Canada's mental health最新文献

The authors outline the history and activities of a Patients' Rights and Ethics Committee established by a major psychiatric hospital. In this context they discuss the impact of contemporary issues, the need to re-emphasize rights that have been established, and various factors influencing the approach and effectiveness of such a Committee.

The author contrasts the "paternalistic" and the "civil libertarian" views of non-consensual treatment of institutionalized psychiatric patients. Citing court cases and relevant literature, he emphasizes that competent patients have the right to refuse treatment, even when this decision is considered foolish. Involuntary hospitalization need not imply incompetence to refuse treatment, and the determination of such incompetence should be subject to rigorous safeguards. The nature of psychiatric treatment and the institutional setting necessitates procedures to ensure that consent truly is voluntary and informed. For patients judged incompetent, the decision to treat without consent should be influenced by various considerations related to diagnosis, prognosis, and the nature of the proposed treatment.

Patient rights, professional ethics and situational dilemmas in mental health services are discussed in terms of their interrelationships, with a major focus on voluntary clients and community-based services. Vignettes are provided under the headings of: I. The rights to respect, dignity, and non-discrimination; II. The rights to appropriate treatment, to consent and to refuse; III. The rights to least restrictive, least intrusive intervention; IV. The rights to confidentiality of personal information, to consent to or refuse release of records, and the right to peruse personal records. The author stresses that the rights and responsibilities of various parties must be balanced to arrive at the best decisions.

In May, 1982, the Ontario Minister of Health set out the bare essentials of a proposed advocacy program for psychiatric patients. In November, a Toronto family doctor, actively involved in civil rights issues, was appointed to develop and coordinate the program. In May, 1983, eleven advocates were appointed to advise and assist patients in each of the province's ten psychiatric hospitals. The advocates came from various backgrounds--legal, psychiatric nursing and social work, labour negotiation, pastoral and other public services. This paper describes the design, function and scope of Canada's first province-wide psychiatric patient advocate system and some major issues identified in the first year.

The author provides a brief description, with two case examples, of the activities, philosophy and objectives of the Ombudsman Office operated by the Canadian Mental Health Association in Windsor, Ontario.

This paper describes the background, structure, methods and objectives of a citizen advocacy organization in Pointe-Claire, Quebec. It discusses the various roles of the citizen advocate volunteer in advancing the interests of the psychiatric patient, both in the hospital and in the community. These roles may be instrumental, expressive, legal, or a combination of these. The examples discussed are taken from actual cases from the West Island Citizen Advocacy office.

The author outlines a model recently adopted by the Province of Alberta to provide suicide prevention, intervention and postvention services. Based on the proposals of a Provincial Task Force, the model features interrelated programs of outreach, education and training, research, and fund-raising. It is designed to make use of community resources in an efficient and coordinated manner, attacking the problem on several fronts.

This exploratory study investigated perceptions of palliative home care nurses regarding their roles. Results are based on structured interviews with all ten nurses providing care in a home care program for dying patients. Most nurses agree that nursing the terminally ill is a distinctive kind of nursing, requiring particular capabilities, and providing its own unique frustrations and satisfactions. While nurses experienced stress, especially the nurses who had spent a shorter period of time working for the program, they had a variety of ways to cope with stress. Suggestions for hospice program planning and future research are presented.

Children's mental health services are facing a number of issues that prompt reexamination of some key assumptions underlying traditional ways of delivering services. On close examination, there is little support for assumptions that the worst cases are referred for help; untreated "sick" children become "sick" adults; and treatment effects generalize. A shift in paradigm to a "community mental health" model is explored. The factors determining the acceptance of this model are discussed.

This document "A Guide to Knowledge and Skills Necessary for Employment Within a Mental Health Service" was developed over the course of a number of meetings by the Provincial and Territorial Directors of Mental Health Divisions. It arose from a concern expressed from all parts of the country that the graduates of some professional schools were not necessarily equipped by their training to assume roles in mental health services. The document has no mandatory aspect and is intended only as an advisory guideline, to be helpful to employers and to those planning to work in direct mental health services.