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AbstractContext: Since the 90's, the province of Quebec pass through a deinstitutionalization process and integrated resources for people having concurrent mental health and drug related disorders were created. In Quebec, no study specified the utilization of services by homeless people with concurrent disorders, a population who face difficulties in receiving services. Objective: To describe utilization of mental health and substance related disorders services of clientele using resources intended for homeless people. Methods: This study uses data from a survey conducted on the clientele of resources for homeless persons in Montreal and Quebec city (n=757). Mental health problems, substance use disorders and concurrent disorders, as well as utilization of services related to these problems by clientele from resources for homeless people are presented. Results: Twenty-two percent of this population had concurrent disorders during a one-year period. They don't use more mental health and substance related disorders services than those with a single problem and their utilization of these services is very low. Conclusion: Some suggestions are brought (supportive housing, PACT programs) and it is proposed to continue working on integration of services in order to improve accessibility for this clientele.

Keywords: itinérance, troubles concomitants, utilisation des services, santé mentale, toxicomanie, épidémiologie, homeless, concurrent disorders, utilisation of health services, mental health, substance abuse disorders, epidemiology, itinerancia, problemas concomitantes, utilización de servicios, salud mental, toxicomanía, epidemiología

AbstractThis article focuses on the models and statuses of neo-traditional uses of psychotropic agents. It begins by examining the contexts and functions of so-called traditional uses, emphasizing the factors which contribute to their normalization and transformation. Among these factors, the marginal and identificatory dimensions of uses are examined in their dynamic relations with the membership group and surrounding society. The example of shamanism and neo-shamanism is then studied to illustrate the shift in traditions and the difficulty in distinguishing the old from the new, the indigenous from the exogenous, when it involves legitimizing these uses on the social and cultural level as well as among their proponents. The examination reveals a wide range of ways of conceiving neo-traditional practices depending on their integration, tolerance and normative status in society. The article closes by emphasizing the importance of the roles played by intellectuals and “author-guides” in constructing models, the normalization process and the promotion of neo-traditional uses of psychotropic agents.

Keywords: usages traditionnels, néo-tradition, psychotropes, chamanisme, néo-chamanisme, intellectuels, construction des normes, traditional uses, neo-tradition, psychotropic agents, shamanism, neo-shamanism, intellectuals, constructing standards, usos tradicionales, neotradición, psicofármacos, chamanismo, neochamanismo, intelectuales, desarrollo de normas

SUMMARYThe experience accumulated over the years with psychotic indi-viduals risks being lost in confusion if care is not taken to introduce certain reference questions and to respond to them, at least partially. In this text, we will ask ourselves the following questions while attempting to communicate, through them, our experience and the elements of response that we have discovered there : 1. What is the dynamic of the encounter with the psychotic in the acute phase? What response should we choose among the three which are possible : sealing-over, integration or accompaniment? 2. What are the stages in the process of equilibration in the young schizophrenic? 3. Does an effective model of accompaniment exist? We will end this article with several questions which might serve as directions for eventual research efforts.

ABSTRACT This article first looks at research to date concerning the psychology of emotions by providing a brief overview of the classic theories, particularly the James/Cannon debate as well as the different approaches to defining emotions, their functions and their components. The author then presents the various theories that prioritize either cognition, emotion or a reconcialiation between cognition and emotion. Also, the author stresses the importance of analyzing non-verbal language used while interacting during a conversation, namely in the field of therapy which is a privileged forum for sharing emotions. Followed is a brief outline of the benefits of the ethological approach. When candidates are being trained for a support role, this approach - particularly during the feedback phase - facilitates access to representations linked to affects, as well as to the reviviscence of affects associated to both partners in the exchange.

AbstractIn this essay, the author states that the first onset psychoses clinics described in many articles of this special issue of Santé mentale au Québec are not as evidence-based than the enthusiasm of its promoters would lend to believe. Using three stories based on observations made recently in Quebec where the argument of evidence-based support was brought, it will be illustrated how groups, their interventions and programs positioned themselves to their advantage.. These promoters in the health care system aim at better care, but they are also motivated by their own professional, departmental and research agendas ; they are supported by other logics and stakeholders like pharmaceutical firms, consumers and relatives; but can be slowed down by decision-makers and planners querying the ressources required, the efficiency, the accessibility, the training and the impact on other programs in a balanced mental health care system. This essay also briefly review the definitions, the limits of an evidence-based approach, and its origins from clinical epidemiology and public health. It does not consist solely of evidence drawn from randomised clinical trials and quantitative research designs, but also from qualitative and mixed designs, that have been developed by human sciences. The practice and application of evidence is not mastered in mental health systems, but the author hopes that with increased training by all stakeholders in its use, it will introduce a continuous evaluation at the individual clinical level, at the program and system levels. A continuous questioning that signals quality in clinical practices and services.

Based on a field survey carried out over a period of three years in the region of Paris and involving young people of Chinese descent who are seeing a psychiatrist in the private or public sector, the present article is focussed on the relationship between these young people and their parents, and more especially on the phenomenon of “inverted parenting,” showing how these migrant children help their parents enjoy the various resources acquired in or related to their host country. Using her analyses of the two-stage migration process—since the gap between the migration(s) of the parents and that of the child may exceed 10 years—the author first highlights three aspects of inverted parenting: cultural, economic, and administrative, together with their underlying logic. Subsequently, she takes into consideration the reactions of the young people involved with this inversion. Having first described the way they feel about being “required” to make themselves available to their parents, she examines the strategies they adopt to circumvent these inverted parenting responsibilities through their outside world (school, work, care settings, associations, etc.) where they hope they may access new possibilities.

Keywords: Relation intergénérationnelle, migrant chinois, obligation familial à rebours, souffrance psychique, ascension sociale, France, Intergenerational relationship, Chinese migrant, inverted parenting, psychological distress, upward mobility, France

AbstractIn recent years the use of theoretical elements and techniques stemming from traditional Indian spirituality, such as yoga and mindfulness meditation, by Western mental health professionals and researchers, has grown substantially. These techniques are often favourably received by Westerners and have become very popular. However, it is difficult to identify a clear theoretical position on these topics in the field of psychology to determine which are the reliable sources for such critical analysis. This paper aims to understand the relationship between Western theories of psychology and those of Indian spirituality, through the current patterns of cultural appropriation as well as through the historical context of contact between the two traditions since the late nineteenth century.

Psychic care of refugee claimants, victims of extreme and intentional trauma engages a particular clinic requiring that the therapist remains vigilant to concerns of citizenship. However, the psychoanalytical contribution, when by its self insufficient, is fundamental to understand what is addressed from one subject to another, in transference and counter-transference. The presence of a cultural mediator (interpreter), far from polluting the therapeutic relation, in the contrary, enriches it, in finding a process of objectalisation. Nevertheless, if exile remains before anything subjective, one must pay particular attention to the context of immigration policies of the host country and to the context of conflict of the country of origin. Indeed, it is the quality of this psychic « to-and-fro » between the host group and the native group, a support of the re-symbolization process that protects the collapse of intra and inter-subjective links. In these conditions, the therapist occupies moreover a position of « passeur ». However, what is fundamentally addressed is the question of ‘human condition'.

Several similarities exist in the phenomenology of obsessive-compulsive disorder (OCD) and eating disorders (ED : anorexia nervosa and bulimia). Both disorders include obsessive thoughts and compulsive or ritualized behaviours. Furthermore, these two disorders frequently present with similar comorbid disorders. In this article, the authors examine similarities between ED and OCD, and whether eating disorders can be conceptualized as a variant of obsessive-compulsive disorders. This raises the possibility that treatments proven effective for OCD could be successfully adapted for ED. The authors consequently further examine both treatments utilized for both disorders.