, J., Thomas, E., Case, A., Scott, V., and Wandersman, A. (2021). Community psychology: Linking individuals and communities, APA Books. [4th ed.]. Available online: https:\/\/www.apa.org\/pubs\/books\/community-psychology-fourth-edition-sample-chapter."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lincoln, Y. S., and Guba, E. G. (1985). Naturalistic inquiry, Sage Publications.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Magwood, O., Salvalaggio, G., Beder, M., Kendall, C., Kpade, V., Daghmach, W., Habonimana, G., Marshall, Z., Snyder, E., O\u2019Shea, T., Lennox, R., Hsu, H., Tugwell, P., and Pottie, K. (2020). The effectiveness of substance use interventions for homeless and vulnerably housed persons: A systematic review of systematic reviews on supervised consumption facilities, managed alcohol programs, and pharmacological agents for opioid use disorder. PLoS ONE, 15, (1).","DOI":"10.1371\/journal.pone.0227298"},{"key":"ref_25","first-page":"2298","article-title":"Caring for vulnerable populations during a pandemic: Literature review","volume":"13","author":"Marsh","year":"2020","journal-title":"International Journal of Caring Sciences"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/S2215-0366(24)00163-9","article-title":"The lancet psychiatry commission on youth mental health","volume":"11","author":"McGorry","year":"2024","journal-title":"Lancet Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Mejia-Lancheros, C., Lachaud, J., O\u2019Campo, P., Wiens, K., Nisenbaum, R., Wang, R., Hwang, S. W., and Stergiopoulos, V. (2020). Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness. PLoS ONE, 15, (2).","DOI":"10.1371\/journal.pone.0229385"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.socscimed.2013.06.032","article-title":"Structural competency: Theorizing a new medical engagement with stigma and inequality","volume":"103","author":"Metzl","year":"2014","journal-title":"Social Science & Medicine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1001\/jamapsychiatry.2021.0841","article-title":"Suicide risk in medicare patients with schizophrenia across the life span","volume":"78","author":"Olfson","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1192\/bjb.2020.49","article-title":"Homelessness, housing instability and mental health: Making the connections","volume":"44","author":"Padgett","year":"2020","journal-title":"BJPsych Bulletin"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"19","DOI":"10.3109\/09540261.2012.655712","article-title":"Recovery in Canada: Toward social equality","volume":"24","author":"Piat","year":"2012","journal-title":"International Review of Psychiatry"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Pinkhover, A., Celata, K., Baker, T., Chatterjee, A., and Lunze, K. (2024). Mobile addiction treatment and harm reduction services as tools to address health inequities: A community case study of the Brockton neighborhood health center mobile unit. Frontiers in Public Health, 12.","DOI":"10.3389\/fpubh.2024.1407522"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Russolillo, A., Moniruzzaman, A., Carter, M., Raudzus, J., and Somers, J. M. (2023). Association of homelessness and psychiatric hospital readmission-a retrospective cohort study 2016\u20132020. BMC Psychiatry, 23, (1).","DOI":"10.1186\/s12888-023-04945-z"},{"key":"ref_34","unstructured":"Scott, P. (2017). The SAGE encyclopedia of communication research methods, SAGE Publications."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Stergiopoulos, V., Gozdzik, A., O\u2019Campo, P., Holtby, A. R., Jeyaratnam, J., and Tsemberis, S. (2014). Housing first: Exploring participants\u2019 early support needs. BMC Health Services Research, 14.","DOI":"10.1186\/1472-6963-14-167"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.psc.2020.05.003","article-title":"Training psychiatrists to achieve mental health equity","volume":"43","author":"Sudak","year":"2020","journal-title":"The Psychiatric Clinics of North America"},{"key":"ref_37","unstructured":"Ellen, I. G., and O\u2019Flaherty, B. (2010). Housing First: Ending homelessness, promoting recovery, and reducing costs. How to house the homeless, Russell Sage Foundation."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"651","DOI":"10.2105\/AJPH.94.4.651","article-title":"Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis","volume":"94","author":"Tsemberis","year":"2004","journal-title":"American Journal of Public Health"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3171","DOI":"10.1038\/s41380-023-02202-z","article-title":"Towards a youth mental health paradigm: A perspective and roadmap","volume":"28","author":"Uhlhaas","year":"2023","journal-title":"Molecular Psychiatry"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Wang, J. Z., Mott, S., Magwood, O., Mathew, C., Mclellan, A., Kpade, V., Gaba, P., Kozloff, N., Pottie, K., and Andermann, A. (2019). The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: A systematic review. BMC Public Health, 19, (1).","DOI":"10.1186\/s12889-019-7856-0"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e543","DOI":"10.1016\/S2468-2667(20)30201-2","article-title":"Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: A retrospective cohort study","volume":"5","author":"Williams","year":"2020","journal-title":"The Lancet Public Health"},{"key":"ref_42","unstructured":"World Health Organization (2021). Guidance on community mental health services: Promoting person-centred and rights-based approaches, World Health Organization."}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/3\/30\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:44:26Z","timestamp":1760028266000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/3\/30"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,28]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["ejihpe15030030"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe15030030","relation":{},"ISSN":["2254-9625"],"issn-type":[{"value":"2254-9625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,28]]}}}