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This article aims at achieving a detailed qualitative vision of the chronic disease in the adolescent population and its specific issues. To that end, a first-person experiential research based on significant events regarding healthcare pathways was developed. Six interviews were conducted with three practitioners. The results of this research allow us to identify spaces of configuration in terms of parenthood, of therapeutic alliances and of negotiating care strategies between teenagers, parents and professionals. Which co-construction spaces should be built with the teenagers in conflict or in rupture or with the suffering parents? Which positions should be adopted by practitioners to avoid or postpone chronicity?

Keywords: maladie chronique, adolescence, parcours de soin, chronicité, chronic disease, adolescence, care, chronicity

This article aims at studying the interactions between political thought and psychoanalysis theory in Claude Lefort's writings, starting with the notion of “originary division” of the social realm. The importance Lefort has given to conflictuality in his redefinition of democracy is often linked to his reading of Machiavelli: understanding the status and the fundamental role played by political conflicts requires to oppose Machiavelli to Marx. But the word “conflict,” used to describe disagreement, discord, and even class struggle, is often superseded by the word “division” characterised by Lefort as an original division. It might be better to turn to Lacan instead of Machiavelli to fully understand what is at stake here. Even though Lefort has never clearly explained himself on this reference, the influence of certain concepts (symbolic, Law, desire) is quite tangible in his work so that it would be useful to make, or re-make, the connection with them.

The clinical symtoms of sexual violence faces us with the primary process field, or even with the primal process field. Bodily aspect, representation and movement remain entangled there. The use of acts are rooted in the stumbling blocks of these identity basis arising from the bodily aspect. Therapeutic groups enable the non-verbal disclosure rising, which may be contained in and so to be decorporated and represented. It is therefore a question of articulation between the primary process field and the secondary process field, as well as between the way of the affective and the way of the ideal.

Keywords: affectif, idéal, corporéité, passage à l'acte, soin, affective, ideal, bodiliness, acting out, treatment

Narcissistic personality disorder (NPD) and not otherwise specified personality disorder (borderline and narcissistic) are major mental health problems for men. These pathologies predispose patients to significant relational difficulties which are characterised by intense reactions to perceived threats to the self-esteem and an impaired empathic ability. Understanding these disorders as affect dysregulation stimulated by shame, the author presents how patients in this context are prone to lose their capacity to mentalize. This article describes a specific individual and group mentalization-based treatment and its implementation for treating narcissistic men. Different reflections on the treatment, on empathy, as well as on the adaptation of this treatment for NPD patients are presented and illustrated with clinical vignettes.

Keywords: mentalisation, trouble de la personnalité narcissique, trouble de la personnalité mixte, groupe, homme, mentalization, narcissistic personality disorder, not otherwise specified personality disorder, group, man

Depressive disorders have become one of the main causes of sick leave in recent years. For the individuals concerned, the risk of long-term work disability is very real and generates considerable human and social costs, not to mention financial costs. Despite its importance, the issue of the return to work is rarely presented to primary care professionals, among others, as a priority to be factored into their clinical interventions. The latter thus have very few guidelines to help them choose the best intervention for promoting a timely return to work and may even question the relevance of such an objective.The purpose of this article is therefore to propose a set of reference points for primary care professionals by answering the following question: why and how should the return to work be supported following sick leave for a depressive disorder? The first part of the article provides an overview of current knowledge that supports the relevance of early intervention to the prevention of long-term work disability. The second part proposes a number of promising interventions for achieving this objective and feasible for primary care professionals. These proposals are based on recent research work by our team.

Keywords: trouble dépressif, retour au travail, incapacité au travail, soins primaires, réadaptation au travail, depressive disorders, return to work, work disability, primary care, occupational rehabilitation

Objectives In the context of the 100th anniversary celebrations of the Hôpital en santé mentale Albert-Prévost, the present article retraces the history of this pioneering institution in the provision of psychiatric care in the province of Québec.Methods Multiple psychiatrists and health-care professionals who once worked or are still working at Albert-Prévost were interviewed to record their recollection of how psychiatric care was delivered as knowledge about mental illness progressed and how different defining historical events concerning the administration of this institution unfolded. Private and public archives as well as articles documenting the history of this institution were consulted in order to contextualize the participants' experiences.Results A brief exploration of the historical and political context that led to the creation of the Sanatorium Albert-Prévost is provided. The key administrative, political and sociological issues are described at each critical period as well as the interplay between the growing knowledge base about the causes and treatments of psychiatric problems and different models of provision of care as different generations of clinicians search for an optimal practice and organisation of care. It's triple mission of care, teaching and research is described.Conclusion The Hôpital en santé mentale Albert-Prévost has contributed in a significant manner in the shaping of mental health care provision in Québec and several physicians and other health care professionals who have worked there, throughout the past century, have been key contributors to the social, educational, cultural and political advances in this province.

Keywords: Pavillon Albert-Prévost, Camille Laurin, psychiatrie, Québec, Pavillon Albert-Prévost, Camille Laurin, psychiatry, Québec

Recent studies inform of increases in reported mental health problems in higher education students worldwide, with suicide and homicide being the most dramatic outcomes. Improving first-hand intervention and implementing mental health prevention and promotion strategies in colleges and universities are amongst the most commonly mentioned means of addressing these concerns. While institutions increasingly favor mental health promotion, most programs have not been properly evaluated and most strategies cannot be replicated. The article analyses results obtained from literature reviews and meta-analysis focusing on mental health prevention and promotion strategies targeting college and university students. Mindfulness, cognitive-behavioral and relaxation strategies, as well as social ability training, appeared to be the most effective if they were practiced under supervision. The implementation of supervised mental health prevention strategies within a setting-based systematic and multifactorial promotion frame could significantly decrease mental health problems in higher education students.

Keywords: santé mentale, prévention, promotion, université, collège, mental health, prevention, promotion, university, college

To support personal recovery, any person with a mental illness should have access to a range of practices recommended by scientific evidence. The peer support are some of the services recommended by the Mental Health Commission of Canada for the reduction of the economic and social burden of mental illness. If peer support from families is poorly documented, peer support and mutual aid from users have been the subject of several studies. Based on two studies in which she participated, addressing the needs of families, and its experience as a non-profit support organization for families, the Quebec Society of Schizophrenia (QSS) has reflected on the family support problem upon entry in the health system as well as the involvement of families as peer support. This article presents the implementation pilot project of Family Peer Support services initiative, fruit of collaboration between QSS and University Institute of Mental Health in Montreal and the issues and recommendations of the first year of implementation.

Keywords: soutien par les pairs, familles, système de santé, implantation, changement de pratiques, peer support, family, health system, implementation, change practices

Objectives This manuscript provides a first description of a specialized clinical work addressing the radicalization leading to violence phenomenon in Canada. Since July 2016, a multidisciplinary clinical team attached to a mental health and primary care program in Montreal proposes specialized consultations to support partners across Quebec.Methods This paper describes the clinical team approach, the consultation service organization and illustrates through clinical vignettes the main categories of social and clinical problems referred to the team during its first year of operation.Results Our preliminary observations confirm the relevance of a multidisciplinary assessment based on a systemic approach to the phenomenon of violent radicalization to provide an understanding of the different social, family and individual factors associated and to formulate a psychosocial and/or psychiatric intervention plan.Conclusion The presentation of clinical cases proposes to the social, community and mental health actors an understanding of the phenomenon of violent radicalization as it manifests in the health, youth protection and educational networks in Quebec and suggest intervention perspectives.

Keywords: radicalisation violente, évaluation clinique, approche systémique, interventions psychosociales, violent radicalization, clinical evaluation, systemic approach, psychosocial interventions