Documents found
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281.More information
Objective This article aims at filling some gaps in the literature regarding conditions conducive to high-quality collaborative care in youth mental health (YMH) for migrant families. It focuses on the factors that are susceptible to foster the engagement of migrant families in the services, by examining the clinical encounter, as well as sociopolitical and institutional dimensions.Methods Using a multiphase mixed methods design, it sequentially follows qualitative and quantitative results regarding migrant families within the different projects of a research program on collaborative care in YMH in culturally and socioeconomically diverse neighborhoods, done in Montreal during the last decade. These results come from data collected through questionnaires, semi-structured interviews, focus groups, participatory observation and documentation, with research participants being children, adolescents and parents from migrant families, clinicians and managers.Results The results suggest that the sociopolitical and macro institutional system finds its way into the clinical space by influencing the process of care. In particular, successive reforms of the health system challenge institutions and YMH teams in their capacity to create a favourable environment for continuity of care and interinstitutional partnership and interprofessional collaboration, factors associated with families' engagement into care. This engagement is also dependent on the representations of mental health and services that migrant families hold. These representations are shaped by their experience of the services, but also by what their sociocultural environment and the public discourses allow them to imagine of these services. This calls for the integration of cultural and sociopolitical dimensions within the concept of engagement. Finally, results also suggest that schools are playing an important role to foster engagement in mental health care.Conclusion The quality of mental health care for migrant children and adolescent relies on the engagement of families, as well as on the mutual engagement of clinicians and of their institutions. Political contexts where tensions between majority and minority groups are present can also act as barriers to the care. Given that migrant families are engaging less in the services compared to non-migrant families, these considerations call for an important review of avenues to facilitate engagement of migrant families into collaborative care YMH services. This article suggests certain avenues to promote this engagement.
Keywords: santé mentale jeunesse, soins en collaboration, engagement, migrants, contexte systémique, collaborative care, migrant, engagement, youth mental health, systemic context
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282.More information
Objective The objectives of this review were to identify and compare major international initiatives aiming to integrate mental health services in primary care and to summarize the lessons learned for similar integration efforts in the province of Quebec, Canada.Methods We conducted a narrative review of the literature guided by a conceptual framework drawn from the literature on integrated care. We identified relevant initiatives to support primary mental health care integration through Pubmed searches and through previous systematic reviews on this topic. We then selected those initiatives that provided sufficient details on their key characteristics, outcomes, and implementation issues (e.g. barriers, facilitators). We focused our analysis on large-scale initiatives as these offered the most potential for impacts on population mental health. This process resulted in the selection of 20 initiatives that were described in 153 articles and reports. Our synthesis was guided by our conceptual framework, which distinguishes between five types of integration, namely clinical, professional, organizational, systemic and functional integration.Results Of the 20 primary mental health care integration initiatives, 3 targeted youth, 14 targeted adults or multiple age groups, and 3 were targeted towards seniors. Most initiatives aimed to implement collaborative care models for common mental disorders in primary care. Other initiatives focused on co-locating mental health professionals in primary care, supporting the emergence of a diversity of integration projects led by community-based primary care practices, or the merger of primary care and mental health organizations. Most initiatives were based on clinical, professional and functional integration strategies. Across initiatives, a range of positive outcomes were reported, notably to the accessibility and quality of services, the satisfaction of patients and providers, the costs of services, and impacts on patients' health and quality of life. Integration initiatives encountered many common barriers to implementation. However, steps taken to properly prepare and execute the implementation process, as well as ensure the sustainability of initiatives, helped initiative leaders to overcome certain barriers. The lessons for Quebec include the need to continue to reinforce evidence-based models of collaborative mental health care in primary care and promote a culture of continuous quality improvement and a more widespread use of information technologies that can support integrated care.Conclusion This review shows that integrating mental health services into primary care is a complex process that depends on a variety of strategies occurring at multiple levels of the healthcare system. However, it is also a unifying process that holds much potential to significantly impact the mental health and well-being of populations.
Keywords: soins intégrés, services de santé mentale, soins primaires, soins de collaboration, collaboration interdisciplinaire, integrated care, primary care, mental health, collaborative care, interdisciplinary collaboration, review
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283.More information
This article presents the results of an exploratory research conducted with young people attending Auberges du coeur that host troubled and homeless youth in Drummondville and Montreal. We looked at their relationship to mental health diagnoses and medication, and how they are followed by health professionals. We will revisit three key elements of our study: 1. the existence of long processes of solitary adjustment with regard to medication that may result in the abandonment or refusal of prescription; 2. the difficulties of accessibility to certain services, including psychological help; 3. the development of an ambiguous relationship, both “expert” and “critical” with the uses of the medication, leading to a distancing from certain institutions, medical or related to social services.
Keywords: Jeunes, Santé mentale, Diagnostics, Médication, Jeunes en difficulté, Jeunes en situation d'itinérance, Auberges du coeur, Québec, Youth, Mental Health, Diagnosis, Medication, Youth in difficulty, Homeless youth, Auberges du coeur, Québec
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284.More information
The authors discuss their experience with group psychotherapy of children within the public health system and community services spanning the last fifteen years. They specify treatment indications, regarding heterogeneity of diagnoses among other criteria, and outline their model of group work. Anxieties pertaining to group implementation, the group as an object, group illusion, the elaboration of differences, non saturation of meaning, excitation and the parental support group will be discussed and illustrated with clinical cases.
Keywords: groupe, psychothérapie, enfant, psychanalyse, group, psychotherapy, child, psychoanalysis
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285.More information
The implementation of level systems are gaining popularity in North America for students with behavioral disorders. Educators are very satisfied to work in these programs and consider that theses services are very effective to help students with behavior disorders. However the implementation of these types of services raise some problems at different levels, mainly ethical, theoretical, and therapeutic. This article presents a brief overview of the characteristics of level systems and their use. It also points out the advantages associated with these systems and the principal criticisms made about them. After, results of evaluative researches about their efficacy are presented.
Keywords: Système à paliers, classe à niveaux, trouble du comportement, modification de comportement, recension des écrits, Level system, engineered classroom, behavior disorder, behavior modification, literature review
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286.More information
RÉSUMÉ: La présente recherche propose une exploration, à caractère heuristique, s'ancrant dans une écriture à la première personne radicale, un Je ferme et vivant qui se rapatrie sur le chemin de son cœur. La chercheure se pose en sa qualité de sujet, créant des conditions d'altérité nécessaires à la communicabilité de la démarche. Ce parcours heuristique aborde des thématiques telles : le deuil, la colère et les séparations nécessaires. Les procédés méthodologiques créent un mouvement d'existence et de vie neuve. La chercheure, par un retour à caractère autobiographique, revisite des évènements difficiles de son histoire, parsemés des situations-limites de son existence. Assumant un diagnostic de Troubles déficitaires de l'attention avec hyperactivité chez l'adulte (TDAH), la chercheure accepte l'épreuve exploratoire de la recherche caractérisée par une …
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287.More information
Quebec universities are experiencing an upsurge in students with disabilities (SWD), which creates pressure on internship supervisors. Although most supervisors know that these students need support, they are unaware of the measures and legal obligations in place to ensure that SWD have the same opportunities for success as their peers. While some studies focus on supervisors' observations of the challenges faced by SWD, very few examine the views of SWD about the kind of support they need to meet the challenges of their practicums. This observation led us to seek out the voices of SWD through a questionnaire. The analysis of the data highlights that these students experience challenges similar to those of many of their colleagues without disabilities, but which seem amplified by challenges specific to their condition. The analysis also highlights the need for students to be supported by supervisors who are open to differences, providing an atmosphere of safety for discussing challenges and for working together to identify the actions to be taken to ensure a successful internship.
Keywords: Étudiantes en situation de handicap, stage, université, accompagnement, accommodement
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288.More information
In response to the new reality of distance education imposed in all areas of teaching and learning during the COVID-19 pandemic and the urgency to adapt to this new reality with innovative pedagogical practices, a group comprised of university teachers, lecturers, students, and practitioners affiliated with two schools of social work in Québec developed a podcast series. It features the voices of social workers in diverse practice settings and was designed to bridge theory and practice in social work intervention, thereby supporting social work practice as well as field education courses. The purpose of this article is to share lessons learned in our co-creation journey, to discuss the emergence and development of this project as well as the challenges and facilitators we encountered. We document our reflections to inform others who might wish to develop such a tool in higher education.
Keywords: enseignement supérieur, baladodiffusion, travail social, collaboration interuniversitaire, formation pratique, post-secondary education, podcasts, social work, inter-university collaboration, field education
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289.More information
Contexte. Les adolescents hébergés en centre de protection de l’enfance et de la jeunesse (CPEJ) présentent plusieurs difficultés psychologiques, dont des comportements agressifs (pousser, frapper, intimider) qui ont des conséquences graves. Pour comprendre ces comportements et ultimement mieux intervenir, on doit d’abord distinguer leur fonction: il y a l’agression proactive (AP) qui est manifestée de façon délibérée dans l’objectif d’atteindre un but et il y a l’agression réactive (AR) qui est défensive et manifestée pour retirer une menace réelle ou perçue. Les deux fonctions sont corrélées ensemble, mais elles sont aussi distinctes et reliées à des facteurs de risque personnels différents. Au nombre de ces facteurs, il y a les traits d’insensibilité aux émotions (traits IE), l’empathie, la colère et l’inhibition (fonction exécutive). Lorsqu’on étudie …
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290.More information
Keywords: santé mentale, politiques de la relation, psychiatrie