Sante Mentale au Quebec最新文献

Context In France, both Return to Work (RTW) and sustained employment following extended medical leave are critical concerns, due to the substantial risk of professional disengagement after returning to work. Professional disengagement, influenced by a combination of work-related and health-related factors, necessitates proactive awareness, prevention, and adapted support to maintain employment. The involvement of diverse stakeholders in this process complicates access to available resources, highlighting the need for effective coordination. The occupational health law of August 2, 2021, mandates that Inter-Company Occupational Health Services (SPST) establish Professional Disengagement Prevention (PDP) units. These units are tasked with coordinating RTW support actions among the relevant stakeholders. Objective This exploratory research examines the collaborative process for RTW within a PDP unit at a rural SPST. It analyzes the development of a multi-partner collaborative process with the Health Insurance (Assurance Maladie) and a service provider specializing in maintaining the employment of workers with disabilities. The research aims to describe the development of this multi-partner collaboration and to elucidate the roles of organizational factors and the professionals' understandings of work disability in this process. Method A qualitative methodology was employed, involving the observation of meetings and a word association task with the stakeholders. This approach was used to identify both the facilitators and barriers to collaboration and to analyze the stakeholders' perceptions. Results The analysis identified several facilitators, including effective communication, coordination, and complementarity, as well as barriers, such as operational methods, role ambiguity, and workload. While facilitators enhanced communication and coordination, barriers were associated with limited availability and discrepancies between planned and actual work, intensified by administrative and human resource constraints. The co-construction of a collaborative tool facilitated interactions, decision-making, and improved the efficiency of RTW. Results indicate that sustained collaboration requires role clarification and aligned expectations over time. Perceptions of Professional Disengagement showed both commonalities and differences among the actors, with "support" being central but other elements revealing inter-professional variability. Conclusion In conclusion, the study emphasizes the importance of allowing sufficient time for the development of a shared understanding of roles and perspectives among stakeholders. This is crucial for fostering a robust work collective and ensuring the long-term success of multi-partner collaborations. The collaborative creation of a shared tool was shown to be a significant facilitator in establishing effective collaboration, built on shared, rather than entirely common, understandings.

The mental health of Quebec's student population appears to have been deteriorating for several years. Faced with these challenges, the ministère de l'Enseignement supérieur in Quebec has developed the Action plan on student mental health in higher education, which aims to support higher education institutions in implementing practices and measures that can contribute to the well-being and development of a flourishing mental health of the student population. The plan calls for the creation of service corridors between institutions and the health and social services network (HSSN). A number of other ministerial orientations also call for this approach. At present, information on these corridors remains limited, and they do not appear to be the subject of research anywhere in the world, particularly in Quebec. Objective The aim of this article is to document the state of service corridors between universities and the HSSN in Quebec. Method The data at the heart of this article comes from an inventory produced by 17 universities. A thematic analysis of the data was carried out using a deductive and inductive approach, with the aid of N'Vivo software. Results Five themes emerged from the analysis: 1) Issues related to current service corridors between universities and the HSSN; 2) Consequences of the absence of service corridors for students; 3) Consequences of the absence of service corridors for universities; 4) Main factors that could hinder the implementation of service corridors; 5) Proposed solutions. Conclusion Anticipated impact: This article highlights the absence of service corridors between universities and the HSSN, despite the many efforts made to create them and the ministerial orientations that encourage their creation. The article proposes a number of very concrete and actionable solutions that are perfectly aligned with ministerial orientations and that would help reduce emergency room use in Quebec. First priority could be given to students in need of specialized services who must be referred to the HSSN. The use of the mental health access mechanism, present in the HSSN, appears to be the simplest and most coherent approach, given that this mechanism aims to improve access to specific and specialized mental health care and services.

Objectives The study of mental health at work and return to work (RTW) in France shows by itself the subject is little developed in French labour and welfare legal doctrine. This study analyse how labour law in France is able-or not-to support the RTW of people who suffer or have suffered from a mental or psychic disorder. Method The method is in line with the usual practices of French legal doctrine, consisting of a study of existing legal regulations in France and an analysis of these. For example, legal standards specific to disability or chronic illness is used. Nevertheless, this subject requires us to explain the difference between "employment" and "work" within the French labour law approach-this chapter deals with "work." We also recall some fundamental legal standards. Results This study provides a dual analysis: that of labour law and that of welfare law, including social security law and employment law. The results takes into account the distinction between people suffering from chronic and non-chronic disorders, as well as disorders caused by work and those not caused by the performance of work, in order to highlight the appropriate legal regime, applied, existing or non-existent in France. Conclusion The approach of French labour and welfare law to issues relating to mental health and RTW presents real difficulties in terms of existing construction and implementation in practice. This obviously represents a limitation in dealing with the issue. Nevertheless, we explore the possibility of presenting the original concept of "préjudice d'anxiété", which strongly emphasizes the link between the social law approach to psychological suffering caused, according to the Cour de cassation, by the psychological disorders engendered by knowledge of the high risk of developing a serious pathology due to exposure to highly noxious or toxic materials or products during one's working career and due to maintaining at work despite these terrible conditions.

Objective Managers play an important role in supporting employees returning to work after long-term sick leave. However, little research has focused on the support practices that these managers use when dealing with employees returning to work after burnout. This exploratory study has two objectives. First, it outlines the variety of return to work (RTW) support practices implemented by managers. Second, it describes these managers' perceptions of burnout. We argue that these perceptions of burnout influence the type of support that they provide. Method A series of semi-structured interviews were conducted with 13 volunteer managers to describe the RTW support practices in place and their perceptions of burnout. All managers had been confronted, at least once, with supporting a team member's RTW after burnout (absence of more than one month). Results Managers provide four types of RTW support, including minimal support, collective support, and progressive support. Results are consistent with the general hypothesis and show a relationship between the perceptions of burnout and the type of support provided. Supervisors' perceptions of burnout have an impact on the type, amount, and effectiveness of their support. Conclusion In terms of practical implications, the results indicate that managers need training on burnout, its causes, and its consequences for RTW. They also need training in managing the emotions involved in supporting employees returning to work. The results also show the need to institutionalize collective procedures and systems to support RTW in order to reduce the risk of stigmatization and to promote inclusion and job retention.

Objectives The literature highlights the role of the manager in the successful return to work (RTW) after an absence due to common mental disorders (e.g., depressive disorders). However, few studies have specifically examined the influence of leadership style in this context, thus limiting the knowledge that could inform effective behaviors in organizational settings for sustainable RTW. This paper aims to examine the role of leadership and support practices developed by managers and employers in the context of RTW. Two studies are presented. The first study analyzes the influence of leadership style (transformational vs. authoritarian) and perceived organizational support on employees' retention after their RTW. The second study examines the extent to which managers and employers perceive their ability to implement practices recognized in the literature as promoting sustainable RTW.

Method: In Study 1, 84 employees who had returned to work after a long-term sickness responded to an online questionnaire (Qualtrics). Among them, 70% were on sick leave due to a common mental disorder (CMD). In Study 2, which was international in scope, 30 employers and human resources managers and 28 managers responded to an online questionnaire (LimeSurvey). This questionnaire focused on RTW practices for employees on sick leave due to a CMD, covering the entire RTW sequence.

Results: Study 1: Multiple regression analysis highlights that transformational leadership plays a significant role in reducing burnout and the intention to leave the job, unlike authoritarian leadership, while enhancing the perception of organizational support. Furthermore, the mediating role of SOP and burnout in the effect of transformational leadership on the intention to leave has been demonstrated. Study 2: Descriptive analyses indicate that employers and human resources managers find it easier to communicate rules to the various RTW stakeholders within the organization. However, their self-efficacy is lower when it comes to supporting managers in implementing work accommodations for the affected employees. With respect to managers, they feel capable of establishing measures that promote the sustainable RTW of team members. However, they find it more challenging to adopt RTW practices during the employee's sick leave and to implement preventive measures for relapses.

Conclusion: These two studies highlight the importance of supportive attitudes in job retention and identify areas of difficulty encountered by managers. The discussion presents research perspectives and recommendations to better support managers, employers, and human resources managers.

Introduction Supported employment, financed by the French Government since 2016, has demonstrated its positive impact on employment access and retention for people declaring a mental health disorder (40% of people supported in 2022). Objective The objective of the analysis of avoided costs, led by the Agence nouvelle des solidarités actives (Ansa) in 2021 and 2022, was to measure the economic impact of supported employment on public finances. This analysis focused on three types of costs: social benefits, psychiatric hospitalizations, and medical leave. Method The method consisted of collecting information from supported employment clients to compare these costs over three years (the year before supported employment and the following 2 years). In total, 462 people responded to the questionnaire, including 136 people over 2 consecutive years. These 2 samples were representative of the entire population of supported employment clients (9,300 people at the end of 2022). Results This analysis demonstrates significant avoided costs with, on average, a saving of 802 euros per person during the first year and 1,213 euros per person during the second year of supported employment. If we extrapolate to the total number of clients at the end of 2023, this constitutes a saving of 7.3 million euros for the year 2022 alone and this only on the 3 types of costs observed. The largest part of avoided costs can be attributed to a significant drop in the cost of psychiatric hospitalizations (-56% over 2 years) and in the cost of social benefits (-8.5% over two years). This analysis also demonstrates that the avoided costs are greater for people declaring a mental health disorder (average avoided cost amounts around 2,200 euros per year). This difference is largely explained by the drop in the number of psychiatric hospitalizations, whether as a percentage of people hospitalized (from 18% the year preceding entry to 9% and 12% over the following 2 years) and by the reduction in the average number of days of hospitalization (from 31 days in the year preceding entry to 20 days in subsequent years). For this public, we also see a slight decrease in the cost of medical leave (-16% over 2 years). Conclusion From a purely economic point of view, this analysis demonstrates a greater impact of supported employment for people suffering from mental health disorders and the need to strengthen links with mental health professionals to orient people towards supported employment.

Domestic violence is now an international social issue. Although some countries have been slow to respond, many have developed interventions based on an empowerment approach. This article examines a number of psychological variables and their impact on the implementation of an accountability approach in a group of participants from France and Canada (Quebec). The variables examined are traumatic and dissociative symptoms, attachment and suicide risk. Although these factors are crucial, they have been little studied, even though they may have an impact on the quality of support provided to perpetrators of domestic violence. Objectives Our objectives were to identify the psycho-socio-criminological profiles of perpetrators of domestic violence who had attended a course or an intervention group. We also wanted to compare these two groups and their respective support in order to hypothesize about the implementation of an accountability process in relation to certain psychological variables. Method A total of 57 men were interviewed, 38 from France and 19 from Quebec, who completed questionnaires on attachment, suicide risk, traumatic and dissociative symptoms, and socio-demographic data. Results The French and Quebec groups of men were similar in terms of their socio-demographic profiles, but there were significant differences in the types of violence reported. The Quebec group reported more sexual violence than the French group, while the French group reported more physical violence than the Quebec group. There were no significant differences in the results of the questionnaires on attachment and suicide risk, but the questionnaires on traumatic and dissociative symptoms were significantly higher among the Quebec perpetrators of domestic violence. Conclusion These differences may be explained by differences in the recruitment sites, the level of self-reflection and the time between the act of violence and the research interview. Secondary prevention work needs to be carried out so that perpetrators of domestic violence can identify their difficulties and verbalise and mentalise the issues that affect them. In addition, the obligation to attend training courses on responsibility, as proposed in France, seems appropriate but not sufficient. Individual meetings with a counsellor or psychologist, as a complement to these courses or groups, could help to increase the level of responsibility for the act and encourage more in-depth work. This awareness could in turn reduce the risk of re-offending and intergenerational transmission.