Lesson 2 Mental Health and Vulnerable Groups

The iHere project specifically targets disadvantaged groups in society in Europe. For this we would like to take a closer look at some of these groups and their risk factors in terms of mental health. It should be mentioned that people with mental illness can already be counted as such among the vulnerable groups.

The number of children and adolescents affected by mental health disorders in Europe is alarmingly high.

Since many mental health problems manifest themselves in childhood, it is especially crucial to install appropriate help at an early stage, if necessary.

Source: Mental health: Children failed at vulnerable point – BBC News


Source Graphic: Mental Health Care, Children and Behavioral Health Integration | CDC

Nearly 1 in 5 children suffers from a mental, emotional or behavioral disorder, such as anxiety, depression, attention deficit or hyperactivity disorder (ADHD). Children and adolescents whose mental health is impaired benefit from early diagnosis and treatment.

There are professional practitioners who have specialized in children’s mental health, such as:

  • Child and Adolescent Psychiatrists
  • Child Psychologists
  • Behavioral Therapists

Mental health disorders are a leading cause of health-related disabilities in children and young people and can have adverse and long-lasting effects

Source: Mental health of children in London (publishing.service.gov.uk)


Mental health of children in London (publishing.service.gov.uk)

In general, we speak of elderly people from the age of 65. In our society, there is a trend that the elderly population is increasing due to longer life expectancy.

For a better understanding of elderly people we want to point out what is important to them at this stage of life:

  • A full life 
  • Care planning
  • Dignity
  • Early intervention
  • Holistic
  • Hope 
  • Multi-disciplinary
  • Person-cented
  • Recovery focus
  • Resilience
  • Respect

Many elderly people live alone. The results of a study show that more than 1 in 4 elderly people living alone suffer from a mental illness (26.2%). In contrast, older people who do not live alone are affected by mental health problems in only 1 in 5 cases (22.7%).

Mental health problems among older people can often be reduced simply by counteracting factors such as loneliness and social isolation.

This can be reduced, for example, by social meeting places or even regular social contacts (family visits, telephone calls, care services, hobbies, etc.).

Mental disorders change and manifest with age, especially if left untreated. Therefore, mental illness can be very damaging in old age, especially as it can often be compounded by other (physical) health conditions, such as dementia. In addition, people with a mental illness are more likely than the general population to have another serious illness, such as cardiovascular disease. The occurrence and severity of mental health problems, especially when drug and alcohol problems are also present, are likely to be exacerbated in people with underlying conditions such as physical disabilities, brain injuries, degenerative neurological conditions, or age-related cognitive impairment. People with preexisting mental health problems who have a terminal disease and need end-of-life care may be among the most underrepresented and disadvantaged populations in our society.

Our public hospital system often struggles to provide multidisciplinary care, comprehensive assessment, appropriate care planning, and subsequent monitoring and care. The greatest challenge here is collaboration between nursing and therapeutic treatment, as there is often a focus on only one field.

Migrants and refugees may be exposed to various stressors that affect their mental health and well-being before and during their escape, as well as during their settlement and integration. The prevalence of common mental disorders such as depression, anxiety, and post-traumatic stress disorder (PTSD) tends to be higher among migrants exposed to adverse circumstances and refugees than among the receiving population. Many migrants and refugees do not have access to mental health services or encounter barriers to accessing them. They also face interruptions in continuity of care.

Factors that negatively impact the mental health and well-being of migrant and refugee children include socioeconomic disadvantage, discrimination, racism, low family cohesion, and frequent school changes. Children who have been separated from their parents are at increased risk of developing depression, anxiety, suicidal thoughts, behavioral disorders, and substance abuse problems.

Many immigrants and refugees suffer from stress (e.g., feelings of anxiety and sadness, hopelessness, sleep disturbances, fatigue, irritability, anger, and/or pain). For most people, these reactions improve over time.


Migrants and refugees often face various problems and stressors that can occur at different stages of the migration process:

  • Pre-migration: lack of livelihood and education and development opportunities, armed conflict, violence, poverty and/or persecution.
  • Migration and transit: difficult and life-threatening conditions, including violence and detention, and lack of access to services to meet basic needs.
  • Post-migration: obstacles to accessing health care and other services to meet basic needs, as well as poor living conditions, separation from family members and support networks, possible uncertainty regarding work permits and legal status (asylum application), and in some cases immigration detention.
  • Integration and settlement: poor living or working conditions, unemployment, assimilation difficulties, challenges related to cultural, religious, and gender identities, problems obtaining entitlements, changing policies in host countries, racism and exclusion, tensions between host populations and migrants and refugees, social isolation, and possible deportation.

Why do we need to differentiate between genders in mental health? To answer this, we need to look at several biological, sociocultural and behavioural differences that have an impact on mental disorders.

  • Biological influences: Female hormone fluctuations are known to play a role in mood and depression. For example, women tend to produce less of the mood stabilizer serotonin and break it down more slowly than men, which may be the reason for higher rates of depression.
  • Sociocultural influences: Despite progress in gender equality, women still face challenges when it comes to socioeconomic power, status, position, and dependence, which may contribute to depression and other disorders.
  • Behavioral influences: Women are thought to be more likely than men to report mental disorders, and doctors are more likely to diagnose women with depression and treat them with mood-altering medications. However, women are sometimes afraid to report physical violence and abuse.

Source Picture: Mental Health Resources for Women – All IN for Health


What mental health problems are women most likely to suffer from?

While men are more likely to suffer from early-onset schizophrenia, antisocial personality disorder, and alcoholism, some mental illnesses are more common in women, including:

  • Depression: Women are twice as likely to be affected by depression as men (12% of women vs. 6% of men).
  • Anxiety and specific phobias: although men and women are equally affected by mental illnesses such as obsessive-compulsive disorder and social phobias, women are twice as likely as men to suffer from panic disorder, generalized anxiety, and specific phobias.
  • Post-traumatic stress syndrome (PTSD): Women are twice as likely to develop PTSD after a traumatic event.
  • Suicide attempts: Even when men and women share a common mental health diagnosis, symptoms, and therefore treatment, can be drastically different. Additionally men are four times more likely to die by suicide than women, but women are two to three times more likely to attempt suicide than men.
  • Eating disorders: Women account for at least 85 percent of all cases of anorexia and bulimia and 65 percent of cases of binge eating disorder.

Let’s talk about the Mental Health issues faced by the Women of today – iThrive Counselling

Similarly to older people, there is a great deficit in appropriate assistance for disabled people. This is particularly due to the fact that the focus is often on physical symptoms and not on mental health. However, it is important to consider the health of a person as a whole.

A recent study found that adults with disabilities are more likely to report experiencing mental health problems than people without disabilities. In 2018, an estimated 17.4 million (32.9%) adults with disabilities suffered from frequent mental health problems. Common mental distress is associated with poor health behaviors, increased health care utilization, mental health disorders, chronic illnesses, and limitations in daily living.