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Bipolar disorder is a chronic mental illness characterized by recurrent affective episodes, as well as marked residual symptoms that interfere with functioning. Pharmacotherapy remains the cornerstone of treatment. Unfortunately, medication has limited effects on some aspects of the disorder, while many patients have difficulty complying with pharmacological treatment. This literature review examines the role of psychoeducation as a complementary treatment for patients with bipolar disorder. Different formats of structured psychoeducation are presented, including two evidence-based, manualized treatments. With a view to dissemination, recommendations are proposed for the implantation of psychoeducation in Quebec's healthcare system.

A growing numbers of researchers in the health sector are opting for innovative research approaches that combine methodologies from the social sciences and the performing, literary and visual arts. This article compares and contrasts two methods for disseminating research findings related to health : science cafés and artistic performance (visual arts, song, poetry, theatre). An analysis of questionnaires and interviews completed by 78 respondents shows that artistic performance is more effective in communicating research results based on three of the four evaluation criteria used : it triggers more emotions among audience members, generates more questions on the topic concerned, and influences a greater number of people to alter their viewpoints and change their practices. Science cafés and artistic performance both help participants to better understand the issues examined. The arts, however, shine a different light on these issues.

Keywords: arts, café scientifique, dissémination des connaissances, évaluation, application des connaissances, arts, science café, knowledge dissemination, evaluation, knowledge translation, artes, café científico, diseminación de conocimientos, evaluación, aplication de conocimientos

AbstractAssessment of the implementation of an innovative experience: network of integrated services for the elderly in the Bois-Franc region Conscious of problems related to coordination of services for the elderly on its territory, the working group on health and social services of the Bois-Francs in the Mauricie and Centre-du-Québec regions implemented in February 1997, after two years of planning, a new coordination model of services for the frail elderly. This model is innovative because it combines the unique entry, case management, individualized services plan as well as the presence of three levels of concertation : strategic, tactical and clinical. The model also has the characteristic of offering comprehensive services to the elderly. This article describes the major results of an assessment of the implementation and process of this model. This assessment aimed at documenting the activities and functions of the coordination mecanism of services in order to see to what extent the model implemented and its functionning is close or not to the one proposed and this, in a perspective of bringing the necessary adjustments. The major results on clientele reached, various functions of a team of case managers and organization of work are discussed in the light of other studies on coordination of services for frail older people. Suggestions regarding these results and those pertaining to efficiency and cost in another study are made in order to improve the efficiency of the model. Many components of this new model could be applied to other clientele.

AbstractThis article surveys the status of people with mental disorders in the light of international human rights law and assesses if their rights are respected in the Canadian context. The authors recognize that although the national systems of countries such as Canada provide significant civil and constitutional protections on the positive rights of its citizens, including those who suffer from intellectual disability, the same cannot be said with respect to entitlements to the provision of social services. The authors argue that this shortcoming must be remedied. Finally, the authors conclude that it is paramount to closely monitor the apparent dissonance between internationally recognized rights to adequate healthcare and freedom from discrimination and their strict application in the Canadian context.

Objectives In recent years, issues related to physical health took on a major role in the care of youth who experienced a first episode psychosis (FEP). Compared to the general population, people with a psychotic disorder have a reduced life expectancy of 15 years, with physical health problems accounting for 60 to 70% of that part. With the increased awareness about these issues, physical activity is considered as a new prevention and intervention strategy in the recovery process for youth with a FEP. The objective of the present article is to summarize the different physical health issues in FEP and the impacts of physical activity.Methods Narrative review addressing physical health issues, the role of antipsychotics, the need for metabolic monitoring, and for improvement of lifestyle habits (e.g., smoking, sedentary lifestyle, physical inactivity, poor diet) in youth with a FEP. The impact of physical activity on physical and mental health, on smoking cessation as well as the interest of adventure therapy in the recovery process will be discussed. Finally, we will propose motivational strategies and tools to promote physical activity. In the different sections, we will support our arguments with the highest levels of evidence available (e.g., meta-analyses, systematic reviews, randomized controlled trials, cohort studies, N-of-1) and highlight implications for clinical practice.Results Metabolic health problems progress rapidly after the initiation of antipsychotic treatment, and inadequate lifestyle habits contribute to the development of these problems. In an early intervention context, several types of physical activity have shown benefits on physical health, psychotic symptoms, functioning and more generally in the recovery process. Nevertheless, few patients spontaneously engaged in regular physical activity because of low motivation. Physical activity interventions should be adapted to the FEP population and several factors taken into consideration such as the type of physical activity, its context, intensity, frequency, motivational parameters, and support/supervision from health professionals.Conclusion From a physical and a psychiatric perspective, the years following treatment initiation for FEP are critical. Considering its positive impacts on different dimensions of recovery physical activity interventions should be integrated into the range of services offered in early intervention services.

Keywords: activité physique, habitudes de vie, obésité, psychiatrie et mode de vie, physical activity, health behaviour, obesity, lifestyle psychiatry

Objectives Based on clinical experience and literature, this article aims to stimulate reflection among the actors involved concerning the organization of services and the interventions to be favored with young people living both a first episode of psychosis and a situation of residential instability or homelessness. The objective of this article is to provide an overview of the literature on the situation of these young people and their needs, the challenges they face in their pathway within the healthcare system and the various interventions to consider with them both to prevent or exit homelessness.Method This literature review presents a narrative synthesis of articles from literature reviews or primary studies published in French or English between 1995 and March 2021, with a focus on the services and intervention practices implemented in Quebec in recent years. Certain interventions can be made at different periods of time in a young person's journey to change their trajectory and prevent homelessness or limit its duration and consequences. Throughout this article, a case study will illustrate these interventions occurring at different times in the life of a young person.Results The risk of residential instability and homelessness in young people living with emerging psychosis is higher than in the general population. This situation can contribute to the onset or worsening of psychosis due to the stress associated with difficult living conditions and the increased possibilities of victimization experiences. This great precariousness can also be the consequence of psychosis and its associated conditions. However, very few studies focus specifically on young people experiencing both a first episode of psychosis and a situation of homelessness or residential instability. The instability associated with homelessness complicates their pathway to mental health care, delays their access to the appropriate services and interferes with their engagement in follow-up. Interventions aimed at preventing homelessness include support in the transition to adulthood and identifying situations of residential instability. Regarding the organization of care, integrated mental health service centers for young people and the development of partnerships, networking and intersectorality make it possible to overcome certain challenges. Intensive outreach interventions models as well as interventions aiming residential stability are favorable to young people who are already experiencing homelessness.Conclusion Residential instability and homelessness imply several challenges faced by young people living with emerging psychosis concerning the access, the continuity and the quality of mental health services. Integrated interventions both to prevent or exit homelessness can be implemented to stem this problem.

Keywords: jeunes adultes, psychose émergente, itinérance, instabilité résidentielle, intervention, programme d'intervention précoce, services de santé mentale, soins de santé, accès aux services, engagement dans les services, young adults, emerging psychosis, homelessness, residential instability, intervention, early intervention program, mental health services, health care, access to services, engagement in services

SummaryIn their introduction, the authors analyze, in the light of research on social stratification based on age, some of the social inequalities which people in retirement have fallen victim to. This stratification has been particularly discriminatory towards the elderly if one examines class and sex disparities, segregation of the older stratum, rejection by the active sectors of society, and the stigmatization of agism, all of these being important factors in the social definition of aging.

This joint study examines Jacques Ferron's (1921-1985) complex attitude towards Louis Hémon and his original and highly personal reading of the latter's work. Fascinated by Hemon's biography as much as by his work, and feeling a profound affinity with the man, Ferron was particularly alert to what he considered the autobiographical dimension of the Breton writer's fiction. We chose to focus on this biographical association, first identifying the elements that led Ferron to see himself in the other writer, then tracing, through his private correspondence and public writings, the development of his “passion” for Hémon. Our discussion concludes with a close study of the complex Hémonian intertextuality running through Ferron's novel Les roses sauvages, a work where literary criticism is woven into the fiction and where Ferron's own autobiographical project is enriched by his reading of Hémon's life and work. The aim is to highlight this important and little studied instance of Hémon's reception in Quebec and suggest new avenues for interpreting the work of both Ferron and Hémon.

In this article, we explore the heart of the debate on the nature of the school-family-community partnership and its underlying rationales. We challenge the underpinnings and uses of the ecosystem which is considered at the root of collaborative practices and parental engagement. By inserting the ecosystem into a metatheory, we place collaborative practices along a continuum that reflects the nature and the degree of interactions between those engaged. Our standpoint looks at this partnership in relation to an ecosystemic perspective that is based on contextual and sociocultural perspective. To illustrate how such an ecosystemic logic can be applied to collaborative practices and parental engagement, we refer to the program Famille, école, communauté, réussir ensemble (FECRE), which was implemented in the province of Quebec between 2002 and 2009.

Keywords: Partenariat école-famille-communauté, pratiques collaboratives, engagement parental, écosystémie, métathéorie, théories de l'activité, dynamic system theory, interculturalité, School, family; community partnership, collaborative practices, parents' engagement, ecosystemy, meta-theory, activity theory, dynamic system theory, interculturality

The social work profession operates in the context of the implementation of a partnership between school, family and community. In this context, the social worker is assigned the role of supporting parent participation in the school environment. This role is put into perspective regarding the practices relating to the participation and social action that are characteristic of the profession. The tensions that arise between the fields of Education and Social work lead us to define this role around a socio-cultural logic where the Social worker is considered a cultural mediator.

Keywords: Participation parentale, partenariat école-famille-communauté, pratique professionnelle, travail social, culture, Parental participation, school, family, and community partnership, professional practices, social work, culture