Showing papers in "Canadian journal of community mental health in 2017"
TL;DR: In this paper, a two-phase, multi-sectoral project aimed at enhancing youth services addressing substance use in Ontario is described, where a youth-focused website and survey, focus groups, and interviews are used to elicit perspectives from multiple stakeholders.
Abstract: This article describes a two-phase, multi-sectoral project aimed at enhancing youth services addressing substance use in Ontario. In the information gathering phase, a youth-focused website and survey, focus groups, and interviews were used to elicit perspectives from multiple stakeholders. In the implementation phase, capacity-building and consultations on transition-aged youth needs were conducted to inform youth transition-readiness checklists. We discuss the importance of engaging youth as collaborators as well as respondents and the processes used to tailor findings to local contexts for implementation.
25 citations
TL;DR: In this article, the authors highlight the multi-faceted approach undertaken in British Columbia over the past decade to promote positive mental health through social-emotional learning in schools.
Abstract: Social and emotional learning is increasingly recognized as playing an important role in the promotion of positive mental health in schools. In 2012, the Mental Health Commission of Canada identified child and youth mental health as a priority for the transformation of mental health systems in Canada. To this end, comprehensive efforts to promote positive social and emotional development in schools and to foster safe and caring school environments are urgently needed. This paper highlights the multi-faceted approach undertaken in British Columbia over the past decade to promote positive mental health through social-emotional learning in schools.
20 citations
TL;DR: This community-based, participatory research project elicits traditional knowledge from Elders living in Cape Dorset, Nunavut to identify Inuit values, beliefs, and actions with the potential to improve community wellness.
Abstract: Nunavut communities struggle with numerous challenges related to social distress. It is important to specify that these struggles represent a rupture with traditional Inuit society. Most research to date has linked colonization and ongoing social inequity to these distresses. This community-based, participatory research project elicits traditional knowledge from Elders living in Cape Dorset, Nunavut. The aim is to identify Inuit values, beliefs, and actions with the potential to improve community wellness. The themes that emerge include respect, leadership, family connection, inclusion of traditional knowledge, working together, and resiliency. Results resonate with other community wellness research projects in Nunavut.
15 citations
TL;DR: With 5 billion dollars in new federal funding to improve access to mental health services set to roll out over the next 10 years, a window of opportunity has opened to begin to close the long-standing gap in mental health funding.
Abstract: With 5 billion dollars in new federal funding to improve access to mental health services set to roll out over the next 10 years, a window of opportunity has opened to begin to close the long-standing gap in mental health funding in Canada. Public spending on mental health in Canada is only 7% of public spending on health overall (Jacobs et al., 2010), well short of the 9% called for in the Changing Directions, Changing Lives: The Mental Health Strategy for Canada (MHCC, 2012). This percentage is also well short of the disease burden comprised by mental illnesses, which ranges from 13% globally (WHO, 2011) to 23% in the UK (OECD, 2014). By comparison, recent figures from the Organisation for Economic Cooperation and Development (OECD, 2014) indicate that some countries devote as much as 18% of their health spending to mental health, with the UK sitting at 13%. Even with new targeted federal funding, closing, or at least narrowing, this gap will require careful attention to lessons learned in the past. Thi...
14 citations
TL;DR: This paper integrates principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care into a Canadian Model for Collaborative Mental Health Care.
Abstract: For 20 years mental health and primary care providers across Canada have been working collaboratively together to improve access to care, provider skills, and patient experience. The new strategic plan of the Mental Health Commission of Canada (MHCC) offers many opportunities for collaborative care to play a role in the transformation of Canada’s mental health systems. To assist the plan, this paper presents principles underlying successful projects and ways that mental health and primary care services can work together more collaboratively, including integrating mental health providers in primary care. It integrates these concepts into a Canadian Model for Collaborative Mental Health Care that can guide future expansion of these approaches, and suggests ways in which better collaboration can address wider issues facing all of Canada’s health care systems.
12 citations
TL;DR: Findings show that the perspectives of mental health service providers are largely consistent with those of housing providers, and identify a range of support gaps and barriers in housing and mental health in Canada.
Abstract: People experiencing mental illness and homelessness face numerous barriers to becoming housed. Service providers who work with this population also encounter challenges to meeting service users’ needs, yet their perspectives have been only minimally studied. Using survey data from a pan-Canadian study, this article explores the barriers and facilitators to fostering lasting change in housing and mental health according to 96 housing providers and 186 community-based mental health service providers. Findings show that the perspectives of mental health service providers are largely consistent with those of housing providers, and identify a range of support gaps and barriers.
11 citations
TL;DR: The results highlight that disparate stakeholders agree regarding the need for transformational change shifting away from waiting times and crisis-driven services leading to powerlessness among youth and caregivers.
Abstract: Research indicates a decline in mental health service utilization between the ages of 16 to 25, leaving emerging adults with mental illness at risk for worsening outcomes. The authors utilized a community-based participatory research (CBPR) approach to explore the mental health landscape for youth aged 16–25 in London, Canada. Interviews and focus groups (n = 30) with community and hospital system leaders, youth and caregivers were transcribed and coded using an approach informed by constructivist grounded theory. There was consensus regarding difficulties in the current system including wait times and crisis-driven services leading to powerlessness among youth and caregivers. Solutions include delivery of services through a flexible, real-time system that emphasizes patient and caregiver engagement, youth centric services and recovery-oriented care across the hospital/community continuum. The results highlight that disparate stakeholders agree regarding the need for transformational change shifting away ...
9 citations
TL;DR: A youth-adult partnership in a system-level initiative is showcased, and a replicable strategy for developing resources relevant to youth needs and preferences is highlighted.
Abstract: Youth engagement can improve the accessibility, effectiveness, and sustainability of programs and resources for youth. Little is known about youth engagement in system-level initiatives. As part of Systems Improvement through Service Collaboratives, an Ontario initiative that aimed to improve the system of care for youth with mental health or addictions needs, youth and adults in London, Ontario partnered to co-create Be Safe. The Be Safe resource helps youth manage mental health crises and identify local services. This article showcases a youth-adult partnership in a system-level initiative, and highlights a replicable strategy for developing resources relevant to youth needs and preferences.
8 citations
TL;DR: This study describes family physicians’ and nurse practitioners’ perceptions of the need for consultation and collaboration from mental healthcare specialists and the theme, Looking for Help, is explained by three categories: My Comfort Zone, I Lack the Education, and Not Enough Time.
Abstract: Primary care providers deliver the majority of mental health care to individual Canadians. Researchers suggest that these practitioners are not prepared to deliver these services and require collaboration with mental health specialists to better meet patients’ needs. This study describes family physicians’ and nurse practitioners’ perceptions of the need for consultation and collaboration from mental healthcare specialists. The theme, Looking for Help, is explained by three categories: My Comfort Zone, I Lack the Education, and Not Enough Time. Findings from this study may inform future collaborative mental healthcare initiatives and primary care networks.
8 citations
7 citations
TL;DR: Implementation of FASD-informed recommendations, such as those of the Truth and Reconciliation Commission of Canada (2015), can provide a more effective approach to mental health services and improve mental health outcomes.
Abstract: It is the current authors’ perspective that the successful implementation of Changing Directions, Changing Lives, which seeks to improve mental health and well-being in Canada, cannot be realized effectively without considering FASD. Given that 94% of individuals with FASD also have mental disorders, practitioners in the mental health system are encountering these individuals every day. Most mental health professionals have not been trained to identify or diagnose FASD, and therefore it goes largely “unseen,” and individual treatment plans lack efficacy. Implementation of FASD-informed recommendations, such as those of the Truth and Reconciliation Commission of Canada (2015), can provide a more effective approach to mental health services and improve mental health outcomes.
TL;DR: The results show a significant difference between the 2 groups only in the number of days of hospitalization, particularly in the psychiatric unit.
Abstract: The At Home / Chez Soi demonstration project was conducted to investigate the effectiveness of the Housing First model in 5 Canadian cities. Using a randomized controlled trial design, this study evaluates the impact of this project on the use of health services by people with severe and persistent mental health problems and a history of homelessness in the greater Moncton area. The sample comprised 193 homeless persons, 95 in the control group and 98 in the treatment group. The results show a significant difference between the 2 groups only in the number of days of hospitalization, particularly in the psychiatric unit. Factors associated with the use of health services by people who are homeless and who have severe mental health problems need to be further investigated.
TL;DR: It is concluded that journey approaches to youth mental health research could support the implementation of Canada’s mental health strategy in unique and crucial ways.
Abstract: We know much about the alarming trends in youth mental health; however, we know far less about the journeys that Canadian youth are taking toward better mental health. This article begins with a conceptual synthesis of the literature about the ways in which scholars are invoking the journeys of youth. We then present two examples of youth journeys in mental health from our current Atlantic Canada Children’s Effective Service Strategies in Mental Health project (ACCESS-MH) and conclude that journey approaches to youth mental health research could support the implementation of Canada’s mental health strategy in unique and crucial ways.
TL;DR: Findings from a case study are presented that describe what makes the Caroline Families First Wraparound Program work, the barriers and facilitators to its success, and draw conclusions about the lessons learned.
Abstract: The Caroline Families First Wraparound Program operationalizes cross-sectoral collaboration and planning, family peer support, and family-directed care consistent with strategic directions within the Mental Health Strategy for Canada. In this spotlight article, we present findings from a case study that describes what makes the program work, the barriers and facilitators to its success, and draw conclusions about the lessons learned. For example, while family-directed care is a core and essential value of the program, unless well understood, it can create tensions within teams. Similarly, structural factors such as provider reimbursement can inhibit physician involvement. Suggestions about these and other contextual factors can inform other efforts to mobilize the Mental Health Strategy.
TL;DR: It is suggested that consensus conferences are a promising way to operationalize the Mental Health Strategy for Canada through policy and practice changes.
Abstract: This case study explores how the Consensus Conference on the Mental Health of Emerging Adults, hosted by the Mental Health Commission of Canada in 2015, can impact mental health policy and practice in Canada. The study draws on interviews from 14 delegates who attended the conference. Participants praised innovations such as the inclusion of an emerging adult panel that provided feedback on all discussions, and efforts to make the consensus-building process meaningful in the Canadian policy context. Findings suggest that consensus conferences are a promising way to operationalize the Mental Health Strategy for Canada through policy and practice changes.
TL;DR: Age, city, and need-for-care variables were associated with UMHCN in multivariate analysis and implications of the findings for policy and program planning are discussed.
Abstract: Persons who are homeless experience higher levels of mental illness, unmet mental healthcare needs, and physical healthcare needs than the general population. This study aimed (1) to determine the reasons contributing to having unmet mental healthcare needs (UMHCN) and (2) to examine the determinants of UMHCN among a representative sample of adults who are homeless or vulnerably housed in three Canadian cities (N=1190). Almost a quarter (23.3%) of the sample reported UMHCN in the past year. The reported reasons for having UMHCN pertained especially to the availability (31.5%), accommodation (22.1%), and acceptability (21.3%) of services. Age, city, and need-for-care variables were associated with UMHCN in multivariate analysis. Implications of the findings for policy and program planning are discussed. Les personnes sans-abri presentent des niveaux plus eleves de maladie mentale, de besoins de soins de sante et de besoins non combles de soins de sante mentale que la population generale. Cette etude visait...
TL;DR: It is argued that mental health policy, research, and practice should move away from the term community in favour of a framework that addresses basic needs, disability justice, intersecting social identities, and the structural forces that impact the lives of people with psychiatric disabilities as they “recover” in settings outside of hospital.
Abstract: The concept of “community” is ubiquitous in mental health policy, research, and practice in Canada; however, its meaning is rarely defined In this paper, we consider the positioning of “community” within the Canadian historical and political mental health context and reveal that it contrasts with the lived experiences of people with psychiatric disabilities We argue that mental health policy, research, and practice should move away from the term community in favour of a framework that addresses basic needs, disability justice, intersecting social identities, and the structural forces that impact the lives of people with psychiatric disabilities as they “recover” in settings outside of hospital
TL;DR: This article seeks to bridge the gap between existing knowledge and current practice, and provides recommendations for mental health practitioners who work with immigrant and refugee population arriving from war-torn countries.
Abstract: With the inception of the mental health strategy for Canada, Changing Directions, Changing Lives, the ever increasing ethnic diversity in this country demands re-examination of our approaches to mental wellbeing and illness in the immigrant and refugee population arriving from war-torn countries. Contemporary clinical practice among mental health practitioners is not reflective of the emerging literature in this field, which points towards meaningful and culturally competent care. This article seeks to bridge the gap between existing knowledge and current practice, and provides recommendations for mental health practitioners who work with this population.
TL;DR: In this paper, the authors explore, par le biais d'une etude de cas qualitative, les perceptions des professionnels and professionnelles sur l'egalite and l'inegalite dans les processus de partenariat en action communautaire dans le domaine de la petite enfance.
Abstract: Cet article explore, par le biais d’une etude de cas qualitative, les perceptions des professionnels et professionnelles sur l’egalite et l’inegalite dans les processus de partenariat en action communautaire dans le domaine de la petite enfance. La theorie de l’action communautaire en coalition (TACC) de Butterfoss et Kegler (2009) a ete utilisee pour examiner specifiquement les processus de communication, de prise de decisions, de gestion des conflits et d’administration. Les donnees ont ete recueillies par le biais de trois sources : les entretiens individuels, les observations et l’analyse documentaire. Le materiel obtenu a ete soumis a une analyse thematique. Les resultats mettent en evidence que les professionnels et professionnelles utilisent des indicateurs d’egalite et d’inegalite dans deux niveaux distincts de partenariat : le niveau de la haute sphere administrative ou le rapport entre la contribution financiere des institutions partenaires et les benefices que les partenaires retirent modulent ...
TL;DR: A unique initiative in Ontario that provided implementation supports and funding for agencies and lessons learned and implications for bridging the gap between research and practice are explored.
Abstract: As child and youth mental health agencies apply the recommendations from the national mental health strategy, a strong focus has been placed on the implementation of evidence-informed practices to ensure the best outcomes for those they serve. Although a considerable amount of research exists on the implementation of best practices and the key factors to successful implementation, far less exists in terms of concrete strategies to support such initiatives. This article describes a unique initiative in Ontario that provided implementation supports and funding for agencies. Lessons learned and implications for bridging the gap between research and practice are explored.
TL;DR: In this article, preliminary evaluation findings on the operation of the new Winnipeg Mental Health Court (MHC) program, launched in 2012, were presented, in addition to profiling the demographic, legal, and mental health backgrounds of program participants.
Abstract: Mental health courts (MHC) are still relatively new in Canada and there is a dearth of research available regarding program structure and outcomes. This article presents preliminary evaluation findings on the operation of the new Winnipeg MHC program, launched in 2012. In addition to profiling the demographic, legal, and mental health backgrounds of program participants, we use a pretest- post-test design to compare rates of criminal justice involvement (N = 35). Participation in the MHC appeared to reduce justice system contact, supporting at least initial optimism about program efficacy. Greater inclusion of minorities was an area targeted for improvement. Study findings provide partial support for further development and implementation of mental health courts in Canada.
TL;DR: Thirty-five DIS policy designers in Australia and Ontario explained how they consider mental illnesses when designing policy, and five challenges emerged: validating duration, proving an illness, (un)differentiating mental illnesses, managingmental illnesses, and separating the person from the illness.
Abstract: In most disability income support (DIS) programs, mental illnesses is the fastest growing category of illness, but it is unknown how policy designers consider this vulnerable group. Forty-five DIS policy designers in Australia and Ontario explained how they consider mental illnesses when designing policy. Using a grounded theory approach, five challenges emerged: validating duration, proving an illness, (un)differentiating mental illnesses, managing mental illnesses, and separating the person from the illness. Each challenge is described and compared across Australia and Ontario. These challenges provide a framework for other settings to determine how well their DIS policies have considered mental illnesses in policy design.
TL;DR: This study argues that ethnicity is a barrier to suicide prevention in Indigenous populations and recommends improvements to the design and implementation of suicide surveillance and prevention strategies.
Abstract: Suicide is a concern for many Indigenous communities in Canada. Suicide rates in Canada have decreased but rates in Saskatchewan remain above the national average. In northern Saskatchewan, where First Nations and Metis people make up 85% of the population, suicide rates are well above the national rate. The majority of reported suicides in this region are committed by adolescents and young adults. However, the current rate of suicide among First Nations and Metis youth in Saskatchewan cannot be determined because ethnicity is not tracked on hospitalization and coroner records. Our study argues this is a barrier to suicide prevention in Indigenous populations and recommends improvements to the design and implementation of suicide surveillance and prevention strategies.
TL;DR: The Recovery College at Ontario Shores as discussed by the authors provides service users who have mental health challenges with courses, which they choose, to learn about recovery, mental health, treatment options, leisure, and fun.
Abstract: The Recovery College at Ontario Shores provides service users who have mental health challenges with courses, which they choose, to learn about recovery, mental health, treatment options, leisure, and fun. College components designed to enhance recovery also include peer support and access to the library to enhance individualized learning.
TL;DR: CHAMP, an innovative community-based intervention that integrated psychological intervention and collective empowerment strategies to reduce stigma, was found to be effective for marginalized communities.
Abstract: Marginalized communities bear a disproportionate burden of syndemic challenges related to HIV, mental illness and addiction. Stigma is a major barrier to effective responses. CHAMP, an innovative community-based intervention that integrated psychological intervention and collective empowerment strategies to reduce stigma, was found to be effective for such a population.
TL;DR: There is a need for a pan-Canadian strategy aimed at reducing suicide deaths and reaching all Canadians, and development of equitable access to psychotherapy and mental health literacy programs should be priority goals.
Abstract: Responsibility for suicide prevention falls to the Government of Canada and Health Canada. The issue of suicide affects Canadians of all ages and in all regions of the country, hence the need for a pan-Canadian strategy aimed at reducing suicide deaths and reaching all Canadians. The availability and accessibility of mental health services constitute important resources for suicide prevention and a target for interventions that can be made to rapidly reduce the suicide rate. Such a strategy to improve services should include quality surveillance and quality control programs, such as suicide audits and the use of linked government administrative databases. Population-based strategies to prevent and treat depression must also be established and should be based on the Nuremberg model. In particular, development of equitable access to psychotherapy and mental health literacy programs should be priority goals.
TL;DR: In recent times, cultural competence has contributed much to the commissioning of dementia services and the success of its use has been reported widely in the provider and insurance arena.
Abstract: Cultural competence has proven to be a very efficient tool in reducing healthcare disparities and improving healthcare experiences, compliance with therapy, and reducing incidents of misdiagnosis. This effect is because professionals are recognizing the value and significance of including the person in need of services in their assessment and decision making. While this rationale has also long been considered part of good practice among healthcare professionals (providers) within the mental health arena and nursing care and the success of its use has been reported widely in the provider and insurance arena, the notion seems to have escaped the commissioning arena. Commissioners are responsible for specifying, procuring, and monitoring services and are missing out on the value of completing culturally competent needs assessments for their localities. Synonymous with cultural competence is “person-centred care.” In recent times, cultural competence has contributed much to the commissioning of dementia servi...
TL;DR: The aim was to compare the studies, and a framework for the different elements used to assess mental health costs was created, which can help analysts to understand the purpose of different cost components.
Abstract: Since 2000, 5 studies have been published that each purported to estimate aggregate national mental health costs in Canada. Each of these studies used a different method. Our aim was to compare the studies, and we created a framework for the different elements used to assess mental health costs (direct costs, indirect costs, transfer payments, and “human” costs). In addition, each study used different parameters (population covered, diagnosis) and cost components to estimate the economic impact of mental health. Our framework can help analysts to understand the purpose of different cost components. We conclude that to achieve a consensus on the magnitude of mental health costs, we need to use more standardized approaches.
TL;DR: In this article, an evaluation porte sur les effets d'une formation dans le domaine de la violence sexuelle, destinee au personnel en milieu scolaire et developpee par un organisme communautaire specialise dans ce domaine.
Abstract: Cette evaluation porte sur les effets d’une formation dans le domaine de la violence sexuelle, destinee au personnel en milieu scolaire et developpee par un organisme communautaire specialise dans ce domaine. Les resultats indiquent que cette formation contribue a accroitre les connaissances, les attitudes favorables exemptes de prejuges vis-a-vis la violence sexuelle et le sentiment d’autoefficacite du personnel scolaire (n = 42) a court terme et 3 mois apres la formation. De plus, les participants et participantes rapportent une frequence considerable de situations dans lesquelles ils ont transfere les apprentissages dans leurs pratiques professionnelles.
TL;DR: Linear regression analysis indicates that homeless persons’ mental health, community integration, general health status, number of symptoms, and recovery are playing a role in a better quality of life in the family and therefore can help to exit homelessness.
Abstract: Family relationships are known to play a significant role in helping persons with mental health issues exit homelessness. This study aims to identify the independent quality of life factors that correlate with quality of family relationships. A cross-sectional design was used involving individuals enrolled in the At Home initiative for homeless persons with mental illness in five cities across Canada (N = 2,255). Linear regression analysis indicates that homeless persons’ mental health, community integration, general health status, number of symptoms, and recovery are playing a role in a better quality of life in the family and therefore can help to exit homelessness.