Canada's mental health最新文献

This paper reports on the existence of a Self-Help Clearinghouse in Metropolitan Toronto which uses a community-based model of service delivery in the mental health system and is marked by a high degree of consumer participation. Some of the functions of the Self-Help Clearinghouse are (i) information and referral, (ii) community education, (iii) community development and (iv) research.

This paper outlines a participatory approach to developing a new model of service delivery for high-support housing. A consumer committee was recruited from among the inpatients and outpatients of a large psychiatric hospital in Metropolitan Toronto. Their task was to analyze three existing models of high-support housing, using structured interviews and visits, and to develop a new approach. The discussion focuses on the participation experience itself. A number of strategies were employed to reduce the traditional barriers between professionals and consumers. Using both the research results and the consumers' impressions of their experience, these strategies were evaluated for their efficacy.

Since November 1984, the Elixir project has devoted its efforts exclusively to the problem of alcohol and drug (minor tranquillizer) consumption by women. From January 1985 to June 1987, this prevention project reached 2,693 women and 911 health intervenors. The following is a description of the implementation of the project, its key characteristics and the effects it seems to have had on the people involved.

The development of community psychiatry has modified the practice of psychiatry both with respect to place of practice (in the community) and mode of practice (focused on the multi-disciplinary team approach). Administrators, however, tend to evaluate the activities of teams working outside the hospital against the standards for a medical model based on a professional-patient relationship. These standards do not take into account activities carried out in the community. The purpose of this study is to present an instrument that will make it possible to evaluate the activities of the various professionals as a function of the time actually allocated to the various activities and the satisfaction of the different professionals involved. This demonstrates that the time spent outside clinics is very low except for the social workers, and that the professionals feel somewhat dissatisfied with this.

"Centres d'accueil" (reception centres) for the aged will be required to become increasingly involved with seniors presenting psychological or psychiatric problems, because of both the increase in life expectancy and the philosophy of avoiding the institutionalization of such seniors in psychiatric settings. One of the activities of the consulting psychiatrist is to meet the patient to establish a diagnosis and suggest treatment; however, the support of the care-giving team is the consultant's primary concern. The psychogeriatric consultant makes a rapid, on-site decision on suitable treatment for the patient, thus avoiding a potentially upsetting transfer. In addition, the consultant encourages active involvement by staff in the management of the psychiatric problem.

To ascertain if decentralization of mental health services, making them more accessible to the public, would be reflected in a decrease in the dropout rate, a comparison was made between dropout rates just prior to and immediately following decentralization. This involved examining 1350 closed files representing cases seen during a three-year period after decentralization and comparing the findings with those of a previous study of files of 588 cases seen during a year before decentralization. The dropout rate decreased from 46% to 43%; while statistically significant, this change was too small to be of any practical importance. However, analysis of demographic and clinical variables in the post-decentralization sample proved most interesting. On the whole, it confirmed the findings from previous investigations, i.e. dropouts tended to be younger, less well-educated, of low socioeconomic status (SES), and were most commonly diagnosed as having a personality disorder. Although some therapists had a comparatively large proportion of dropouts, this discrepancy may reflect the distribution of difficult cases rather than the effectiveness of the therapists.

The definition of the concepts of mental health and mental health promotion have been much discussed in Quebec for a number of years. The authors of this article present their point of view on the role the Local Community Service Centres (LCSCs) could play in implementing a mental health action plan. On the basis of a definition of the concepts of mental health and mental health promotion and an outline of the goals and objectives of mental health promotion, the authors discuss certain areas of intervention for the various sectors of practice in the LCSCs. Their article closes with some cautions about the limitations of health promotion in the LCSCs.

A number of women experience difficulties during the climacteric related to the major change they are undergoing (i.e. physical, psychological, social and familial). These difficulties are often linked to negative attitudes and misunderstanding concerning the phenomena involved. This article describes a holistic prevention and health promotion program aimed at women aged 40 to 55. The program, in the form of an awareness-raising group, addresses the physical and psychological aspects of this period in a women's life, and presents participants with avenues to greater autonomy and better overall health. The organizational and evaluation aspects of the program are also presented.