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Paper Type: Article (898)	15 May 2024

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Integrative Strategies to Address Complex HIV and Mental Health Syndemic Challenges in Racialized Communities: Insights from the CHAMP Project
Canadian Journal of Community Mental Health • Vol. 36 • No. 3 • pp. 65 - 70
Marginalized communities bear a disproportionate burden of syndemic challenges related to HIV, mental illness and addiction. Stigma is a major barrier to effective responses. CHAMP, an innovative community-based intervention that integrated psychological intervention and collective empowerment strategies to reduce stigma, was found to be effective for such a population.
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Determinants of Unmet Mental Healthcare Needs of Single Adults Who Are Homeless or Vulnerably Housed
- Arnaud Duhoux,
- Tim Aubry,
- John Ecker,
- Rebecca Cherner,
- Ayda Agha,
- Matthew J. To,
- Stephen W. Hwang, and
- Anita Palepu
Canadian Journal of Community Mental Health • Vol. 36 • No. 3 • pp. 41 - 57
Persons who are homeless experience higher levels of mental illness, unmet mental healthcare needs, and physical healthcare needs than the general population. This study aimed (1) to determine the reasons contributing to having unmet mental healthcare needs (UMHCN) and (2) to examine the determinants of UMHCN among a representative sample of adults who are homeless or vulnerably housed in three Canadian cities (N=1190). Almost a quarter (23.3%) of the sample reported UMHCN in the past year. The reported reasons for having UMHCN pertained especially to the availability (31.5%), accommodation (22.1%), and acceptability (21.3%) of services. Age, city, and need-for-care variables were associated with UMHCN in multivariate analysis. Implications of the findings for policy and program planning are discussed.Les personnes sans-abri présentent des niveaux plus élevés de maladie mentale, de besoins de soins de santé et de besoins non comblés de soins de santé mentale que la population générale. Cette étude visait (1) à déterminer les raisons des besoins non comblés des soins de santé mentale (BNCSM) et (2) à examiner les déterminants des BNCSM auprès d›un échantillon représentatif d›adultes sans-abri ou logés de façon précaire dans trois villes canadiennes (N = 1190). Près d›un quart (23,3%) de l›échantillon a rapporté des BNCSM lors de l›année passée. Les raisons principales des BNCSM portaient sur la disponibilité (31,5%), l’accommodement (22,1%), et l›acceptabilité (21,3%) des services. L’âge, la ville et les besoins de soins étaient les variables associées aux BNCSM en analyse multivariée. Les implications des résultats pour la planification des services et le développement des politiques sont discutées.
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Canadian Service Providers’ Perceptions of Barriers and Support Gaps in Housing and Mental Health
- Nick Kerman,
- Reena Sirohi,
- Susan Eckerle Curwood, and
- John Trainor
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 61 - 75
People experiencing mental illness and homelessness face numerous barriers to becoming housed. Service providers who work with this population also encounter challenges to meeting service users’ needs, yet their perspectives have been only minimally studied. Using survey data from a pan-Canadian study, this article explores the barriers and facilitators to fostering lasting change in housing and mental health according to 96 housing providers and 186 community-based mental health service providers. Findings show that the perspectives of mental health service providers are largely consistent with those of housing providers, and identify a range of support gaps and barriers.
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Recommendations for Canadian Mental Health Practitioners Working With War-Exposed Immigrants and Refugees
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 107 - 119
With the inception of the mental health strategy for Canada, Changing Directions, Changing Lives, the ever increasing ethnic diversity in this country demands re-examination of our approaches to mental wellbeing and illness in the immigrant and refugee population arriving from war-torn countries. Contemporary clinical practice among mental health practitioners is not reflective of the emerging literature in this field, which points towards meaningful and culturally competent care. This article seeks to bridge the gap between existing knowledge and current practice, and provides recommendations for mental health practitioners who work with this population.
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Knowledge Mobilization and Mental Health Policy: Lessons from the Canadian Consensus Conference on the Mental Health of Emerging Adults
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 19 - 59
This case study explores how the Consensus Conference on the Mental Health of Emerging Adults, hosted by the Mental Health Commission of Canada in 2015, can impact mental health policy and practice in Canada. The study draws on interviews from 14 delegates who attended the conference. Participants praised innovations such as the inclusion of an emerging adult panel that provided feedback on all discussions, and efforts to make the consensus-building process meaningful in the Canadian policy context. Findings suggest that consensus conferences are a promising way to operationalize the Mental Health Strategy for Canada through policy and practice changes.
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Spotlight on Caroline Families First Wraparound Program: Lessons for Advancing Collaborative Family-Centred Care for Complex Child and Youth Mental Health
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 191 - 204
The Caroline Families First Wraparound Program operationalizes cross-sectoral collaboration and planning, family peer support, and family-directed care consistent with strategic directions within the Mental Health Strategy for Canada. In this spotlight article, we present findings from a case study that describes what makes the program work, the barriers and facilitators to its success, and draw conclusions about the lessons learned. For example, while family-directed care is a core and essential value of the program, unless well understood, it can create tensions within teams. Similarly, structural factors such as provider reimbursement can inhibit physician involvement. Suggestions about these and other contextual factors can inform other efforts to mobilize the Mental Health Strategy.
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DR. ELLIOT GOLDNER
- Louise Bradley
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 241
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Implementing Implementation: Practical Lessons Learned From Supporting Evidence- Informed Service Delivery in Community-Based Child and Youth Mental Health Agencies
- Evangeline Danseco,
- Ann Barber,
- Kelcie Brown, and
- Charlie Carter
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 165 - 190
As child and youth mental health agencies apply the recommendations from the national mental health strategy, a strong focus has been placed on the implementation of evidence-informed practices to ensure the best outcomes for those they serve. Although a considerable amount of research exists on the implementation of best practices and the key factors to successful implementation, far less exists in terms of concrete strategies to support such initiatives. This article describes a unique initiative in Ontario that provided implementation supports and funding for agencies. Lessons learned and implications for bridging the gap between research and practice are explored.
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Youth Services System Review: Moving From Knowledge Gathering to Implementation Through Collaboration, Youth Engagement, and Exploring Local Community Needs
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 133 - 149
This article describes a two-phase, multi-sectoral project aimed at enhancing youth services addressing substance use in Ontario. In the information gathering phase, a youth-focused website and survey, focus groups, and interviews were used to elicit perspectives from multiple stakeholders. In the implementation phase, capacity-building and consultations on transition-aged youth needs were conducted to inform youth transition-readiness checklists. We discuss the importance of engaging youth as collaborators as well as respondents and the processes used to tailor findings to local contexts for implementation.
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Engaging Youth in a Mental Health System Improvement Initiative in Ontario: Developing the Be Safe Resource
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 121 - 131
Youth engagement can improve the accessibility, effectiveness, and sustainability of programs and resources for youth. Little is known about youth engagement in system-level initiatives. As part of Systems Improvement through Service Collaboratives, an Ontario initiative that aimed to improve the system of care for youth with mental health or addictions needs, youth and adults in London, Ontario partnered to co-create Be Safe. The Be Safe resource helps youth manage mental health crises and identify local services. This article showcases a youth-adult partnership in a system-level initiative, and highlights a replicable strategy for developing resources relevant to youth needs and preferences.
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Closing the Mental Health Gap: The Long and Winding Road?
- Mary Bartram and
- Steve Lurie
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 5 - 18
With 5 billion dollars in new federal funding to improve access to mental health services set to roll out over the next 10 years, a window of opportunity has opened to begin to close the long-standing gap in mental health funding in Canada. Public spending on mental health in Canada is only 7% of public spending on health overall (Jacobs et al., 2010), well short of the 9% called for in the Changing Directions, Changing Lives: The Mental Health Strategy for Canada (MHCC, 2012). This percentage is also well short of the disease burden comprised by mental illnesses, which ranges from 13% globally (WHO, 2011) to 23% in the UK (OECD, 2014). By comparison, recent figures from the Organisation for Economic Cooperation and Development (OECD, 2014) indicate that some countries devote as much as 18% of their health spending to mental health, with the UK sitting at 13%. Even with new targeted federal funding, closing, or at least narrowing, this gap will require careful attention to lessons learned in the past. This article explores how the gap in mental health funding came about in Canada and provides a more detailed analysis of the size of the gap itself. While it is now clear that the federal government will introduce a transfer that is directly targeted to mental health, there are still many policy options to consider for moving forward with next steps, including provincial/territorial contributions, accountability mechanisms, outcome measures, the insurance/financing model, and how tightly eligible expenses are tied to specific initiatives, population groups, or levels of evidence.
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Introduction to the Second Special Issue
- Gillian Mulvale and
- Steve Lurie
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 1 - 3
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Innovative Prospects for Suicide Prevention and Action Opportunities for the Public Health Agency of Canada and the Government of Canada
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 205 - 237
Responsibility for suicide prevention falls to the Government of Canada and Health Canada. The issue of suicide affects Canadians of all ages and in all regions of the country, hence the need for a pan-Canadian strategy aimed at reducing suicide deaths and reaching all Canadians. The availability and accessibility of mental health services constitute important resources for suicide prevention and a target for interventions that can be made to rapidly reduce the suicide rate. Such a strategy to improve services should include quality surveillance and quality control programs, such as suicide audits and the use of linked government administrative databases. Population-based strategies to prevent and treat depression must also be established and should be based on the Nuremberg model. In particular, development of equitable access to psychotherapy and mental health literacy programs should be priority goals.
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A Comparison of the Use of Physical and Mental Health Services by Homeless People With Severe Mental Health Problems in the Moncton Area Through the At Home/Chez Soi Program
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 77 - 105
The At Home / Chez Soi demonstration project was conducted to investigate the effectiveness of the Housing First model in 5 Canadian cities. Using a randomized controlled trial design, this study evaluates the impact of this project on the use of health services by people with severe and persistent mental health problems and a history of homelessness in the greater Moncton area. The sample comprised 193 homeless persons, 95 in the control group and 98 in the treatment group. The results show a significant difference between the 2 groups only in the number of days of hospitalization, particularly in the psychiatric unit. Factors associated with the use of health services by people who are homeless and who have severe mental health problems need to be further investigated.
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DR. PAULA NINA GOERING
- Elizabeth Lin
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 239
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Youth Journeys in Mental Health: Invoking Unique Patient Perspectives
Canadian Journal of Community Mental Health • Vol. 36 • No. 2 • pp. 151 - 164
We know much about the alarming trends in youth mental health; however, we know far less about the journeys that Canadian youth are taking toward better mental health. This article begins with a conceptual synthesis of the literature about the ways in which scholars are invoking the journeys of youth. We then present two examples of youth journeys in mental health from our current Atlantic Canada Children’s Effective Service Strategies in Mental Health project (ACCESS-MH) and conclude that journey approaches to youth mental health research could support the implementation of Canada’s mental health strategy in unique and crucial ways.
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Decolonizing Approaches to Inuit Community Wellness: Conversations with Elders in a Nunavut Community
Canadian Journal of Community Mental Health • Vol. 36 • No. 1 • pp. 1 - 13
Nunavut communities struggle with numerous challenges related to social distress. It is important to specify that these struggles represent a rupture with traditional Inuit society. Most research to date has linked colonization and ongoing social inequity to these distresses. This community-based, participatory research project elicits traditional knowledge from Elders living in Cape Dorset, Nunavut. The aim is to identify Inuit values, beliefs, and actions with the potential to improve community wellness. The themes that emerge include respect, leadership, family connection, inclusion of traditional knowledge, working together, and resiliency. Results resonate with other community wellness research projects in Nunavut.
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Les perceptions des professionnels et professionnelles sur l’égalité et l’inégalité dans les processus de partenariat en action communautaire : une étude de cas dans le domaine de la petite enfance
- Rodrigo Quiroz,
- Liesette Brunson, and
- Nathalie Bigras
Canadian Journal of Community Mental Health • Vol. 36 • No. 1 • pp. 15 - 40
Cet article explore, par le biais d’une étude de cas qualitative, les perceptions des professionnels et professionnelles sur l’égalité et l’inégalité dans les processus de partenariat en action communautaire dans le domaine de la petite enfance. La théorie de l’action communautaire en coalition (TACC) de Butterfoss et Kegler (2009) a été utilisée pour examiner spécifiquement les processus de communication, de prise de décisions, de gestion des conflits et d’administration. Les données ont été recueillies par le biais de trois sources : les entretiens individuels, les observations et l’analyse documentaire. Le matériel obtenu a été soumis à une analyse thématique. Les résultats mettent en évidence que les professionnels et professionnelles utilisent des indicateurs d’égalité et d’inégalité dans deux niveaux distincts de partenariat : le niveau de la haute sphère administrative où le rapport entre la contribution financière des institutions partenaires et les bénéfices que les partenaires retirent modulent les perceptions d’inégalité; et le niveau du terrain où la nature des échanges, la prise de décisions par consensus, la distribution des tâches ainsi que l’interdépendance en ce qui concerne les besoins, les contributions et les retombées conditionnent les perceptions d’égalité.
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Real-Time Needs, Real-Time Care: Creating Adaptive Systems of Community-Based Care for Emerging Adults
- Javeed Sukhera,
- Jill Lynch,
- Nancy Wardrop, and
- Kristina Miller
Canadian Journal of Community Mental Health • Vol. 36 • No. 1 • pp. 41 - 53
Research indicates a decline in mental health service utilization between the ages of 16 to 25, leaving emerging adults with mental illness at risk for worsening outcomes. The authors utilized a community-based participatory research (CBPR) approach to explore the mental health landscape for youth aged 16–25 in London, Canada. Interviews and focus groups (n = 30) with community and hospital system leaders, youth and caregivers were transcribed and coded using an approach informed by constructivist grounded theory. There was consensus regarding difficulties in the current system including wait times and crisis-driven services leading to powerlessness among youth and caregivers. Solutions include delivery of services through a flexible, real-time system that emphasizes patient and caregiver engagement, youth centric services and recovery-oriented care across the hospital/community continuum. The results highlight that disparate stakeholders agree regarding the need for transformational change shifting away from traditional medical models.
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“Our Next Generation”: Moving Towards a Surveillance and Prevention Framework for Youth Suicide in Saskatchewan First Nations and Métis Populations
- Caroline L. Tait,
- Peter Butt,
- Robert Henry, and
- Roger Bland
Canadian Journal of Community Mental Health • Vol. 36 • No. 1 • pp. 55 - 65
Suicide is a concern for many Indigenous communities in Canada. Suicide rates in Canada have decreased but rates in Saskatchewan remain above the national average. In northern Saskatchewan, where First Nations and Métis people make up 85% of the population, suicide rates are well above the national rate. The majority of reported suicides in this region are committed by adolescents and young adults. However, the current rate of suicide among First Nations and Métis youth in Saskatchewan cannot be determined because ethnicity is not tracked on hospitalization and coroner records. Our study argues this is a barrier to suicide prevention in Indigenous populations and recommends improvements to the design and implementation of suicide surveillance and prevention strategies.
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Integrative Strategies to Address Complex HIV and Mental Health Syndemic Challenges in Racialized Communities: Insights from the CHAMP Project

Determinants of Unmet Mental Healthcare Needs of Single Adults Who Are Homeless or Vulnerably Housed

Canadian Service Providers’ Perceptions of Barriers and Support Gaps in Housing and Mental Health

Recommendations for Canadian Mental Health Practitioners Working With War-Exposed Immigrants and Refugees

Knowledge Mobilization and Mental Health Policy: Lessons from the Canadian Consensus Conference on the Mental Health of Emerging Adults

Spotlight on Caroline Families First Wraparound Program: Lessons for Advancing Collaborative Family-Centred Care for Complex Child and Youth Mental Health

DR. ELLIOT GOLDNER

Implementing Implementation: Practical Lessons Learned From Supporting Evidence- Informed Service Delivery in Community-Based Child and Youth Mental Health Agencies

Youth Services System Review: Moving From Knowledge Gathering to Implementation Through Collaboration, Youth Engagement, and Exploring Local Community Needs

Engaging Youth in a Mental Health System Improvement Initiative in Ontario: Developing the Be Safe Resource

Closing the Mental Health Gap: The Long and Winding Road?

Introduction to the Second Special Issue

Innovative Prospects for Suicide Prevention and Action Opportunities for the Public Health Agency of Canada and the Government of Canada

A Comparison of the Use of Physical and Mental Health Services by Homeless People With Severe Mental Health Problems in the Moncton Area Through the At Home/Chez Soi Program

DR. PAULA NINA GOERING

Youth Journeys in Mental Health: Invoking Unique Patient Perspectives

Decolonizing Approaches to Inuit Community Wellness: Conversations with Elders in a Nunavut Community

Les perceptions des professionnels et professionnelles sur l’égalité et l’inégalité dans les processus de partenariat en action communautaire : une étude de cas dans le domaine de la petite enfance

Real-Time Needs, Real-Time Care: Creating Adaptive Systems of Community-Based Care for Emerging Adults

“Our Next Generation”: Moving Towards a Surveillance and Prevention Framework for Youth Suicide in Saskatchewan First Nations and Métis Populations

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