Sante Mentale au Quebec最新文献

Objectives The stigma surrounding individuals with mental conditions persists, making their return to work or access to employment complex. These negative stereotypes are often internalized by the affected individuals, leading to self-stigmatization. Literature shows that the medical and entrepreneurial sectors harbor many prejudices and apprehensions towards these individuals. In contrast, the fields of rehabilitation and employment support, which frequently interact with these individuals and use recovery approaches, show less resistance. Although the stigma of these populations is relatively well-documented, few studies have differentiated the perceptions of actors responsible for implementing their return and reintegration into work. This study aims to identify and compare these actors' tendencies to stigmatize individuals with mental conditions and their intentions of professional inclusion. Method As part of the international survey by the community of practice in mental health and work (CoP-SMT), data was collected through an online quantitative survey involving 586 actors in the return to work and reintegration processes. Four actor systems were identified: health, corporate, employment support, and individuals with mental disorders on sick leave or job seeking. The questionnaire included a two-factor stigma scale (perceived organizational burden and negative emotions) and a professional inclusion intention measure with three indicators (avoidance, paternalism, and collaboration). Factor analysis and internal consistency validated the psychometric qualities of these measures. Variance analyses with post-hoc comparisons allowed the comparison of responses from categories of 20 or more actors, reducing the sample to 473 participants. Results The results highlight a significant effect of the actor system on stigma and professional inclusion intention. They reveal that actors involved before employment (rehabilitation and employment support) are less prone to stigmatize and more open to including individuals returning or reintegrating into work than those within the company (hierarchy, colleagues, and occupational health professionals). They also show the persistence of self-stigmatization among individuals with mental health issues returning or reintegrating into work. Conclusion To better interpret the results, the experience of coexistence and inclusion in the ordinary work environment of individuals with mental health conditions is explored, considering the roles of various stakeholders. Knowledge, conceptual orientations around mental health, and collaborative multidisciplinary work are suggested as anti-stigma strategies. Based on these findings, research perspectives and recommendations are formulated.

Over the past few years, several psychosocial rehabilitation strategies in mental health (PSR) have been developed to assist individuals living with severe mental health disorders (SMHDs) to fully exercise their social participation. However, the effectiveness of PSR strategies is often undermined as they remain fragmented, compartmentalized, and not cohesively integrated with one another. Furthermore, while there is scientific consensus and evidence on the usefulness and need for integrative PSR practice models, their effective implementation is not well understood and continues to be a marginal practice. Objective The main objective of this research is to identify and describe the contextual factors (enablers, barriers) influencing the implementation of the Baromètre Practice Model in different organisational contexts. The research also aims to co-produce recommendations with various stakeholders to improve the BPM and the strategies for its implementation. Methodology Drawing from the organizational participatory approach, a qualitative multiple case study was conducted with two French organization's housing individuals living with SMHD. Data collection involved multiple sources including participant observations, focus groups with accompanied persons, semi-structured dyad interviews with health professionals, and round-table discussions with a scientific committee. A theoretical synthesis combining the Capability and Personalised Care and Services approaches, and the Consolidated Framework for Implementation Research (CFIR), guided the iterative thematic analysis process. Results More than 40 contextual factors were identified and grouped into four main interrelated categories: organizational context and process; interprofessional practices; support practices; personal recovery process and maximum participation of people living with SMHDs. The interactions between these different factors led to the emergence of specific systemic dynamics: the contagion of experiences (positive or problematic); inertia, leading to a return to previous habits and modes of operation; and dynamization, which brings about a reinforcement of the motivation among actors to adopt and implement new practices. Conclusion This research provides a better understanding of the internal organizational contextual factors that influence the implementation of the Baromètre Practice Model. It also shows that it is possible to operationalise this model in various organisations offering care and services to individuals living with SMHDs. Research must continue to facilitate the implementation within health care and health service networks wishing to realize collaborative practices that promote the rights of individuals, their self-determination, and their personal recovery.

Introduction Substance use among resident physicians is an underestimated, poorly understood, and serious problem because of its negative consequences for the health of physicians and also for the health and safety of the patients in their care. Objective To estimate the prevalence and identify factors associated with addictive behaviors among resident physicians at different university hospitals in Morocco. Method We conducted a multicenter cross-sectional descriptive and analytical study involving resident doctors from the 7 university hospital centers in Morocco. Resident doctors were invited to participate voluntarily in the study by completing an anonymous self-questionnaire created on Google Forms and sent via email. Results The questionnaire was completed by 310 resident physicians, representing 11.07% of the total population of resident physicians in Morocco. Among the participants, 16.1% (n=50) reported consuming one or more psychoactive substances, including 11.1% (n=37) for tobacco, 10% (n=31) for alcohol, and 6.1% (n=19) for cannabis. The consumption of ecstasy and cocaine was observed in 0.7% (n=2) for each substance. Additionally, 11.9% (n=37) of resident physicians had psychiatric disorders, and 3.2% (n=10) had attempted suicide at least once. The consumption of psychoactive substances among resident physicians was statistically significantly associated with the male gender (4.59 [2.20-9.57]; p=0.000), as well as with surgical specialty (0.48 [0.26-0.88]; p=0.017). Conclusion At the end of this work, we found that the use of psychoactive substances is frequent among resident doctors, which explains the need for preventive measures and appropriate management.

Introduction This essay reviews the case of Émile Nelligan, Quebec's most celebrated poet and the Institute's most famous patient. Writing a clinical case study should be relevant for readers of a scientific medical journal. This allows the transfer of important clinical knowledge for optimal medical care of patients. Yet, how do we approach a poet? What method can we adopt to avoid betraying him-neither as a poet nor as a patient? Method The approach is open. We must start by reading the poet and consult the different archives and authors who have already studied him. We trace the journey from Nelligan as a poetic prodigy to being interned in a Montreal asylum, all before he turned 20. Case Presentation An overview of the salient facts of Nelligan's family life, education, poetry, and the onset of his dementia praecox. Arguments are reviewed for Nelligan as a case study of the tension between psychiatry/antipsychiatry, freedom/constraint, madness/creativity, developmental/social determinants of health, as well as the "two solitudes" of Quebec society. Implications A reading of Nelligan torn between the dualities of the two solitudes, liberty and constraint; light and darkness; and what it means to read him as our contemporary for psychiatry, for literature and for Quebec identity.

Objective Founded in 1873, the Institut universitaire en santé mentale de Montréal (IUSMM) has a captivating history that significantly reflects the evolution of psychiatry over the years. In recent years, the primary sectors of modern medicine have turned to digital health innovations to enhance patient care development. The main objective of this review is to document advancements in digital health within the IUSMM and its affiliated research center over the past 150 years. Method An integrative review focusing on digital health innovations at the IUSMM was conducted. The Medline, Web of Science, PsycNet (PsycINFO), and Google Scholar databases were consulted from their inception until December 2023. Result The literature review initially identified 239 articles, with 108 duplicates removed during the preliminary analysis. Among the remaining 131 studies, 63 articles were excluded based on title and abstract review, as they did not meet inclusion criteria. After a comprehensive analysis of the initially selected 68 articles for eligibility evaluation, a total of 22 articles were retained. Five categories of articles were identified: virtual reality, digital applications, remote services and therapies, the use of artificial intelligence, and digital personal assistants. Conclusion On the occasion of the 150th anniversary of the IUSMM, this integrative review reveals that digital health innovations are primarily concentrated in the last decade, suggesting promising potential for digital applications in supporting individuals with mental health disorders, although the transition to clinical practice may progress slowly.

Background Created in 2004, the Eli Lilly Canada Chair on schizophrenia research was funded by Eli Lilly, the Institut universitaire en santé mentale de Montréal, Hôpital Sacré-Coeur and Centre hospitalier de l'Université de Montréal. The aim of this article is to provide an historical overview of the scientific activities of the Chair since its inception. Method In order to carry out this historical account, we adopted a bibliometric approach. We carried out a PubMed search of all articles published by any of the Chair holders since its creation in 2004. Once the articles had been identified, we counted all the times they had been cited in the literature. This was done using Google Scholar. We also counted the main themes addressed in these articles. We adopted an externalist perspective for the interpretation of the scientific work. Results Since its creation in 2004, the Chair has published a total of 295 scientific articles, which have been cited 12,892 times. The main themes addressed in these articles are cognition, neuroimaging and antipsychotics, followed by addiction, psychosocial interventions and treatment resistance. The most influential articles showed the presence of an inflammatory syndrome and sleep difficulties in schizophrenia, in addition to corroborating the aberrant salience hypothesis of psychosis, disproving the lateralization of language hypothesis in schizophrenia, and establishing links between antipsychotic treatment and COVID-19. Discussion From an externalist perspective, the evolution of the Chair's work has been influenced by important factors external to the logic of scientific discovery, namely the commercialization of several antipsychotics during the 1990s-2000s, the relative democratization of neuroimaging during the 2000-2010s, the legalization of cannabis use for recreational purposes in 2018 in Canada, and the rise of digital health-notably virtual reality-over the past decade. Conversely, the focus on the neurobiology of violent behavior and the tendency to publish in French-language journals are trends that run counter to current social trends. The article concludes with a reflection on the nature of the concept of psychosis.

The objective of this perspective article is to explore the creation of a new syndrome specific to the Canadian city of Montreal: Conophobia. In a more academic way, the aim is to think about the process which leads to the creation of a new clinical entity and to question how the name of a disease is chosen. In the literature, it is illustrated by syndromes with a name of a city: Stockholm syndrome, Stendhal syndrome, Pisa syndrome, Havana syndrome, Paris syndrome, Lima syndrome or Copenhagen syndrome. Conophobia is a neologism reflecting a potential syndrome linked to the growing observation of an original suffering invading the metropolis of Quebec: anxiety in relation to a clearly identified object that we calls the Cone. New traffic cones have in fact appeared on the streets, by the thousands dotted throughout the neighborhoods, to mark the start of work on public roads. In the context of this invasion, the first observable behavioral anomalies appeared in the population, signs of suffering, and feelings of helplessness among citizens. Media coverage appeared. Almost 30% of orange cones in a given area remained on the streets for no apparent reason, causing unnecessary obstruction and aesthetic nuisance. We were able to observe some vignettes of this phenomenon which cannot be called a clinical vignette at this stage but which in many respects shares links with phobias. Videos that went viral on the networks even showed individuals in several places enraged by the road works, getting out of their cars, grabbing orange cones and throwing them onto the ground next to the street. To our knowledge, there have yet been no hospitalizations or visits to the emergency unit specifically due to a cone. This new semiology or phenomenology can lead the clinician to be attentive to a possible shift in behavior from normal to pathological. The cursor which demarcates this border needs to be studied. The so-called Montreal syndrome allows us to think about the link between mental health and the identity of a city. This relation needs to be improved. Aid and therapies for individuals already suffering from this insidious syndrome could call for individual interventions by health professionals or more community-based prevention interventions. The creation of such a syndrome is part of a biopsychosocial approach which is familiar to the scientific activity of the University Institute of Mental Health of Montreal (IUSMM).

In 1909, 21-year-old Bernadette was hospitalized after the parish priest deemed her to be suffering from "puerperal insanity." She was committed to Saint-Jean-de-Dieu, separated from her newborn and husband, who would send dozens of letters inquiring about her health and longing for the day she could return home. Sadly, that return never happened. This article explores the evolution of psychiatric and mental health practices from the past to the present - and the progress still to be made - by focusing on alternatives to hospitalization. How might Bernadette's care have been managed today? And what could her care pathway look like 50 years from now? Today, the expertise of the Institut universitaire en santé mentale de Montréal (IUSMM) extends beyond its walls, reaching people in their own environments. Bernadette could have received treatment at home, supported by a care team with her husband playing an active role. This article documents current alternatives to hospitalization and links them to the lived experience of a woman who underwent involuntary hospitalization over a century after Bernadette. By examining three distinct eras, we can see not only how far we've come but also the challenges that remain.