Sante Mentale au Quebec最新文献

The Revue Santé mentale au Québec (RSMQ) purpose is to contribute to the mental health knowledge dissemination and acquisition by adding much-needed cultural diversity to a scientific world community dominated by English-speaking journals. The RSMQ leadership wish to expand its societal impact and scientific outreach by working with its institutional partners to attract researchers and clinical practitioners across the world wishing to share their passions for learning in French.

Objectives Hospital emergency departments (ED) are often overcrowded, and patients using ED for mental health (MH) reasons contribute in great part to this situation. In Quebec, in 2014-15, 17% of ED users with mental disorders had visited ED at least 4 times for various reasons. These patients' frequent ED use usually reflects the inadequacy of the services provided to them. A better understanding of the underlying reasons behind this frequent ED use would enable stakeholders to formulate recommendations that would help improve services, making them more suited to the needs of these patients. The aim of this study was to identify the factors that encourage or limit the use of ED by frequent ED users, the term "frequent ED users" being defined as patients who use ED at least 3 times over a one-year period. Methodology Between April and September 2021, 20 ED professionals were interviewed concerning factors they perceived as encouraging or limiting ED use among frequent ED users. Participants worked in a psychiatric ED or in other hospital services (e.g., assessment-liaison module), or were partners of the ED within the territory (e.g., crisis centers). Study data were analyzed using a content analysis method carried out in various stages (e.g., data transcription, content coding), and guided by a conceptual framework comprised of 4 categories of factors that encourage or limit frequent use for MH reasons. These factors were related to the healthcare system, patient profiles, health professionals, and the MH network's organizational characteristics. Results More encouraging factors than limiting ones were identified as pertains to ED use. Most factors were associated with the healthcare system (and particularly with the unavailability of MH services), and with patient profiles, more specifically those with complex mental disorders compounded by psychosocial problems. Organizational characteristics, in particular the deployment of innovations in the ED or in partnership with it, although not widely deployed overall, tended to limit ED use. Conclusion This study highlights the importance of developing more innovations in the ED and in conjunction with other hospital and community services to better meet the needs of frequent ED users, and thus reduce their use of these services. ED should optimize their role in the screening, brief treatment, referral, and quality monitoring of services for patients, particularly those not adequately served by outpatient MH services.

Objectives Collaboration between family caregivers and professionals plays a critical role in the recovery of the person living with a mental health disorder. However, collaborative practices between family caregivers and professionals are impeded by issues relating to confidentiality, particularly in connection with bidirectional information sharing between the parties involved. In doing so, these issues affect the quality of mental health services. Method A qualitative study was conducted with 19 family caregivers and 19 mental health professionals from 2 Quebec regions[2] in order to identify issues related to information sharing and confidentiality from their combined perspective. The Photovoice method was used and individuals semi-directed interviews were conducted with the 38 participants. Results Confidentiality and the refusal of the person living with a mental health disorder to consent to share information remains important and current obstacles in mental health practises. The organization of mental health services should ensure better integration of family caregivers into care teams so that they can contribute to the person's recovery and thus receive all the support and information they need to exercise their role. This study shows that family caregivers have different information needs in order to carry out their role and accompany the person living with a mental health disorder, including the need for general and non-confidential information to better support the person. While respecting the fundamental rights and autonomy of the person, who is free to consent or not to sharing information concerning him or her, professionals and family caregivers can still interact and create an alliance that promotes collaboration and recovery. Conclusion This article offers benchmarks to facilitate dialogue among people living with a mental health disorder, family caregivers and professionals, and to support their actions around information-sharing and respect for confidentiality in mental health practises. Ultimately, the intention here is to foster collaborative practices that will help improve the quality of mental health services.

Anxiety and depression are among the most common mental disorders in the workplace and represent one of the leading causes of disability among workers. Symptoms related to these disorders have important repercussions for workers and organizations, such as a decrease in job satisfaction, as well as various difficulties in functioning at work (e.g., presenteeism, absenteeism). Social support from colleagues and relatives represents a promising lever to support the numerous workers living with symptoms of depression or anxiety. Objective The aim of this study was to identify the social support practices of relatives and colleagues that are perceived as being beneficial to the work functioning of individuals with anxiety or depressive symptoms. Method To do this, we conducted semi-structured interviews with workers presenting symptoms of anxiety or depression (n=25) in order to explore their experiences regarding the social support they received. A 6-step thematic analysis was then performed. Results The results of our research identified 30 social support practices and grouped them into 5 broad functions: friendship (e.g., laughing with colleagues, contacting loved ones through technology or social networks during working hours), emotional support (e.g., listening, resolving conflicts quickly), social support (e.g., sharing experiences with others), instrumental support (e.g., helping with work-related or non-work-related tasks), informational support (e.g., giving advice to help reduce anxiety or depressive symptoms), and validation (e.g., normalizing or de-dramatizing situations). Conclusion In short, this study provides a relevant portrait of the various social support practices that relatives and colleagues can put forward to promote the functioning of workers presenting symptoms of anxiety or depression.

Context In the exercise of his practice, the psychiatrist is commonly called upon to assess the suicidal risk of a patient and may, under the circumstances, engage his professional liability and become the subject of a civil suit in the event of the death of the patient. Despite the existence of guidelines and tools for the assessment and management of suicide risk, the practice often remains unstandardized. Few studies have focused on the assessment and management of this risk from a legal perspective. Some knowledge of case law could be useful to psychiatrists in making future decisions, both from a medico-legal point of view and to improve the care offered. Objectives This article aims to study the civil liability of the psychiatrist following the suicide of a patient by analyzing Canadian case law from a perspective of continuous improvement of practice with particular attention to the assessment and management of suicide risk. Method A systematic review of the judgments was carried out on CanLII.org, a virtual library of Canadian legal information allowing access to the judgments rendered by the courts of first instance, the Courts of Appeal as well as those of the Supreme Court of Canada. The search strategy consisted in using the key words "suicide," "psychiatrie," "faute" and "responsabilité" as well as their English translation to retain the recourses where a judgment was rendered by the court and where at least one psychiatrist acted as a defendant or co-defendant following the suicide of a patient. Results Nine judgments met our inclusion criteria. Since elements were of interest for our research question, it seemed wise to us to also include three decisions where the patient did not die of his suicidal attempt but kept significant sequelae. The analysis of the judgments made it possible to identify the alleged faults most often reproached to the psychiatrist by the plaintiff and to present the usual position of the courts, and the arguments which underlie them. The alleged faults can be grouped into three categories: an assessment of the suicide risk deemed faulty, a management of the suicide risk by supervisory measures deemed faulty and an omission to have used legal custody measures when they should have been applied. In nearly all cases, Canadian courts render a decision in favor of the psychiatrist, demonstrating sensitivity to the reality of psychiatrists' practice. The recommendations resulting from our analysis of Canadian case law support the guidelines of the American Psychiatric Association and the Ontario Hospital Association practice guidelines for suicide risk assessment and management, particularly in terms of the content of evaluation, specific moments of re-evaluation and documentation. Conclusion Knowledge of Canadian case law on civil liability for the suicide of a patient represents an additional asset for the practice of responsible and quality psychiatry.

Objectives Since the 2000s, telework became common practice with the advent of telecommunication technologies. In the lockdown context linked to the COVID-19 pandemic, telework became the norm. The literature indicates that telework can have positive effects (e.g., reduction of commuting) but can also create challenges in terms of work-life balance, productivity at work and relationships within the work collective. Few studies focused on the elements that allow teleworkers to accomplish their work tasks optimally in the pandemic context. This study aimed to identify workers' best practices in telework by bringing forward the strategies they put into practice. More precisely, this study aimed at surveying teleworkers on their winning strategies in telework in order to 1) promote their work-life balance (and vice-versa) and their productivity in telework; and 2) promote their relationship with their immediate supervisor and their colleagues. Method This study allowed us to survey, using LimeSurvey, 318 teleworks in the general population and 405 teleworkers in a large health centre in Québec. We analysed these strategies using thematic analysis with inter judge agreement. Results Our results generated 72 winning strategies used by many teleworkers, to keep a balance between their professional life and their personal life (and vice versa), and promote their productivity at work. These strategies were grouped into 12 large categories. The questions regarding relationships with the work collective generated 41 strategies grouped into five large categories. Strategies mentioned the most frequently touched on notions of structure/routine, organisation of activities, clear separation between personal life and professional life, physical space dedicated to work, familiarity with communication technologies, and holding regular work meetings. Conclusion This study presents an extensive range of winning strategies used by teleworkers. Results highlight the importance of having guidance and support from colleagues and the immediate supervisor. Also, having access to an adequate home workspace, and the presence of a regular work schedule and a routine allows teleworkers to ensure their productivity and keep a good work-life balance. Telework seems to be a noteworthy work mode and deserves a better structural ground to assure workers' wellbeing and success.