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Objectives: The objectives of this article are: 1) to trace the history and role of mental health community organizations (MHCO) in the Quebec mental health system as well as their specific values and practices; and 2) to examine the impact of the Quebec Mental Health Plan 2005-2010 on the functioning of community organizations and their relations with the public healthcare system. Methods: This article draws upon writings produced by the principal provincial and regional community organization associations in Québec, as well as results of previous studies related to inter-organizational relations among MHCO. Results: The Quebec community-based system consists of several successive generations of the MHCO, each constructed within a particular context. Before 1960, the Canadian Mental Health Association offered activities for promotion and prevention in mental health and participated in the development of several MHCO. The 1970s witnessed the formation of groups aimed at the protection of human rights and the first alternative resources. During the 1980s and 90s, a proliferation of MHCO followed upon their formal recognition by the Ministère de la Santé et des services sociaux (MSSS). These new organizations were established not so much in opposition, or as an alternative, to the public mental health system, but in complement with it. By 2012-13, there were 412 MCHO financed by the MSSS offering services to the population. Roughly half were located in the regions of Montreal, Montérégie and the Capitale Nationale. The MHCO are distinguished from public institutions by a number of characteristics: 1) treatment based not on diagnosis but on the overall situation of the person; 2) shared experience with peers; and 3) empowerment, inviting the person to become involved in decisions concerning his/her treatment and service use as well as decisions that concern the functioning of the organization; 4) establishment of more egalitarian relationships between service users and treating professionals; and 5) rootedness of the organization within the community. MCHO are grouped at the provincial level according to their functions, their ideological affinity, and or their particular mandate, but there is no national classification of community organizations as yet. The financing of community organizations remains a principal source of discontent. The MSSS has indicated that the overall financing of MCHO should correspond to at least 10% of global expenditures for mental health programming, whereas the actual budget is equivalent to only 8.8%. This underfunding obliges community organizations to reduce services despite demands for increased financial assistance, which runs the risk of provoking increased “revolving door” situations, and the utilization of emergency services in cases of service users transferred from hospitals to the Health Social Services Centers, who are in difficulty after losing contact with their service providers who would otherwise have provided follow-up. As well, MCHO fear the loss of their autonomy and of being reduced to the role of secondary services in signing these service agreements. The current reform would represent a step backward for MHCO in terms of recognition of their expertise. The former consultation structures have been dispossessed of any real power, decision making now being in the hands of the regional agency and directors of institutions. Numerous relocations of personnel have also lead to breaks in contact between MCHO and the public system, as these relationships were usually informal. Conclusions: A number of recommendations emanate from these findings that may permit MHCO to respond more adequately to the needs of the population served without calling into question their autonomy: 1) offer more adequate financing, particularly for self-help groups and organizations offering psychosocial rehabilitation, access to education and work reintegration; 2) allocate specific services exclusively to the community-based system in order to avoid duplication in services; 3) recognize a multiplicity of approaches; and 4) reconstruct appropriate decision making structures.

Keywords: organismes communautaires, santé mentale, réforme, pratiques, relations interorganisationnelles, community organizations, mental health, reform, practices, inter-organizational relations

Objectives: Geriatric psychiatry became an official psychiatric subspecialty in Canada in 2009. The first board examinations from the Royal College of Physicians and Surgeons of Canada (RCPSC) took place in 2013. Geriatric Psychiatry focuses on the assessment, diagnosis, and treatment of complex mental disorders in late life, a time when the interface between physical and mental health issues often adds a new level of complexity.Little has been written on the history of geriatric psychiatry in Québec and in Canada. A lesser-known aspect is that from the 1970's onwards, the department of psychiatry at the Université de Montréal (UdeM) and its network of teaching hospitals have played a pioneering role in the development of geriatric psychiatry services and training. We seek to recount the history of geriatric psychiatry at UdeM, by tracing the milestones and identifying the main actors responsible for its development, from the inception of the department of psychiatry 50 years ago. This leads us to share reflections on some of the issues geriatric psychiatry is facing in Québec.Methods: We interviewed several key actors, past and present, of geriatric psychiatry at UdeM. We read through relevant sources such as articles and monographs on the local history of psychiatric services, information bulletins and annual reports from hospitals and from UdeM, as well as other documentation from personal archives.Results: One of the very first geriatric psychiatry services in Canada was founded in 1978 at the Institut universitaire en santé mentale de Montréal, with a dedicated inpatient unit for new admissions of elderly psychiatric patients. A geriatric psychiatry outpatient clinic was inaugurated the same year at the Pavillon Albert-Prévost. Throughout the years, geriatric psychiatry services were also developed in the remaining hospital sites affiliated with the department of psychiatry at the UdeM (Hôpital Maisonneuve-Rosemont, Centre hospitalier de l'Université de Montréal, Institut universitaire de gériatrie de Montréal), driven by dedicated individuals, in accordance with their respective historical background and mission. Clinical training is provided in each of these sites for medical students, psychiatry residents and more recently, for future geriatric psychiatrists. In 2014, the geriatric psychiatry residency program at UdeM was the first to be accredited in Québec by the RCPSC, as well as the first French language geriatric psychiatry program in North America.Conclusion: Geriatric psychiatry in 2015 is a burgeoning field, in a challenging demographic context. Despite the clinical need, major obstacles remain, particularly in the absence of specific geriatric psychiatry positions. Furthermore, the Québec healthcare system is going through a major restructuration in 2015, adding to the uncertainty. The 50th anniversary of the department of psychiatry at UdeM is an opportunity to underline the contribution of UdeM to the development of geriatric psychiatry in Québec, and to emphasize the specific needs of the elderly in terms of mental health care and geriatric psychiatry services.

Keywords: gérontopsychiatrie, formation, organisation des services, santé mentale, aîné, geriatric psychiatry, training, mental health, services organization, elderly

In the context of a New Brunswick research project involving peoplehaving had experiences with the psychiatric system, this articlehighlights some coping strategies used by one of the people interviewedafter she was diagnosed as mentally ill. A structural analysis helpedus to analyse and appreciate some of the variables in her determinedefforts to move away from the psychiatric system while, at themethodological level, this case study reveals and illustrates possibleemerging realities within the ex-psychiatric movement.

Keywords: Oppression, approche, structurelle, pratiques opprimantes, institutions psychiatriques, violence institutionnelle, désinstitutionnalisation, antipsychiatrie, stigmatisation, reprise de pouvoir, étude de cas, expérience narrative, personnes psychiatrisées, pouvoir psychiatrique, reconstruction de soi, Oppression, structural approach, oppressive practices, psychiatric institutions, institutional violence, de-institutionalization, antipsychiatry, stigma, empowerment, case study, narrative experience, psychiatric survivors, psychiatric ex-patients, psychiatric power, self rebuilding

This paper presents the main concepts of which we have shown so far the efficiency in psychoanalytical theory. They have been drawn from Peirce's writings, his phaneroscopy and semiotics ; one can find their justification in our own works. Through these concepts, we are trying to offer a suitable articulation for the field of clinic. To account for the impossible consideration of the form as a precise object, we propose a new idea : the emerging form, or rhythm form. This may well constitute a progress in the understanding of Peirce's logic of vagueness.

From the conceptions of the founder of semiotics, C. S. Peirce, we propose a modelisation of the semiosis of the baby in order to study the interactive processes which occur between a baby and parents, so that when psychopathological symptoms appear, there can be an attempt to understand the mechanisms at stake in the origin of the symptoms so as to deduce “ useful ” interpretations for the baby and his family.

In France, since the Guigou law of June 17th 1998, ambulatory care provided to Sexual Abusers are improved. They lean on the legal framework of therapeutic injunction. Coordinator psychiatrist's mission is to estimate the therapeutic work's quality of the condemned person. In Rhône-Alpes, following the recurrence prevention's plan (2009), referential platforms (PFR) were created within voluntary medical and psychological centers. These platforms, in connection with the CRIAVS (Resource Center for Sexual Violence Author's care providers), answer four missions: welcome, estimate, guide and possibly treat. Since opening of Roanne's PFR various questions raised concerning qualitative aspects of care and recurrence's risk evaluation.

Keywords: AICS (Auteurs d'Infraction à Caractère Sexuel), PFR (Plate-Forme Référentielle), CRIAVS (Centre Ressource pour les Intervenants auprès des Auteurs de Violence Sexuelle), injonction de soins, psychiatrie, AICS (Sexual Abuse), PFR (Referential Platform), CRIAVS (Resource Center for Sexual abuser's care providers), Therapeutic injunction, Psychiatry, AICS (Autores de Infracción a Carácter Sexual), PFR (plataformas referenciales), CRIAVS (Centro Recurso para los profesionales trabajando con Autores de Violencia Sexual), Orden de tratamiento, Psiquiatría

Although it is necessary to avoid hasty conclusions based strictly on biological explanations, what are the consequences for criminal justice if the origin of paedophilic crimes is the result of biological propensities? In order to protect society in the long term, the purpose of this paper is to examine whether the applicability of an exclusive retributive justice is appropriated to tackle paedophilic crime.

Keywords: Pédophilie, Neurobiologie, Rétribution, Récidivisme, Traitement, Paedophilia, Neurobiology, Retribution, Recidivism, Treatment