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- OPEN ACCESS
- Erin M. McCabe,
- Teresa Katherine Lightbody,
- Christine Mummery,
- Angela Coloumbe,
- Kathy GermAnn,
- Beverly Lent,
- Laurene Black,
- Kathryn E. R. Graham,
- Douglas P. Gross, and
- Maxi Miciak
Practitioners in emergency departments across Canada are challenged with providing quality mental health (MH) care for children and youth despite increased demand for services. Coordinated service strategies, such as clinical pathways, are needed to effectively manage paediatric MH disorders. Practitioners in a children’s hospital emergency department implemented a pathway to improve the care of children and youth with MH conditions. This paper describes an external evaluation of practitioner and stakeholder experiences of the initiative as well as the implementation process, then explores current state and lessons learned. The paper provides a unique contribution to the practitioner-led implementation literature. - OPEN ACCESS
- Farooq Naeem,
- Tasneem Khan,
- Kenneth Fung,
- Lavanya Narasiah,
- Jaswant Guzder, and
- Laurence J. Kirmayer
Research into social determinants of mental and emotional health problems highlighted the need to understand the cultural factors. Mental health of immigrants is influenced by a variety of cultural, psychological, social, and economic factors. There is some evidence to suggest that South Asian people have higher rates of mental and emotional health problems than the rest of the Canadian population. Limited research also suggests that psycho-social factors are highly likely to be responsible for these high rates of mental health problems. These psychosocial factors may be impeding access and engagement with the services. These socially determined emotional and mental health problems are more likely to respond to psychosocial interventions than biological treatments. Evidence-based psychosocial interventions such as Cognitive Behaviour Therapy (CBT) and Acceptance and Commitment Therapy (ACT) might offer the way forward. CBT can be offered in a low-cost, low intensity format in a variety of settings, thus addressing the attached stigma. However, these interventions need to be culturally adapted, as these are underpinned by a Western value system. CBT has been culturally adapted and found to be effective in this group elsewhere. This opinion paper describes the need to enhance research on psychosocial determinants of the mental and emotional health problems, status, and the psychosocial determinants of health amongst South Asians in Canada to inform our understanding of the cultural specificity of psychosocial interventions. - OPEN ACCESS
- Nadine Blanchette-Martin,
- Francine Ferland,
- Rosalie Genois,
- Chantal Plourde,
- François Dallaire, and
- Annie Labbé
Il est reconnu que l’intervention intégrée fait partie des meilleures pratiques auprès des personnes présentant un trouble psychotique en concomitance avec un trouble de l’utilisation des substances (TUS). Une telle intervention a été développée dans la région de Chaudière-Appalaches (Québec) afin de favoriser le rétablissement des personnes aux prises avec ces troubles concomitants. Cet article présente l’évaluation des retombées de la participation au programme pour les usagers. Les résultats indiquent qu’un an après avoir débuté, ils ont diminué leurs visites à l’urgence, leurs hospitalisations et leur consommation de substances et ont amélioré leur santé psychologique et leur qualité de vie. - OPEN ACCESSRecovery is a policy framework for mental health in Canada. Key challenges to the integration of recovery include a gap in knowledge about the work that people do to promote their health and well-being in the context of living with mental ill health. This study used Photovoice to explore the lived realities of people living with mental ill health and the impact of the social determinants on their recovery process. Findings from this study inform policy and practice on promoting health work as an important dimension of recovery and community inclusion.
- OPEN ACCESSDe nombreux témoignages de femmes rapportent des expériences de détresse, de souffrance ou de violence lors de l‘accouchement, nommées « violence obstétricale » par les groupes de défense de droits en périnatalité. Or, les écrits mentionnent peu les perceptions des intervenantes en périnatalité confrontées à cette problématique. Par le biais de groupes de discussion auprès d‘intervenantes communautaires en périnatalité au Québec (n = 29), cette étude documente leurs représentations de situations de violence obstétricale, les difficultés qu‘elles rencontrent et leurs stratégies d‘intervention. Les résultats contribuent à une meilleure compréhension de cette forme de violence et à une réflexion sur les efforts à fournir pour favoriser le bien-être des femmes durant la période périnatale.
- OPEN ACCESSMalgré l’offre de soins de santé mentale dans les soins primaires, la fragmentation des soins de santé mentale et physique demeure. Cet article analyse des modèles de prise en charge qui permettraient une globalité des soins, et fonde ses résultats sur 7 études de cas d’équipes multidisciplinaires reposant sur une pratique infirmière élargie au Québec, ainsi que sur des entrevues avec des professionnels de la santé (n = 51). Les résultats démontrent que les rôles demeurent cloisonnés suivant une dichotomie santé mentale et physique, et ce, malgré la composition multidisciplinaire des équipes. Ils indiquent également l’existence d’un rapport inversement proportionnel entre la complexité des situations de soins et le nombre de professionnels impliqués.
- OPEN ACCESSThis paper explores the role of an innovative trauma-informed, strengths-based education program designed to address barriers to education about the self-esteem and well-being of survivors of torture and/or war. Results show a statistically significant change in participants’ self-esteem measures. Qualitative data suggest that the participants perceived the program as a safe space that afforded social support and factual information about access to tertiary education. The program also reinforced participants’ sense of belonging and helped sustain their feelings of hope and motivation. Trauma-informed, strengths-based educational programming is a promising framework that can support survivor’s self-esteem, sense of identity, and successful resettlement.
- OPEN ACCESS
- Catherine Briand,
- Rose-Anne St-Paul,
- Martin Lagacé,
- Gabrielle Massé,
- Amélie Dumont,
- Alexandre Gravel,
- Edith Lafrance, and
- Alex Chayer
Les difficultés fonctionnelles, le faible statut socioéconomique et l’isolement social font partie des facteurs qui influencent les choix alimentaires des personnes ayant un ayant un trouble mental grave. Quelles sont les difficultés rencontrées par les personnes atteintes de troubles mentaux graves concernant l’alimentation ? Cet article présente les résultats d’entrevues de groupe auprès de 23 participants atteints d’un trouble mental grave et à risque d’insécurité alimentaire. Cette étude vise à documenter la perception de ces personnes à l’égard de leur situation alimentaire afin de décrire cette réalité et en permettre une compréhension approfondie. L’analyse qualitative des données d’entrevue permet d’identifier 4 grands thèmes explicatifs. - OPEN ACCESSLes Inuit du Nunavik, suite aux changements sociaux considérables auxquels ils font face, vivent des difficultés importantes de santé mentale. L’objectif de cette recherche est d’explorer la vision qu’ont les jeunes Inuit de la santé mentale et de vérifier si les services offerts par les organismes locaux comblent leurs besoins. Pour ce faire, 5 jeunes adultes de 18 à 25 ans ont été recrutés. Par le biais de Photovoice, ils ont illustré leur définition de la santé mentale. Neuf entrevues semi-structurées ont été menées auprès d’intervenantes et d’intervenants clés oeuvrant au sein d’organismes du milieu. Par une analyse thématique, utilisant les théories de Maslow et de Bronfenbrenner, la vision des jeunes a été analysée ainsi que le rôle de chaque organisme. Une compréhension de leur vision de la santé mentale en ressort et celle-ci est essentielle afin que les ressources mises à leur disposition puissent fournir une réponse culturellement appropriée. Ainsi, il sera possible, en partenariat avec la communauté, de déterminer les actions à prioriser à l’avenir.
- OPEN ACCESSThis study tested the association between tenancy status in public housing and demographic, geographic, socioeconomic, health status, and health service use characteristics using linked population-based administrative data from Manitoba, Canada. The data were analyzed using multivariable Cox proportional hazards regression. Age, residence location, receipt of income assistance, residential mobility, being diagnosed with a substance abuse disorder, and continuity of care were significantly associated with moving. Voluntary moves were only associated with socioeconomic characteristics, while eviction was also associated with health status and health service use characteristics. Public housing authorities can benefit from this profile of resident characteristics in order to identify who may need supports to have a successful tenancy.
- OPEN ACCESSIt is common for individuals with fetal alcohol spectrum disorders (FASD) to require support for mental health and addictions but there are challenges associated with receiving appropriate care in Canada. This qualitative investigation of the barriers and enablers to the development of a clinical pathway in mental health and addictions included focus groups of individuals with FASD, caregivers, family members, and clinicians. Data was thematically coded and the following themes are described: the absence of support outside of crisis, the struggle of navigating separated services, the common experience of service providers who lack understanding of FASD, and the benefits of FASD-informed care.
- OPEN ACCESSThe current study evaluated the effectiveness of a novel three-hour Guided Mindfulness Program on participants’ management of depression, anxiety and stress. The intervention included an educational component emphasizing the psychological value of mindfulness practice combined with a practical training component in mindfulness techniques. The Depression Anxiety Stress Scale was administered at three points in time before and after participation in the program. Additionally, semi-structured interviews were conducted to explore perceived quality of life, happiness, and stress 4 to 8 weeks following the program. All participants reported improvements in overall well-being and reported significant decreases in negative affect when comparing pre-program scores (baseline) to follow-up scores. Notably, qualitative interview results indicated that participants attributed most positive post-program results to informal mindfulness practice.
- OPEN ACCESSMobile crisis services for children and youth have been available in Ontario since 2000 yet little descriptive information about such services exists. In this evaluation, crisis workers gathered demographic information and details about the nature of the crisis from youth ages 12 to 17 and parents/guardians of children from birth to 17 years of age during a crisis intervention. Approximately two weeks post-intervention, participants responded to a quantitative questionnaire administered via telephone that measured levels of upset, awareness, coping, and confidence. This paper adds to the literature by describing the types of calls received, characteristics of service users, and outcomes for youth and families. The findings suggest this type of service may be valuable in serving youth, and that more rigorous examination is required by mobile crisis services for youth to demonstrate the true contribution.
- OPEN ACCESSSocial support is closely connected to mental health and well-being as well as experiences of housing vulnerability. This study explored differences between homeless and vulnerably housed women in their experiences of social support. Forty-nine homeless and 43 vulnerably housed women completed 3 measures to assess their social networks, social support networks, and global social support. Vulnerably housed women reported fewer social support network members than homeless women. Social support network size was found to be a predictor of global social support score. These findings suggest that housing status impacts social support in homeless and vulnerably housed women, which may have implications for their well-being.
- OPEN ACCESS
- Marie-Josée Fleury,
- Guy Grenier,
- Jean-Marie Bamvita,
- Catherine Vallée,
- Lambert Farand, and
- François Chiocchio
Cet article explore l’impact des structures et processus de travail des équipes sur les personnes utilisatrices dans trois réseaux de services en santé mentale du Québec dans un contexte de réforme. Des coordonnateurs (N = 41), professionnels de soins (N = 311) et des personnes utilisatrices (N = 327) ont été sondés. Les effets sur les personnes utilisatrices dans le troisième réseau, semi-urbain, sont similaires à ceux du premier réseau, urbain et mieux nanti. L’autonomie d’équipe, la participation décisionnelle et des interactions avec les partenaires du réseau peuvent contribuer à améliorer la continuité des services, la qualité de vie et le rétablissement des personnes utilisatrices malgré un financement moindre. - OPEN ACCESS
- Daphnée Genesse,
- Katherine Bécotte,
- Audrey Brassard,
- Coralie Purcell-Lévesque, and
- Katherine Péloquin
Environ un couple canadien sur six est confronté à l’infertilité. Le stress découlant du diagnostic et des traitements de fertilité peut affecter le bien-être psychologique des hommes comme des femmes. La présente étude examine l’expérience psychologique des hommes et des femmes québécois. L’analyse thématique des entrevues semi-structurées de huit femmes et six hommes a permis de dégager les éléments plus spécifiques à la femme, à l’homme et les éléments communs aux deux. Comprendre l’expérience psychologique des hommes et femmes en traitement de fertilité permettra d’adapter les interventions des professionnels de la santé selon le genre pour soutenir adéquatement chaque partenaire. - OPEN ACCESSCette étude qualitative s’intéresse aux facteurs pouvant expliquer les difficultés rencontrées par les jeunes hommes (18–35 ans) ayant vécu un premier épisode psychotique à établir et maintenir des relations amoureuses. Douze participants ont pris part à une entrevue semi-structurée d’environ 60 minutes. Quatre thèmes principaux sont ressortis de l’analyse des données, soit la Gestion de la proximité, la Conception de l’intimité, l’Identité et le Processus de rétablissement. Les difficultés rencontrées seraient liées à des expériences relationnelles antérieures et à des difficultés métacognitives et de régulation émotionnelle suite à un épisode psychotique, mais des études supplémentaires sont requises.
- OPEN ACCESS
- Elizabeth Guevara,
- Mireille Valois,
- Ina Winkelmann,
- Ridha Joober,
- Karen Goldberg, and
- Srividya N. Iyer
The availability of affordable, youth-friendly, recovery-oriented housing for persons with first-episode psychosis is limited. We report on the conceptualization, implementation and implications of a pilot housing project combining the principles of specialized early intervention for psychosis and those of “Housing First,” which holds much promise to address this service gap. - OPEN ACCESSThe workplace has a significant impact on individuals’ mental health and provides an ideal opportunity to address and enhance mental health. Ottawa Public Health created a series of videos and activities to support workplaces to take action on mental health. They have received national acclaim and are widely in use.
- OPEN ACCESSL’objectif de l’étude était d’explorer la façon dont les migrants et migrantes de l’Afrique subsaharienne définissent les troubles mentaux ainsi que les conséquences qu’ils y associent. Un total de 50 personnes ont participé à une entrevue individuelle. Alors que certaines personnes définissent les troubles mentaux à travers le concept de folie dont les principaux symptômes sont de nature comportementale et cognitive, d’autres adhèrent à une conception plus large qui englobe des troubles de nature affective et relationnelle. En retour, les troubles mentaux peuvent menacer les projets de vie, la santé et la sécurité physique de la personne atteinte et peuvent avoir des retombés sur ses relations interpersonnelles et sur la société en général. Les implications pour la pratique des professionnels sont discutées.
- OPEN ACCESSUsing a qualitative design, this study examines changes in the caregiving relationship in ten siblings caring for a brother or sister with severe schizophrenia. Siblings reported mourning the loss of a person they once knew and struggled to accept the brother or sister’s dependency in day-to-day living. As the relationship progressed, siblings became closer to their ill brother or sister and learned to appreciate modest accomplishments as evidence of success. Siblings expressed ambivalence toward transitioning into a primary caregiving role as their parents aged. Including these siblings in community care planning is a necessary step in supporting them toward this transition later in life.
- OPEN ACCESSUne formation pour le dépistage des troubles du comportement alimentaire (TCA) destinée à des intervenant(e)s des services de santé généraux du Québec a été évaluée dans le but de cerner ses effets sur l’utilisation de données probantes dans les pratiques. L’analyse des réponses aux questionnaires complétés par les intervenant(e)s révèle une acquisition de connaissances, des réactions positives envers la formation et une intention d’utiliser les connaissances acquises. Lors d’entretiens semi-structurés postformation (3 mois), les intervenant(e)s rapportent avoir utilisé les connaissances sous diverses formes et ont identifié des facteurs influençant l’adoption des pratiques enseignées. L’importance d’adapter les pratiques au contexte québécois est discutée.
- OPEN ACCESSOperating in a small urban Canadian location, Change Clinic is a brief counselling service intended for child and adolescent mental health issues. It blends principles from different strength-based and client-centred approaches to counselling (e.g., solution-focused, narrative, and single session therapies). Using the parent-report version of the Strengths and Difficulties Questionnaire, changes in child and adolescent mental health difficulties were assessed. Compared to pre-test scores, significant improvements in behavioural, emotional, and hyperactivity problems were observed six months after delivery of the service. Effect size was estimated to be moderate (.62) based on the Added Value Score calculation. Almost three quarters of clients were served in one to two sessions.
- OPEN ACCESSThere is a growing mental health crisis among university students in Canada. The purpose of this pilot study was to explore the effect of an in-class mindfulness intervention on the mental health of undergraduate students. Cross-sectional design was used and data were collected using self-reported questionnaires that included scale-rated and open-ended questions (n = 435). Integrating open-ended themes with statistical findings, the final analysis suggests the intervention had a positive effect on the mental health of student participants. A classroom environment that fosters learning, builds community, and encourages compassion were identified as ways in which the intervention “works” to promote positive mental health.
- OPEN ACCESS
- Phyllis Montgomery,
- Amy Wuest,
- Cheryl Forchuk,
- Tracy Smith-Carrier,
- Momodou S. Jeng (Mo), and
- Abraham (Rami) Rudnick
This study describes the meaning of social inclusion to persons living with mental illness and poverty. Participants were recruited from health and social services where they completed the Community Integration Questionnaire (CIQ). From this sample, 46 participants attended one of three focus groups that corresponded with their self-reported CIQ scores. Thematic analysis showed that regardless of their CIQ scores, participants described freedom as both a liberating process for, and outcome of, social inclusion; freedom allows for the accumulation of health and social capital commensurate with one’s complex needs, and freedom represents success in the construction life surrounded by affirming others. - OPEN ACCESSThe Dalhousie University Social Work Community Clinic, a unique inter-professional community-university initiative, opened its doors in 2014 and has supported over 400 marginalized community members and provided field placements for over 65 health profession students. The clinic espouses a social justice/ anti-oppressive teaching, learning and service delivery platform.
- OPEN ACCESS
- Ginette Aubin,
- Manon Parisien,
- Norma Gilbert,
- Bernadette Dallaire,
- Véronique Billette, and
- Julie Beauchamp
To better support the social participation of seniors with mental health or psychosocial challenges, we developed a manualized group program. Following program testing, participating agencies and group leaders expressed their appreciation of the program and identified its facilitators and barriers. The revised version is available in French and English. - OPEN ACCESS
- Marc Corbière,
- Patrizia Villotti,
- Carolyn S. Dewa,
- Hélène Sultan-Taïeb,
- Franco Fraccaroli,
- Sara Zaniboni,
- Marie-José Durand, and
- Tania Lecomte
Social firms (SFs) are an appealing model for people with a mental health condition who are having difficulties maintaining their employment in a competitive labour market. The goal of this study is to compare the availability of work accommodations in two types of Canadian SFs, by interviewing supervisors working in adapted enterprises and consumer/survivor-run businesses, and by obtaining the perceptions of the workers with a mental health condition regarding the usefulness of these accommodations. Results indicate accommodations in both types of SFs are readily available and useful. A significant difference between the two types of SFs is the availability of a job coach whose presence workers found useful in adapted enterprises. Natural supports from stakeholders (e.g., supervisors, job coach) are important for work sustainability. - OPEN ACCESSQualitative studies provide a different kind of understanding of the effectiveness of community treatment orders (CTOs) by exploring the perspectives of stakeholders. This article documents a systematic review of 12 qualitative studies that explored the views of families of individuals on a CTO. Relevant databases and grey literature were searched. Themes were identified: the benefits of CTOs outweigh the disadvantages, CTOs increased their involvement in care, and families were dissatisfied with aspects of the CTO process. Recommendations include how to maximize the benefits of CTOs, reduce administrative burdens and employ strategies to increase involvement of families in the care of their loved ones.
- OPEN ACCESSThis investigation examined needs and concerns of transgender youth and their families throughout the island of Newfoundland. Twenty-four youth and 21 parents completed qualitative questionnaires. Both parent and youth participants expressed concern about general practitioners’ lack of knowledge of transgender healthcare. Trans youths’ main concerns included lack of parental support, feelings of dysphoria, the desire to be fully accepted, and safety. Parents’ main concerns included wait times for care, their child’s mental health, lack of information or guidance, safety, and depathologizing their children’s identities. The findings point to six key recommendations for healthcare providers and policymakers.
- OPEN ACCESSThis report describes how graduate students in nursing education have developed capacity among student nurses in response to the opioid crisis in Canada by using education on harm reduction practice and naloxone administration.
- OPEN ACCESSTrauma, addiction, and homelessness for Indigenous people are interwoven with colonialism and the loss of culture. I’taamohkanoohsin is a grassroots program that was developed to support healing and recovery for a highly marginalized Indigenous population with concurrent mental health challenges and other complex needs in a downtown core neighbourhood.
- OPEN ACCESS
- Manuel Riemer,
- Carol A. Stalker,
- Livia Dittmer,
- Cheryl-Anne Cait,
- Susan Horton,
- Narges Kermani, and
- Jocelyn Booton
The walk-in counselling (WIC) model of service delivery has been found to reduce psychological distress more quickly than a traditional model of service delivery involving a wait list. A question remains, however, as to the relative benefit of the WIC model for different client groups. The present study uses graphical inspection and multilevel modelling to conduct moderator analyses comparing two agencies, one with a WIC clinic and the other with a traditional wait list approach, and their relative impact on psychological distress. Key findings regarding the differential benefits for different types of presenting problems as well as clients at different stages of change are discussed. - OPEN ACCESS
- Mélanie M. Gagnon,
- Delphine Collin-Vézina,
- Renée Séguin,
- Martine Hébert,
- Mireille Cyr, and
- Isabelle V. Daignault
Le but de l’article est de présenter les résultats d’un consortium d’experts désignés par le Centre d’expertise Marie-Vincent. Le mandat du consortium était d’évaluer l’état des connaissances sur les agressions sexuelles envers les enfants âgés de 5 ans et moins. Cette synthèse met en lumière les défis liés au dépistage, aux enquêtes et à l’évaluation de l’agression sexuelle chez les jeunes enfants. Le manque important de connaissances à ce sujet limite le développement de cadres de référence pour orienter les stratégies de prévention et d’intervention, qui pourtant s’avèrent essentielles pour contribuer au mieux-être des jeunes victimes et de leurs familles. - OPEN ACCESSThis paper describes the development and psychometric testing of the Substance Use Wellness Tool, created to help raise awareness about alcohol and other substance misuse among university undergraduates. The tool is a self- and peer-reflection guide that students can use to monitor and alter their patterns of substance use. Exploratory and confirmatory factor analysis showed that the tool was unidimensional and that all 13 assessed domains were important. Cronbach’s alpha indicated the tool was highly reliable. Construct (convergent) validity for alcohol use with the 10-item AUDIT was also good, with strong correlations overall and within subgroups defined by gender, year of study, and university site.
- OPEN ACCESSAlthough many individual risk factors have been identified for student mental health problems and alcohol misuse, there is a relative paucity of research that examines how variables, such as campus environment, contribute to students’ experiences of these problems. This study examined a series of perceived campus environment factors (e.g., feeling valued, feeling they fit in, believing faculty care about them, perceived administrative concern for mental health and substance abuse) and the relationships among these perceived campus environment variables and students’ mental well-being, risk of harmful drinking, and their willingness to seek help for a substance use or mental health concern. A total of 1,885 first-year undergraduate university students including 938 females, 936 males and 11 “non-binary” participants, from three geographically diverse Canadian university sites, completed online surveys. The results demonstrated significant associations among the perceived campus environment variables and both mental health and alcohol misuse outcomes. It was also observed that whether a student lived in residence or off campus significantly affected which campus environment factors were most associated with their reported mental health and alcohol misuse. Additionally, willingness to help-seek was related with students’ perceptions of campus culture. These patterns globally demonstrated the importance of campus culture for student mental health and alcohol use. Strengths and limitations of the study, as well as directions for future research on the relations of campus culture to mental health, substance use, and help-seeking are discussed.
- OPEN ACCESS
- Ivy-Lee L. Kehayes,
- Amanda Hudson,
- Kara Thompson,
- Christine Wekerle,
- Heather Stuart,
- Keith Dobson,
- Terry Krupa, and
- Sherry H. Stewart
Alcohol intoxication is often involved for both victims and perpetrators of sexual victimization. Yet, alcohol-involved sexual victimization research has mainly focused on female victims, excluding male victims. The current study addresses gaps in the literature by focusing on sex differences in the emotional harms (anxiety and depression symptomatology) experienced by sexual victimization victims when either the perpetrator or victim was drinking. Five-hundred-and-ten undergraduate drinkers (153 male; 357 female) participated. Models included two dichotomized predictors that occurred during participants’ first year of university (sexually victimized when the victim was drinking, sexually victimized by someone who was drinking), and two emotional outcomes (anxiety, depression). Age was controlled in all path analyses and sex was examined as a moderator. When predictors were examined in separate models, both predictors were associated with increased anxiety but not depression. These effects were significantly stronger among men. When both predictors were entered simultaneously, individuals who were victimized by someone drinking displayed increased anxiety, and this relationship was stronger among men than women victims. Being victimized when drinking was no longer associated with anxiety, consistent with prior findings that post-traumatic distress may be minimized when a trauma occurs while the victim is intoxicated. Results highlight the impact sexual victimization can have for both male and female victims, and point to the need for evidence-based policies to prevent emotional second-hand alcohol harms among male and female students alike. - OPEN ACCESSThis paper describes a project that took place at three large Canadian universities aimed at engaging male students to address alcohol misuse and associated mental health issues through a gendered and campus culture lens. Although considerable effort has been put into decreasing alcohol misuse on campuses, most of this effort has been aimed at individual factors, rather than targeting the cultural and gendered context through which most post-secondary students consume alcohol. Gender transformative and gender sensitive health promotion approaches were guiding frameworks for the project. In addition to discussing how gender theory was implemented in a post-secondary context, this paper also explores some of the key features that guided these projects including the Summit Model, social marketing, sharing narratives of alcohol misuse and mental health, and planning for sustainability. Key lessons learned in engaging male students to be involved in challenging gendered norms related to alcohol misuse on campus are discussed.
- OPEN ACCESSThe social norms approach to changing excessive drinking behaviour is predicated upon findings that overestimations of peer drinking predict one’s own drinking behaviour. Prior studies have yet to examine whether such social norms effects pertain equally to both genders. First-year students from a Canadian university (N = 1,155; 696 males, 459 females) were assessed for the relationship between misperceived drinking norms and hazardous drinking using the Alcohol Use Disorder Identification Test-Consumption scale (AUDIT-C). A significant positive relationship between the overestimated drinking frequency norm and hazardous drinking was determined for female students, where the odds of hazardous drinking increased by 1.92 (95% CI: 1.32–2.79) when the norm of other female students was overestimated. A non-significant association was found for male students, where the odds of hazardous drinking were unrelated to overestimation of the drinking norm of other male students. The null association for male students highlights a potential problem when using social norms interventions for alcohol reduction for males in the university context. Implications of these results for the utilization of the social norms approach to alcohol reduction are discussed.
- OPEN ACCESS
- Heather Stuart,
- Shu-Ping Chen,
- Terry Krupa,
- Tasha Narain,
- Salinda Horgan,
- Keith Dobson, and
- Sherry Stewart
The Caring Campus project was a three-year intervention research project funded by Movember Canada that fostered new awareness regarding the interconnection between gender, mental health, and substance (specifically alcohol) misuse on three university campuses in Canada, and encouraged new approaches to promote young men’s health. In this project, we demonstrated that male students are willing to assume leadership roles to promote mental health and healthier alcohol use to their peers and enact a social agenda for change. Empowerment strategies encouraged male students to enlist like-minded peers to advance men’s mental health and transform campus drinking cultures, including countering gender-based ideals and norms associated with mental health problems and substance misuse. There is now great potential to influence the way in which other post-secondary institutions approach mental wellness and substance misuse using the Caring Campus model, which uses student empowerment to catalyze change. - OPEN ACCESS
- FREE ACCESSTo increase access to evidence-based care, people with depression and anxiety in a Canadian community hospital were offered internet-delivered CBT (iCBT) or in-person CBT. The iCBT outpatients had a lower attrition rate with similar symptom reduction. Our results suggest that other clinics and hospitals could use iCBT to facilitate care.
- FREE ACCESSTransitions (2nd edition) is an evidence-based life-skills resource designed to help post-secondary students transition from high school to college or university. This study was an on-campus evaluation of peer-led seminars of the mental health content from Transitions. A cross-sectional survey was conducted to assess the mental health literacy of three groups of students: master trainers, student trainers, and seminar participants. Post-seminar, there were significant improvements in mental health knowledge and help-seeking, two key components of participants’ mental health literacy. This peer-led approach is a feasible option with the potential to improve student mental health literacy within a short time frame.
- FREE ACCESSWe created a person-centred care pathway for people with depression in a primary care team. An electronic form supported clinicians in assessing and documenting depression, accessing guidelines, making referrals and sharing the plan with the client. Assessment, documentation of depression, and referrals for cognitive behaviour therapy increased.
- FREE ACCESSLe présent article décrit le lien entre la santé mentale et l’identité ethnolinguistique des étudiantes et étudiants d’un établissement d’enseignement postsecondaire francophone en contexte linguistique minoritaire dans l’Ouest canadien. Dans l’ensemble, les Franco-Manitobains affichaient une forte identité ethnolinguistique et une meilleure santé mentale. En revanche, les francophones d’un autre pays étaient plus à risque d’éprouver un problème de santé mentale, et ce, malgré une forte identité ethnolinguistique. À l’évidence, pour ces étudiantes et étudiants et ceux d’origine canadienne anglophone, l’identité ethnolinguistique est positivement associée à la santé mentale et devrait donc être considérée de façon plus spécifique au moment de l’élaboration des stratégies de promotion de la santé mentale destinées aux établissements d’enseignement postsecondaire canadiens.
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- Skye Pamela Barbic,
- Sean A. Kidd,
- Zachary T. Durisko,
- Rosemary Yachouh,
- Gausiha Rathitharan, and
- Kwame McKenzie
Personal recovery is an overarching goal that underpins mental health community support and clinical services in Canada. Surprisingly, little information is available about the personal recovery needs of community-dwelling Canadians with mental illness. The purpose of this study is to describe these needs in a sample of adults living in a large urban centre. We performed a multi-site cross-sectional survey of adults who receive community-based mental health services in an urban setting. Participants were asked to complete six patient-reported outcome (PRO) measures about personal recovery, hope, mastery, and depression. We used descriptive and correlational analyses to summarize the data according to an established evidence-based theoretical conceptualization of recovery. Two hundred and twenty-eight individuals participated in the study. Participants indicated high levels of self-reported empowerment and hope and optimism about the future. In contrast, participants reported low levels of perceived connectedness, identity, and meaning in life. In conclusion, this study identified that recovery-oriented PRO measures can improve our understanding of the needs and goals of individuals with mental illness and highlight the ways in which individuals can achieve a sense of meaning in life. Understanding the recovery needs of Canadians with mental illness may help foster recovery-oriented healthcare by bringing person-centred approaches to the point of treatment, so as to ensure greater quality and accountability of mental health services. - FREE ACCESSThis study explored the experiences of persons experiencing chronic homelessness with and without rent assistance. Qualitative interviews were conducted with 12 participants in order to determine if and how rent assistance impacted participants’ narratives of recovery. These narrative interviews, along with a focus group conducted with 10 support workers, explored implementation factors impacting recovery narratives. The findings suggest that access to rent assistance helps to promote recovery outcomes, conceptualized as life transitions (streets to home, home to community, and past to future), among individuals experiencing chronic homelessness. These transitions were enhanced by various participant, program, and community factors.
- FREE ACCESSHealthcare professionals play an important role in caring for older adults with multiple chronic conditions (MCC). Yet few studies have examined the experiences of working with this population, particularly among non-physicians. Twenty-two mental health professionals participated in focus groups to explore the experiences of caring for older adults with MCC. Challenges included a fragmented system, stigma, and knowledge gaps. Rewards included the challenges that complexity presented and human connections. Understanding health professionals’ experiences in working with this growing population demographic can assist in the development of appropriate interventions to support providers that best meet the needs of older adults.
- OPEN ACCESSSocial and emotional learning is increasingly recognized as playing an important role in the promotion of positive mental health in schools. In 2012, the Mental Health Commission of Canada identified child and youth mental health as a priority for the transformation of mental health systems in Canada. To this end, comprehensive efforts to promote positive social and emotional development in schools and to foster safe and caring school environments are urgently needed. This paper highlights the multi-faceted approach undertaken in British Columbia over the past decade to promote positive mental health through social-emotional learning in schools.
- OPEN ACCESSThe concept of “community” is ubiquitous in mental health policy, research, and practice in Canada; however, its meaning is rarely defined. In this paper, we consider the positioning of “community” within the Canadian historical and political mental health context and reveal that it contrasts with the lived experiences of people with psychiatric disabilities. We argue that mental health policy, research, and practice should move away from the term community in favour of a framework that addresses basic needs, disability justice, intersecting social identities, and the structural forces that impact the lives of people with psychiatric disabilities as they “recover” in settings outside of hospital.
- OPEN ACCESSIt is the current authors’ perspective that the successful implementation of Changing Directions, Changing Lives, which seeks to improve mental health and well-being in Canada, cannot be realized effectively without considering FASD. Given that 94% of individuals with FASD also have mental disorders, practitioners in the mental health system are encountering these individuals every day. Most mental health professionals have not been trained to identify or diagnose FASD, and therefore it goes largely “unseen,” and individual treatment plans lack efficacy. Implementation of FASD-informed recommendations, such as those of the Truth and Reconciliation Commission of Canada (2015), can provide a more effective approach to mental health services and improve mental health outcomes.
- OPEN ACCESSSince 2000, 5 studies have been published that each purported to estimate aggregate national mental health costs in Canada. Each of these studies used a different method. Our aim was to compare the studies, and we created a framework for the different elements used to assess mental health costs (direct costs, indirect costs, transfer payments, and “human” costs). In addition, each study used different parameters (population covered, diagnosis) and cost components to estimate the economic impact of mental health. Our framework can help analysts to understand the purpose of different cost components. We conclude that to achieve a consensus on the magnitude of mental health costs, we need to use more standardized approaches.
- OPEN ACCESSFor 20 years mental health and primary care providers across Canada have been working collaboratively together to improve access to care, provider skills, and patient experience. The new strategic plan of the Mental Health Commission of Canada (MHCC) offers many opportunities for collaborative care to play a role in the transformation of Canada’s mental health systems. To assist the plan, this paper presents principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care. It integrates these concepts into a Canadian Model for Collaborative Mental Health Care that can guide future expansion of these approaches, and suggests ways in which better collaboration can address wider issues facing all of Canada’s health care systems.
- OPEN ACCESSCultural competence has proven to be a very efficient tool in reducing healthcare disparities and improving healthcare experiences, compliance with therapy, and reducing incidents of misdiagnosis. This effect is because professionals are recognizing the value and significance of including the person in need of services in their assessment and decision making. While this rationale has also long been considered part of good practice among healthcare professionals (providers) within the mental health arena and nursing care and the success of its use has been reported widely in the provider and insurance arena, the notion seems to have escaped the commissioning arena. Commissioners are responsible for specifying, procuring, and monitoring services and are missing out on the value of completing culturally competent needs assessments for their localities. Synonymous with cultural competence is “person-centred care.” In recent times, cultural competence has contributed much to the commissioning of dementia services in a bid to improve and promote person-centred care. It could be argued that there is no person-centred care without cultural competence, which, in simplistic terms, can be defined as care that is undertaken in partnership with the recipient and is of value and significance to the recipient. Culturally competent commissioning and provision of care is therefore to be recommended as capable of addressing quality issues and the problematic variation in services available.
- OPEN ACCESSIn most disability income support (DIS) programs, mental illnesses is the fastest growing category of illness, but it is unknown how policy designers consider this vulnerable group. Forty-five DIS policy designers in Australia and Ontario explained how they consider mental illnesses when designing policy. Using a grounded theory approach, five challenges emerged: validating duration, proving an illness, (un)differentiating mental illnesses, managing mental illnesses, and separating the person from the illness. Each challenge is described and compared across Australia and Ontario. These challenges provide a framework for other settings to determine how well their DIS policies have considered mental illnesses in policy design.
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- OPEN ACCESSCette évaluation porte sur les effets d’une formation dans le domaine de la violence sexuelle, destinée au personnel en milieu scolaire et développée par un organisme communautaire spécialisé dans ce domaine. Les résultats indiquent que cette formation contribue à accroître les connaissances, les attitudes favorables exemptes de préjugés vis-à-vis la violence sexuelle et le sentiment d’autoefficacité du personnel scolaire (n = 42) à court terme et 3 mois après la formation. De plus, les participants et participantes rapportent une fréquence considérable de situations dans lesquelles ils ont transféré les apprentissages dans leurs pratiques professionnelles.
- OPEN ACCESSPrimary care providers deliver the majority of mental health care to individual Canadians. Researchers suggest that these practitioners are not prepared to deliver these services and require collaboration with mental health specialists to better meet patients’ needs. This study describes family physicians’ and nurse practitioners’ perceptions of the need for consultation and collaboration from mental healthcare specialists. The theme, Looking for Help, is explained by three categories: My Comfort Zone, I Lack the Education, and Not Enough Time. Findings from this study may inform future collaborative mental healthcare initiatives and primary care networks.
- OPEN ACCESSThe Recovery College at Ontario Shores provides service users who have mental health challenges with courses, which they choose, to learn about recovery, mental health, treatment options, leisure, and fun. College components designed to enhance recovery also include peer support and access to the library to enhance individualized learning.
- OPEN ACCESSCette étude présente des données concernant la prévalence des psychopharmacoprescriptions chez les enfants de 6 à 12 ans placés dans les foyers de groupe et centres de réadaptation des Centres jeunesse du Québec. Elle précise les classes de molécules, les motifs de prescription et la formation du médecin prescripteur. L’échantillon comprend 101 enfants placés. Les données ont été obtenues par le biais de questionnaires remplis par les éducateurs et éducatrices responsables de ces derniers. Les résultats indiquent que 70 % des jeunes reçoivent au moins une prescription, le plus souvent signée par des médecins spécialistes. Les ordonnances se composent pour la plupart de psychostimulants et d’antipsychotiques, prescrits pour des troubles de l’attention avec hyperactivité.
- OPEN ACCESSMarginalized 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
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. - OPEN ACCESSPeople 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.
- OPEN ACCESSWith 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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- Gillian Mulvale,
- Christina Roussakis,
- Christopher Canning,
- Despina Papadodoulos, and
- Francine Knoops
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. - OPEN ACCESS
- Brieanne Olibris,
- Gillian Mulvale,
- Soo Chan Carusone,
- Elizabeth Lin,
- Michelle Domonchuk-Whalen, and
- Kathleen Whittaker
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. - OPEN ACCESS
- OPEN ACCESSAs 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.
- OPEN ACCESSThis 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.
- OPEN ACCESSYouth 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.
- OPEN ACCESSWith 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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- OPEN ACCESSResponsibility 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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- Sarah Pakzad,
- Paul-Émile Bourque,
- Jimmy Bourque,
- Tim Aubry,
- Lise Gallant,
- Stefanie R. LeBlanc, and
- John Tivendell
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. - OPEN ACCESS
- OPEN ACCESSWe 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.
- OPEN ACCESSNunavut 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.
- OPEN ACCESSCet 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.
- OPEN ACCESSResearch 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.
- OPEN ACCESSSuicide 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.
- OPEN ACCESSMental health courts (MHC) are still relatively new in Canada and there is a dearth of research available regarding program structure and outcomes. This article presents preliminary evaluation findings on the operation of the new Winnipeg MHC program, launched in 2012. In addition to profiling the demographic, legal, and mental health backgrounds of program participants, we use a pretest- post-test design to compare rates of criminal justice involvement (N = 35). Participation in the MHC appeared to reduce justice system contact, supporting at least initial optimism about program efficacy. Greater inclusion of minorities was an area targeted for improvement. Study findings provide partial support for further development and implementation of mental health courts in Canada.
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- Francine Ferland,
- Nadine Blanchette-Martin,
- Audréane Bertrand-Danjou,
- Sophie Blais-Michaud,
- Andrée-Anne Légaré,
- Isabelle Giroux,
- Pascal Garceau,
- Cathy Savard, and
- Annie-Claude Savard
Actuellement, il y a peu de critères standardisés permettant de guider l’orientation des joueurs et des joueuses pathologiques vers les traitements internes ou externes. Les guides de bonnes pratiques suggèrent d’orienter ceux-ci vers des services d’une intensité appropriée à leurs besoins. Selon la littérature, c’est la gravité du problème de jeu de hasard et d’argent (JHA) qui devrait déterminer l’intensité des services requis. Toutefois, la littérature présente une vaste gamme d’indicateurs pouvant permettre de déterminer la gravité d’un problème de JHA. La présente étude a comme objectif de déterminer quels indicateurs de la gravité d’un problème de JHA évalués lors de l’évaluation d’admission en traitement des joueurs et des joueuses sont utilisés pour déterminer de l’orientation vers les modalités de traitement interne ou externe. Les évaluations d’admission de 364 joueurs et joueuses adultes qui se sont présentés dans un service public du Québec spécialisé en dépendance ont été analysées à l’aide d’une régression logistique. Les résultats indiquent que bien que l’évaluation d’admission permette de dresser un portrait exhaustif de la situation du joueur et de la joueuse, seulement 5 indicateurs sont utilisés pour déterminer l’orientation clinique. Les impacts sur la durée de l’évaluation d’admission et sur le travail clinique des intervenants et des intervenantes sont discutés. - OPEN ACCESSFamily relationships are known to play a significant role in helping persons with mental health issues exit homelessness. This study aims to identify the independent quality of life factors that correlate with quality of family relationships. A cross-sectional design was used involving individuals enrolled in the At Home initiative for homeless persons with mental illness in five cities across Canada (N = 2,255). Linear regression analysis indicates that homeless persons’ mental health, community integration, general health status, number of symptoms, and recovery are playing a role in a better quality of life in the family and therefore can help to exit homelessness.
- OPEN ACCESSThe availability of publicly funded psychological therapy for people with mental health challenges is limited in Canada and elsewhere despite evidence supporting its clinical and social benefits. We report on a pilot program of such therapy, presenting its salient features, lessons learned, and future prospects.
- OPEN ACCESSRisks of mental health issues (e.g., depression, anxiety/mood disorders, and suicidality) are found to be elevated among Canadian gay, bisexual, and men who have sex with men (GB-MSM). We studied factors impacting mental health care use in a community sample of 202 GB-MSM in London-Middlesex, Ontario. Our results show that, for the entire sample, experiences of both homophobia and internalized homonegativity are associated with increased prevalence of mental health service use over the past year, and suggest that service use is lower among immigrant GB-MSM than among those born in Canada. Implications for mental health and social service providers are discussed.
- OPEN ACCESSThe objective of this pilot project was to evaluate the effectiveness of the FRIENDS program in reducing anxiety and symptoms of depression for children in Regina public schools. The project comprised 461 children in Grades 1, 4, 5, and 6 who participated in the 10-week FRIENDS program between September 2013 and May 2014. Effectiveness of the program was measured using the Revised Children’s Anxiety and Depression Scale, which was administered at the beginning and end of the program. The percentage of children with subclinical or clinical levels of anxiety and depression significantly decreased from 21.8% to 13.4%. This study validated the effectiveness of the FRIENDS program in children in Regina schools.
- OPEN ACCESSLa prévention est une des premières missions des psychologues hospitaliers et territoriaux en France. Les constats actuels font état d’un faible investissement de ces professionnels et professionnelles en prévention primaire, au profit d’une intervention davantage centrée sur les troubles psychiques et la prévention secondaire. Cette étude qualitative visait à investiguer les représentations sociales des psychologues par rapport à cet objet prévention. En outre d’une attitude positive à l’endroit de la prévention, les résultats font état d’un discours principalement centré sur les enjeux sanitaires de la prévention et sur les risques de la mise en place de nouvelles politiques publiques de prévention.
- OPEN ACCESSIn this paper, we outline three genealogies of housing policy in Canada—affordable housing, mental health housing, and housing for homeless persons—and present the focus, research, and strengths/critiques of these genealogies. The increased visibility and adoption of Housing First (HF) in Canadian policy has created tension between groups working on housing and homelessness. Critics rightly point out that HF does little to increase the availability and accessibility of affordable housing. We discuss the homelessness sector as a bridge between the affordable housing sector and the mental health sector and outline how collaboration might take shape in addressing homelessness and affordable housing in Canada.
- OPEN ACCESSInterprofessional relationships between youth workers and mental health service providers are now understood as an integral aspect of mental health literacy and care provision. This paper reports on findings from an online survey exploring youth workers’ (N = 74) perceptions of mental health literacy, specifically in regards to interprofessional relationships in Canada. Discourse analysis of participants’ qualitative responses revealed three themes: constructing us/them binaries, differential positioning contributing to collaboration, and hierarchical differential positioning contributing to learned helplessness. Constraining and supporting conditions for collaboration include organizational structures and policies that support the development of interprofessional relationships, knowledge of different professions’ roles and responsibilities, and respectful experiences during collaboration.
- OPEN ACCESSInpatient care for adults with eating disorders in Canada is limited. An innovative outpatient interdisciplinary approach and a service use example are presented. With no current benchmark, this approach may offer a practical solution for outpatient teams seeking to be helpful when service users are left to wait for inpatient care.
- OPEN ACCESSThe Caregiver Series, an initiative started in 2013 by the Quality Improvement and Education Team within Children, Youth, and Families, Addiction and Mental Health, Alberta Health Services, aims to provide caregivers and individuals with information about mental health and addiction issues within childhood and adolescence. Knowledge mobilization, collaborating and partnering with schools, taking into account adult learning principles when creating sessions, focusing on high quality content delivered by mental health professionals, decreasing barriers when possible, and incorporating feedback for ongoing quality improvement, are the characteristics that have been a large contributor to the success of the series.
- OPEN ACCESSInterprofessional care (IPC) represents a high degree of collaboration among health professionals to provide comprehensive treatment to clients. Despite increased uptake of IPC in mental health care, few studies have examined its clinical effectiveness in actual practice. A retrospective cohort study examined the treatment outcomes for 183 outpatients with chronic and comorbid mental health difficulties treated with IPC in a community mental health setting. Multilevel modelling demonstrated that clients reported statistically significant improvement in mental health symptoms and functioning during IPC, relative to a waitlist interval. Furthermore, fewer clients reported clinically significant difficulty with symptoms and functioning over the course of treatment with IPC. Findings suggest that IPC may be an effective treatment in outpatient community mental health settings for Canadian adults presenting with chronic and comorbid psychopathology and affected psychosocial functioning.
- OPEN ACCESSThis study analyzed a retrospective sample of articles from 12 major Canadian newspapers to characterize messages about depression in print media. Major themes were positive and focused on promoting awareness and disseminating research findings. Stories often relied on expertise, but seldom included input from those affected by a mental illness. More than half the articles used improper language. Articles rarely provided information to find additional resources. Findings may guide future analyses and programs aimed at improving media coverage of mental illness.
- OPEN ACCESSGoing Off, Growing Strong is a program for Inuit youth facing widespread social, cultural, and economic change. The overarching goals of the program are to: (1) enhance resilience and wellness; (2) build social connections for the youth; and (3) transmit traditional knowledge, skills, and values to participating youth.
- OPEN ACCESSCognitive behavioural therapy-based music (CBT-Music) group is a nine-week guided self-help group for individuals with mild-to-moderate symptoms of anxiety and/or depression. This is a novel treatment developed for use in a community-based mental health setting. A feasibility study (a randomized control trial) has shown promising results for the CBT-Music group.
- OPEN ACCESSCet article traite des personnes atteintes de schizophrénie qui entendent des voix. Il a pour objectif de décrire les croyances qu’elles entretiennent par rapport à leurs voix, le degré d’anxiété qu’elles ressentent et leur perception relativement à leur fonctionnement social. Les stratégies d’adaptation qu’un sous-groupe de l’échantillon déploie sont exposées. Cette recherche s’appuie sur le modèle cognitif ABC qui stipule que les hallucinations auditives sont des événements déclencheurs (A) auxquels les individus donnent un sens en construisant un système de croyances (B) pouvant entraîner des réactions émotionnelles et comportementales (C). Les analyses statistiques montrent que les personnes rapportant des voix omnipotentes plus fortes ont tendance à y résister davantage sur le plan émotionnel et à avoir un moins bon fonctionnement social. Les personnes qui résistent à leurs voix ont tendance à démontrer un degré d’anxiété plus élevé. Les analyses qualitatives font ressortir un consensus à l’effet que prendre sa médication et se distraire des voix sont les stratégies jugées les plus faciles à réaliser et les plus efficaces pour composer avec elles.
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- Élaine de Guise,
- Frédéric Banville,
- Monique Desjardins,
- Marie-Christine Ouellet,
- Yvonne Richard,
- Stéphane Gagnier,
- Simon Bonneau-Beaulieu,
- Hélène Audrit,
- Debbie Feldman, and
- Bonnie Swaine
L’objectif de cette étude est de déterminer les priorités d’action afin d’améliorer l’offre de services de santé mentale suite à un traumatisme craniocérébral (TCC) modéré ou grave. Quatre-vingts participants (intervenants et intervenantes, décideurs et représentants et représentantes de la communauté) ont participlé au forum de discussion. Un logiciel d’analyse qualitative des énoncés de la démarche réflexive (Démarche réflexive d’analyse en partenariat : DRAP) a été utilisé pour recueillir et analyser les énoncés (Boudreault et Kalubi, 2007). Les participants (hommes et femmes) devaient évaluer l’importance de chaque énoncé (incontournable, nécessaire, souhaitable). Un total de 341 énoncés ont été proposés dont 70,3 % ont été jugés comme étant incontournables dans le secteur des pratiques cliniques, 63,2 % dans le secteur des politiques, 50,7 % et 66,6 % dans les secteurs organisation des services et formation respectivement. Cette activité de réflexion provinciale en partenariat propose un plan d’action afin d’améliorer l’offre de services en santé mentale suite à un TCC modéré ou grave. - OPEN ACCESSResearchers examined how young people who are homeless conceptualize and interact with challenging circumstances, adopting a human agency focus rooted in the constructionist model of resilience. Thirty-five young people who were homeless in Ottawa participated in in-depth interviews and/or focus groups. Participants reflected upon their strategic decision-making and described how they solved problems in the midst of adversity, planned for the future, consciously altered their identities, and balanced the costs of engaging in certain behaviours. A constructionist approach to resilience allowed for insight into behaviour that is often seen as risky or outside social norms.
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- Janie Houle,
- Geoffrey Gauvin,
- Bruno Collard,
- Sophie Meunier,
- Nancy Frasure-Smith,
- François Lespérance,
- Benjamin Villaggi,
- Pasquale Roberge,
- Martin D. Provencher, and
- Jean Lambert
This paper reports on the development and evaluation of the Depression Self-Management Workshop (DSMW) that aims to empower participants to implement self-management behaviours in their daily lives in order to improve their mental health and prevent relapse. The 10-session intervention was delivered to 46 adults with depression who completed pre-, post- and follow-up structured interviews and questionnaires. Depressive symptoms were significantly reduced at the end of the intervention and at follow-up. Improvements in participants’ knowledge about depression, self-management behaviours and self-efficacy were also observed. These results were corroborated by the participants’ strong convictions regarding the DSMW’s usefulness. - OPEN ACCESSClinicians completed interviews using the Ohio State University Traumatic Brain Injury Identification Method (TBI-ID) and sections of the Addiction Severity Index (ASI-Lite) with clients who were homeless and receiving community mental health services. Fifty-six percent of clients screened positive for TBI. Clients with a history of TBI were more likely to be using multiple substances, and were more likely to have, and be bothered by, family and emotional problems than clients without TBI. Homeless clients receiving mental health services may have undiagnosed TBI that could affect their ability to benefit from treatment. Such clients may require services that compensate for their cognitive deficits.