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AbstractIn this article, the authors discuss refusal of treatment by psychiatric patients. Basic clinical principles as well as the process in which the psychiatrist must engage are exposed with the legal aspects. Clinical vignettes concretely illustrate these different aspects.

AbstractThis article provides an overview of research that attemps to explain why the economically under-priveledged show the greatest number of distress symptoms and the least sense of well-being. The author also elaborates on what those results mean on the theoretical level and on the intervention level.

AbstractThis article focuses on the main concepts associated with the notion of case management (functions and values). The author analyzes certain results obtained by social workers and brings forward hypotheses concerning integrated models of clinical and community support programs, at the core of which lies the notion of case management.

ABSTRACT This paper explores the rationale for establishing a crisis intervention service in a psychiatric hospital setting. After reviewing the pertinent literature, a description will be provided for a crisis service that has been operating since 1987 in the psychiatric department of a general hospital. Data collected over a 6 month period will be presented in order to examine the types of patients referred to the service, the length of stay on the service and the follow-up. Our findings indicate that a large proportion of the patients referred to the service are diagnosed as having major psychiatric disorders and require some form of medical intervention. Nevertheless, a group of patients could be identified who benefit from traditional crisis intervention and who after receiving circumscribed treatment, require no hospital follow-up. The data will be utilized to outline the various roles that a crisis service can play in a psychiatric institution. The discussion will also focus on the structure and functioning of the service and its potential impact on the rest of the system.

SUMMARYThe authors discuss the available literature on a possible modification of traditional hospitalization in psychiatry : the brief hospitalization. Then they share a 30 month' experience in a transitory treatment unit at Albert-Prévost. Finally, the authors underline the fact that even if research and current use promote such an approach, this form of treatment is rare : they look into the reasons for such a state of affair.

AbstractA pilot study of fathers on parental leave in Tirol The current study examines fathers in parental leave in Tirol. The authors have come to realise that systematic reflections concerning fathers on leave of their work are rare. The authors attempt to answer the following question: does parental leave have implications on child/father attachment? The pilot study examines a small sample of 15 father/child couples. The description and analysis of father/child interactions was elaborated with the Child Adult Relationship Index (CARE-Index) designed by Crittenden (1988, 2000).

ABSTRACTIn this article, the author describes a mode of intervention defined as proactive in mental health care, in the case of an existing pilot project. This type of intervention contrasts with the reactive mode, which is characterized by reactions to urgent requests for services when a situation has deteriorated badly and social network resources are either absent or irrelevant. The author outlines the obstacles to developing such a proactive mode. This approach, which requires a high degree of visibility and accessibility on the part of the practician, involves providing services before they are even requested. Finally, the author examines certain types of proactive interventions whose objective is to offer support to members that are close to the individual.

AbstractPeople with schizophrenia experience difficulties in adapting and managing problematical situations of daily life thus diminishing their social coping skills. Several components such as cognitive deficits and biases associated with symptomatology disrupt their problem-solving skills. In social rehabilitation, it is essential to take into account all characteristics and offer an integrated approach. This article presents an approach to problem-solving skills with a contemporary knowledge of schizophrenia. The functionning of the Clinique Jeunes Adultes of the Louis-H. Lafontaine Hospital is presented and serves as a reference.

AbstractShared Mental Health Care: New approaches to collaboration between mental health and primary care providers Over the last five years, increasing attention has been paid to ways of improving collaboration between mental health and primary care services (shared mental health care). This reflects a growing recognition of the significant role that family physicians already play in handling mental health problems of Canadians in almost every community across the country and the need to improve the working relationships between mental health and primary care services. This paper reviews the impact of these factors and looks at how the concept of shared care has evolved in Canada. It describes initiatives taking place across the country, focusing in detail on one program in Hamilton, Ontario, that has brought counsellors and psychiatrists into primary care settings for the last eight years. It looks at lessons that can be learned from this approach, the opportunities it offers and its applicability to other communities.

SUMMARYThe observation of the behaviours of young adults in their process of professional orientation led the authors to undertake a series of studies to explain the observed behaviours.They suggest first a model of professional orientation situated within a phenomenological and developmental approach. Next, they analyze the perceptions of self and of the environment which influence the orientation process. Lastly, they suggest a framework of interventions appropriate to the orientation model proposed.