Sante Mentale au Quebec最新文献

Objectives This article looks at emotional difficulties experienced by intervention workers and managers from three associations of community organizations (mental health, homelessness and for people with disabilities) in Quebec during the COVID-19 pandemic. More specifically, we document manifestations, sometimes concurrent, of burnout, secondary traumatic stress and psychological distress reported by participants, comparing participants who reported having a management role with those who did not. Method Analyses were conducted based on responses of almost 300 participants to an online questionnaire comprised of 140 items, including scales pertaining to psychosocial risks, professional life quality and psychological distress. Results Our results show that many participants experience emotional difficulties, often experiencing mid levels of burnout, secondary traumatic stress and mid or high levels of psychological distress, or sometimes a combination of two or three difficulties concomitantly. The odds were higher for participants with management roles to obtain a higher score for burnout and psychological distress than for those who did not have a management role. Conclusion Contrary to an observed tendency of focusing on the bettering of individual adaptation skills to stressful situations, emotional difficulties experienced by intervention workers are a collective issue that therefore requires collective solutions. Two limits of this study are the question of the sample's representativity, as well as the way our results could reflect or not the situation of intervention workers in the public sector in Quebec or elsewhere in Canada.

Objectives In Canada, it is estimated that 5 to 31% of police interventions involve people with mental health disorders. The objective of this review of the scientific literature is to raise a myriad of issues in the approach to these patients in the community. We then illustrate this context with a Montreal initiative: The ÉCHINOPS Project (Hybrid Community Team for Innovative Interventions NPO-Psychiatry-SPVM). Method A bibliographic search was carried out in June 2022 on Pubmed, EMBASE, PsycINFO and CINAHL, using MeSH words Police, Law Enforcement, Crisis Intervention, Mental Health Services, Mental Disorders, Mentally Ill Persons, Intersectoral Collaboration, Interprofessional Relations, Interdisciplinary Communication, Patient Care Team and about 40 different key words, leading us to more than 1100 articles, regardless of the time and language of publication. Two members of the research team read the titles and abstracts to retain about 100 articles. Snowball research of bibliographies eventually lead to a sample of about 110 articles. We used the software Zotero version 6.0.37 to manage the sample. They had to be published either in French or English. We then organized our data into sections to summarize the issues: Interactions Between Patients and Police Officers and Procedural Justice; Use of Force and Morbidity; Transport to a Hospital Center; Judicialization; Consultation and Resolution of Situations on Stage; Access to Mental Healthcare and Hospitalizations; Experiences and Satisfaction of Citizens and Beneficiaries; Experiences and Satisfaction of Healthcare Providers; Economic Aspects. Results Over the last 40 years, the deinstitutionalization of psychiatric services has led to an increase in contacts between mental health patients and law enforcement. While demonstrating a cultural change regarding the role of police officers in the general population, initiatives around the world highlight a need for additional training on mental illness and growing interdisciplinarity between police services and the healthcare system. This need requires the development of partnerships and new models of collaboration in the community. Conclusion Made up of mental health nurses and community psychiatrists, the ÉCHINOPS Project team works in collaboration with police forces to play a consulting role and to implement and consolidate mixed practices for people with mental health issues. The team's operation is inspired by the models of mixed intervention teams known as "Co-response" or "Street Triage" which have been the subject of several projects in Canada and other Western countries. A mixed intervention team has taken off as part of a pilot project in Montreal's East-end since January 2022.

Objective The field of psychotherapy is growing and is offering more and more types of treatments. The objective of this paper is to go through many clinical researches and experiences from psychotherapists with several psychotherapies in universities in Montreal and Lausanne, especially in the Institute for Mental Diseases in Montreal (IUSMM). Method Research and clinical evaluations have varied over many years. Many studies and results have been evaluated and discussed over those years. Clinical developments like APAP have been developed and evaluated in various milieus and applications. Various strategies have been proposed like APAP that can be added to many orientations of psychotherapies. APAP is called for Augmentation de la Psychothérapie par Amorçage Préconscient in French or "Psychotherapy Augmentation through Preconscious Priming" in English. Results Many various researches focusing psychotherapies were developed over long periods because psychotherapists were also clinicians and teachers. For example, we were able de proceed with clinical evaluations and many volunteer patients. We were able to demonstrate that preconscious listening was useful to facilitate cognitive change. Conclusion Research on psychotherapy remains difficult and require usually long periods. For example, the research APAP described here took much more than one year. Research remains also difficult because double blind procedures in research on psychotherapy are rare. We were lucky because preconscious listening was out of conscious listening creating a sort of placebo that was to be compared to the listening of personalized preconscious stimuli.

Objective Cannabis is the most commonly used drug in the general population, but its prevalence of use remains higher among people suffering from severe mental disorders. Nevertheless, current cannabis research showed it to be deleterious on psychiatric symptoms, especially among patients with severe mental disorders. This present cross-sectional study aims to evaluate the impact of cannabis consumption on the psychiatric symptomatology of people with a serious mental disorder by controlling for the confounding variables of age, sex and concomitant alcohol or stimulant consumption. Method Secondary analyses were performed on data from 72 participants from a previous study. Their use of cannabis, alcohol and stimulants was measured using the Cannabis Use Problems Identification Test (CUPIT), the Alcohol Use Disorders Identification Test (AUDIT) and the frequency of use question from the Structured Clinical Interview for DSM-5-Clinician Version for Stimulant Use Disorders (SCID-5-CV-TLUS), respectively. Their psychiatric symptoms were measured using the five subscale model of the Positive and Negative Syndrome Scale (PANSS). Results Different linear explanatory models of PANSS symptoms were carried out using a combination of independent variables, i.e. age, sex, CUPIT, AUDIT and the question on consumption frequency of the SCID-5-CV-TLUS. The explanatory model of excitement symptoms is statistically significant (F = 4.629, p = 0.001) and it makes it possible to predict 20.4% of the variance of these symptoms (adjusted R2 = 0.204). In this model, CUPIT is the variable that most influences the model (ß = 0.381; p < 0.001). The explanatory model for positive symptoms is also statistically significant (F = 3.631, p = 0.006) and that makes it possible to predict 15.6% of the variance in these symptoms (adjusted R2 = 0.156). However, the CUPIT would not influence this model in a statistically significant way (ß = 0.125; p = 0.272), but the question on the frequency of consumption of the SCID-5-CV-TLUS would influence it (ß = 0.399; p = 0.001). In addition, the question on the frequency of consumption of the SCID-5-CV-TLUS also influences the explanatory model of excitement symptoms (ß = 0.273; p = 0.022). Conclusion Although further studies, ideally longitudinal, are needed to confirm the deleterious effect of cannabis on excitement symptoms, the present study reiterates the importance of screening and managing consumption habits of drugs, particularly cannabis, in people with serious mental disorders.

Objectives The primary objective of this article is to paint an institutional portrait of the Saint-Jean-de-Dieu Asylum over the first hundred years of its existence, from 1873 to 1973. The secondary objectives are as follows: 1) explore how prevention policies at the end of the 19th century had the effect of increasing the asylum population rather than reducing it; 2) discuss mental health policies that sought to "treat the social" outside the walls of the asylum in an effort to decrease the population; and 3) address the arrival of psychopharmacology that opened the doors of the asylum and turned it into a modern psychiatric hospital, soon renamed Louis-Hippolyte-Lafontaine. Method Since the past exists in silence, and finding data that will enable us to reconstruct a history of Saint-Jean-de-Dieu is a challenge. Our data collection includes all the primary sources we were able to gather (Institut universitaire en santé mentale de Montréal archives, annual government reports on asylums and articles in the magazine L'Union médicale du Canada) as well as secondary sources produced over time, i.e., books and articles published on the history of Saint-Jean-de-Dieu. The qualitative analysis of this data is based on analytical induction (Pascale, 2012). After several readings of the documents, the content is associated with key concepts according to theoretical saturation (Laperrière, 1997) and the data is analyzed according to the most significant key concepts. In our corpus, the key concept of overcrowding in asylums was central to our interpretation. Results This article highlights the improbable primary mission of curing mental disorders at the Saint-Jean-de-Dieu asylum. At the end of the 19th century, as urban impoverishment became increasingly marked, medical theories advocated policies of hasty internment. Despite several provincial laws reiterating that the chronically ill could only be admitted if they were "dangerous, scandalous or monstrous," the population admitted grew steadily until the end of the 1940s. At the same time, the patient/psychiatrist ratio was at best 300 to 1. The creation of a French-speaking psychiatry department and compulsory internships between the World Wars meant that more doctors were trained to work there. But it was the discovery of neuroleptics that enabled a new generation of psychiatrists to open the doors of the institution in the 1960s. The era of the asylum thus came to an end in the form it had taken for just over 100 years. Conclusion The asylum quickly lost its original meaning, that of a place of refuge, and gradually became associated with the seclusion of the insane, thereby increasing the prejudices and taboos surrounding mental disorders, some of which still affect us today.

Objectives Access to stable, safe, and affordable housing is an important determinant of health and community integration among people living with mental illness. Previous studies on housing stability, housing satisfaction and residential preferences among people living with mental illness have primarily been conducted among those with extensive service use experiences. First-time mental health service users, and youth in particular, are likely to present with distinct housing needs. The current study aimed to explore the housing experiences of new mental health service users, as well as the perceived obstacles and facilitators to their residential stability. Methods Projet AMONT is a longitudinal mixed-methods cohort study on the residential trajectories of service users in the 36 months after their initial contact with psychiatric services. The qualitative component consisted in a qualitative descriptive study. Semi-structured individual interviews were conducted with fourteen individuals at the beginning of their service use trajectory. Findings The thematic analysis uncovered how the emergence of mental illness and initial contacts with psychiatric services are associated with transformations in the area of housing and, for many, with housing instability. This instability might occur in continuity with adverse early life trajectories, or through the disruption caused by the emergence of mental illness. Informal social support emerged as the main protective factor against housing instability. Housing satisfaction was associated with multiple and sometimes conflicting needs regarding privacy, safety, social interactions, response to basic needs, performance of activities of daily living, and community integration. The specific developmental issues of youth at the beginning of their service use trajectories influence housing stability and satisfaction. Their housing then becomes a reflection of and laboratory for identity exploration and consolidation. Conclusion The findings highlight the importance of adopting a homelessness prevention lens among people living with a first episode of mental illness, particularly youth with adverse early life trajectories. Many existing approaches could be implemented or strengthened: cross-sector partnerships with all actors present in the trajectories of people with emerging mental illness; family approaches in early intervention, peer support, and screening for unstable housing situations. Adapting practices to the specific developmental characteristics of youth seem to be a key for homelessness prevention for this population.