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- Tracy DeBoer,
- Jino Distasio,
- Corinne A. Isaak,
- Leslie E. Roos,
- Shay-Lee Bolton,
- Maria Medved,
- Laurence Y. Katz,
- Paula Goering,
- Lucille Bruce, and
- Jitender Sareen
The present study explored the prevalence of volatile substance use (VSU ) in a community of homeless adults. The importance of individual life history characteristics (history of traumatic events, residential school history, mental and physical health conditions) were also examined with respect to past-year volatile substance use in this sample. Overall, the results indicate that a variety of traumatic events, particularly residential school history and a number of mental and physical health conditions, were significantly associated with VSU in this urban Canadian sample. These findings have novel implications for community interventions for VSU and highlight the importance of conceptualizing cultural and historical traumas in understanding VSU . - OPEN ACCESS
- Ashley Struthers,
- Catherine Charette,
- Sunita Bayyavarapu Bapuji,
- Shannon Winters,
- Xibiao Ye,
- Colleen Metge,
- Sara Kreindler,
- Melissa Raynard,
- Jacqueline Lemaire,
- Margaret Synyshyn, and
- Karen Sutherland
This paper presents the findings of a systematic search and review examining the acceptability of e-mental health services for children, adolescents, and young adults and their parents and healthcare providers. Multiple databases were searched and abstracts were screened to determine if they met study inclusion criteria. Findings from included studies were synthesized within five dimensions of acceptability: satisfaction, client expectations, uptake, adherence and patient/provider experiences. Twenty-four studies were included, and findings suggest that although clients are generally satisfied with e-mental health and report positive experiences, adherence and uptake can be challenges. In conclusion, e-mental health appears to be an acceptable intervention option for children, adolescents, and young adults and their parents and healthcare providers. Further research is needed to better understand the effectiveness and acceptability of e-mental health for this population, including adherence, patient and provider experiences and integration into existing health systems. - OPEN ACCESSThe Carrier First Nations, who are the original inhabitants of North Central British Columbia, have endured years of hardship as a result of European colonization. Over time, this has resulted in an erosion of traditional practices and a decline in overall health. There is concern that mental health practitioners are not meeting the needs of the Carrier people because they fail to understand the Carrier worldview. In an effort to better understand and respect the Carrier ideas and beliefs about mental health and mental illness, interviews were conducted with 7 traditional healers about their beliefs and their practices. The traditional healers reported that the concept of mental illness did not exist in pre-contact culture. However, the traditional healers who participated in this research actively practise ceremonies and rituals that seek to restore balance and harmony between the person and his or her environment.
- OPEN ACCESSThis study examined the participation of people with lived experience of mental health problems in political, social, and client advocacy. An online survey was conducted of 27 advocacy organizations across Canada. People with lived experience exhibited the highest level of participation in program delivery, with rates of participation varying by advocacy activity and sub-group. Stigma around mental health and severity of illness were rated as the strongest barriers limiting participation. The support of service providers and peer role models were considered effective strategies for increasing participation. Several self-benefits were reported as highly prevalent among mental health advocates.
- OPEN ACCESSThis study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.
- OPEN ACCESSPhotovoice is a photographic technique allowing people to identify, represent, and enhance their community by entrusting cameras to the hands of participants to enable them to capture issues central to their lives. However, few studies have used Photovoice with disadvantaged single mothers, and explicitly studied the impact of using this type of methodology with this population. Hence, the purpose of this study was to assess the impact of Photovoice with disadvantaged single mothers participating in the community-based program Toward Success. Results showed that participants experienced generally positive impacts, such as a sense of accomplishment and increased agency in their lives, and reported no negative impacts.
- OPEN ACCESSSuicidal behaviours are intricately connected to culture, oftentimes reflecting traditional norms and attitudes to health help-seeking and self-management. To describe Korean-Canadian immigrants’ help-seeking and self-management for their suicidal behaviours, 15 participants completed individual semistructured indepth interviews. Using constant comparison analysis, participants’ narratives were analysed to inductively derive two themes: 1) resisting professional help; and, 2) developing effective self-management strategies. The study findings suggest that most participants preferred and opted for self-management strategies rather than seeking professional help. Most participants’ reluctance to seek professional or peer help was underpinned by a fear of the stigma associated with traversing cultural norms by harbouring a mental illness and seeking help for that ailment. In addition, a lack of knowledge about available professional health care services, along with language and cultural barriers, led some participants to perceive mental health services as ineffectual. Participants’ determination to self-manage their suicidality was influenced by cultural norms around honouring and protecting family, and a range of spiritual and religious beliefs also emerged to counter impulses for acting on suicidal thoughts. By shedding light on Korean-Canadian immigrants’ experiences with suicidal behaviours, the findings offer some guidance toward developing culture-sensitive suicide prevention programs.
- OPEN ACCESSThis study compared mental health service experiences of lesbian, gay, or bisexual (LGB), transidentified, and cisgender (nontrans) heterosexual people in Ontario. An Internet-based survey, derived from the Canadian community health survey—Mental health and well-being—Cycle 1.2 (Statistics Canada, 2003), was completed by 326 individuals (194 LGB, 71 trans-identified, 61 cisgender heterosexual). Hierarchical logistic regression models were used to examine group differences. All three groups reported high levels of satisfaction and positive experiences with the provider seen most often in the past 12 months. However, substantial proportions of LGB and trans-identified people reported unmet need for mental health services.
- OPEN ACCESSOur health care system is ill prepared for the growing number of older adults and their families/caregivers who live with responsive behaviours associated with cognitive impairment. Considering the burden of illness, quality of life issues, and escalating costs, system-wide redesign is warranted. The Behavioural Supports Ontario (BSO) project is a province-wide, regionally implemented, evidence-informed change strategy that utilizes quality improvement principles and knowledge translation best practices as critical enablers. This paper describes the project and key lessons learned in the implementation of this initiative that can be applied to other jurisdictions wishing to enable large-scale system redesign and sustainable system change.
- OPEN ACCESS
Evaluating the Planning and Development Phase of a Demonstration Project: At Home / Chez Soi Moncton
This research focused on the planning and development phase of the Moncton site of At Home / Chez Soi, a multisite research demonstration project funded by the Mental Health Commission of Canada, developed to test an innovative approach to working with homeless people living with severe and persistent mental illness in 5 Canadian cities. Using qualitative methods, 11 local key informants participated in semistructured interviews focusing on: (a) early planning processes; (b) principles and values guiding the planning process; (c) planning actions; and (d) stakeholder relationships. We found that contextual elements, especially those related to the small size and bilingual nature of the city and the lack of mental health services in the area, had a significant impact on the planning and development of the project in Moncton. The implications of findings for future planning of complex community interventions are noted. - OPEN ACCESSThis paper describes the implementation of Housing First in a small Canadian city. Given that the majority of Housing First research has been conducted in large American cities, providing a Canadian context in a small city contributes significant insights for similarly sized areas. The main objectives were to determine the adaptations made to the Housing First model and the contextual realities that affected implementation. Data were collected from two sources: (a) a fidelity assessment by an external team of experts; and (b) key informant interviews and focus groups with program staff and consumers. Results demonstrate that Housing First can be successfully implemented in a small city but with certain constraints and adaptations, notably more limited consumer choice of housing, challenges related to consumer access to transportation, and adaptations to program staffing. Implications for practice are discussed.
- OPEN ACCESSCet article présente une évaluation formative d'un programme Logement d'abord (Housing First) offert en région rurale. Les deux objectifs consistent à décrire les personnes desservies et comment le modèle Logement d'abord fut adapté afin d'offrir des services en milieu rural. La recherche repose sur une méthodologie mixte. Le volet quantitatif, de nature descriptive, porte sur 23 participants et participantes. Le volet qualitatif s'attarde à ce qui a pu contribuer à l'implantation du modèle et les défis qui subsistent, selon 15 informateurs clés. Les leçons tirées de l'expérience et les retombées pour les politiques et les programmes de logement au Canada sont discutées.
- OPEN ACCESS
- Sarah Pakzad,
- Saïd Bergheul,
- Jalila Jbilou,
- Jimmy Bourque,
- Julie Ringuette,
- Lise Gallant, and
- Paul-Émile Bourque
Cette étude utilise le modèle de Gelberg-Andersen afin de cerner les caractéristiques des personnes itinérantes de la région de Moncton ayant recours aux services de santé, sociaux et communautaires. Les 194 participants et participantes ont été recrutés dans le cadre du projet At Home / Chez Soi. Ceux et celles souffrant d'un état de stress post-traumatique ont moins eu recours aux services hospitaliers ambulatoires que ceux et celles présentant un autre diagnostic. Les femmes utilisent davantage les services sociaux et communautaires. Nos résultats amènent un éclairage sur la nécessité d'adapter les pratiques et les services de santé, sociaux et communautaires aux besoins et conditions de vie des personnes itinérantes. - OPEN ACCESS
- Jimmy Bourque,
- Linda VanTil,
- Stefanie Renee LeBlanc,
- Brianna Kopp,
- Stéphanie Daigle,
- Jacinthe LeBlanc,
- Jitender Sareen,
- Kathy Darte,
- Liette-Andrée Landry, and
- Faye More
Many veterans at risk of homelessness also suffer from mental health problems. The aim of this study was to identify correlates of veteran status among housing, mental health, and service use variables in a Canadian sample of homeless people with mental illness. The data were obtained from At Home / Chez Soi, a Canadian multisite study. The participants were 99 veterans and a matched comparison group of 297 non-veterans. Data were gathered at baseline and were analyzed using logistic regression. The veteran and non-veteran groups were found to be similar, although veterans attended school longer, and were more likely to have been victims of a robbery in the 6 months prior to enrolment in the study. Veterans were not overrepresented in this sample as compared with the general population. - OPEN ACCESSLe site de Moncton se trouve à être la plus petite des 5 villes canadiennes participant au projet de recherche At Home / Chez Soi visant à expérimenter et évaluer le modèle Logement d'abord. Une des conséquences de cette petite taille est la proximité et l'importance de l'environnement rural. Nous avons ajouté un sous-projet rural (n = 22) au volet qualitatif pour la région de Moncton (n = 20). Nous procédons à une analyse comparative de ces 2 volets de façon à mettre en évidence les opportunités et les contraintes propres à chacun, surtout liés aux transports et à la concentration des services.
- OPEN ACCESSDans le cadre du projet At Home / Chez Soi visant à évaluer l'efficacité de l'approche Logement d'abord, un volet a été consacré à une recherche qualitative basée sur le récit de vie en vue de mieux comprendre les impacts du projet au niveau du mode de vie et des perceptions des participants. Deux groupes de participants, expérimental (n = 10) et de comparaison (n = 10), ont été interviewés au début de l’étude ainsi qu'après 18 mois (groupe expérimental, n = 9; groupe de comparaison, n = 8). L’étude tend à montrer que ce modèle d'intervention contribue à des changements significatifs dans la perception des participants d'eux-mêmes et de leur condition de santé mentale.
- OPEN ACCESSHousing First (HF) effectively houses the majority of homeless individuals suffering from mental illness; however, a small subset continues to struggle with unstable housing. This paper describes a supportive housing pilot program developed at the Moncton site of the At Home / Chez Soi demonstration project for HF participants who have experienced difficulty achieving housing stability while receiving HF services. Specifically, Peer Supportive Housing (PSH) was created for participants demonstrating ongoing unstable housing in the HF program. Results from structured interviews with five program staff and nine tenants of PSH describe the successes, challenges, and perceived outcomes of the early implementation of the program. PSH can supplement HF, and may help to meet the needs of some tenants who are unable to achieve stable housing after a trial of receiving HF services.
- OPEN ACCESSThe At Home / Chez Soi project, funded by Health Canada through the Mental Health Commission of Canada, involves evaluating the implementation and effectiveness of the Housing First (HF) approach, a complex community-based intervention that addresses homelessness in people with severe and persistent mental illness. This paper examines the perspectives of community partners on the implementation of HF in Moncton, New Brunswick. Engagement varied, but overall, HF was seen as fitting well within the network of existing community resources and filling a long-standing gap in services. Community will for sustaining HF was present, though concerns were expressed about sources for ongoing funding.
- OPEN ACCESSThis research uses a longitudinal design to examine aggression and prosocial behaviour as early predictors of substance use behaviours in emerging adulthood. Using data from the National Longitudinal Survey of Children and Youth (NLSCY), self- and maternal reports of early engagement in relationally and physically aggressive behaviours and prosocial behaviours are examined as predictors of cigarette smoking, marijuana use, and alcohol use in emerging adulthood. Using multinomial regression analyses we found that maternal reports of relational aggression significantly predicted daily smoking whereas self-reports did not. Maternal reports of relational and physical aggression did not predict alcohol use and marijuana use; however, self-reports of relational aggression and prosocial behaviour predicted weekly marijuana use in this representative Canadian sample.