Originality and relevance are not the only factors in the success of innovative programs. Community consensus, expertise and credibility of staff, and evaluative approaches are important as well. Virgule ("Comma"), a program aimed at helping 10- and 11-year-olds who are first offenders, has these characteristics. The temporary hitch in the youth's life is viewed not as a definitive failure but as an opportunity for change. This is Virgule's philosophy: "Changing a period into a comma means changing a difficulty into a reason for progress."
On September 2nd, 1998 Swissair Flight 111 crashed in Saint Margaret's Bay, Nova Scotia. Surrounding coastal communities were immediately transformed into disaster response sites. Sixteen community health professionals were interviewed that identified several types of individual and community exposure, including exposure to human remains. The interviews revealed that the coastal communities have responded with silence and stoicism. This silence has been viewed by some health professionals as resilience. The interface of a major disaster, community silence, low help-seeking behaviours, and limited disaster health responses raises the critical question whether this is a profile of resilience or a community silently enduring.
A community mental health survey of 750 women aged 18 to 27 in a large urban centre established mental health profiles using a variety of measures, including investigations of any history of child abuse (including sexual abuse, defined as the unwanted fondling of the child's genital area, or attempted or achieved penetration of the child's body before the age of 17). Overall, 32% of respondents recalled abuse of this type. Of the 750 women, 6.8% had experienced sexual abuse which went on for more than one week. This long-term category included virtually all of those who experienced abuse by a trusted, authority figure. The Trauma Symptom Checklist (TSC) was found to be the most useful instrument among the several used in identifying sexual abuse histories. Scores of 30 or more on the TSC identified 72% of victims of long-term abuse, while 23% of those with scores of 30+ had experienced short-term sexual abuse. Seven percent of individuals with 30+ scores had never experienced (or did not recall) sexual abuse. No particular sub-scale of the TSC had better utility in identifying former victims than did the scale total.
In the twentieth century, Canadian psychologists have been involved with the educational system and the community at several points in time. In this article, the psychology of human development as developed at the Department of Psychology at the University of Toronto from 1916 to 1956 is investigated. In a variety of projects, the mental health of children was investigated in educational settings while measures were designed and tested to prevent maladjustment and to promote mental health. Initially, research and intervention aimed at adjusting school children to the educational setting. Later, a critical perspective on social institutions and Canadian society was articulated.
A permanent register on suicide cases was created and has produced a quantitative description of suicide in Abitibi-Temiscamingue over the period 1986-1991. This study reviews 218 suicide cases reported by the Coroner's Office of Quebec. A content analysis grid was applied on the Coroner's files and has facilitated the study of 87 variables potentially related to suicide. The results present the evolution of the suicide rates in this region in relation to those of other parts of Quebec, and the differences between parts of the region. Many variables were related to suicide (age, gender, urban setting, methods, suicide sites, seasons, etc.). A review of recent literature on suicide throughout the world indicates that patterns of suicide in Abitibi-Temiscamingue follow trends in North America with certain differences.
A permanent register of suicide cases has been established and has made it possible to produce a quantitative description of the suicide phenomenon in Abitibi-Témiscamingue for the period 1992-1996. This study reviews 211 suicide cases reported by the Chief Coroner Office of Quebec. A content analysis grid was applied to the coroners' files and has facilitated the study of 87 variables potentially related to suicide. The results show the evolution of suicide rates in this region in relation to those in other parts of Quebec, and the differences among various parts of the region. Several variables are shown to be significantly related to suicide (sex, age, method used, suicide site, etc.). A review of recent literature on suicide throughout the world indicates that patterns of suicide in Abitibi-Témiscamingue follow present trends in North America and Europe, but with aspects particular to the region.
Multiple sclerosis (MS) is a chronic neurological disease with numerous symptoms and consequences that does not typically reduce life expectancy. Mental health issues are common in this population, yet few investigations have targeted people aging with this disease (i.e., people aged 45+). This study examined factors contributing to mental health challenges among 1282 people with MS aged 45 to 90 and the extent of mental health service use among those who reported problems. Findings showed that functional abilities, age, years since diagnosis, presence of a helper, and self-rated health are related to mental health challenges. Less than 16% of people with mental health challenges were receiving services.
The limitations of a needs orientation for aboriginal mental health planning are evaluated in terms of the discrepancy between First Nations and western medical paradigms of health. We propose an alternative approach that focuses on how aboriginal people conceptualize wellness and describe their strengths. This provides a focus for initiatives that promote well-being by enhancing strengths rather than concentrating solely on deficits. We illustrate this approach by highlighting the indigenous knowledge of urban First Nations people in Vancouver's Downtown Eastside neighbourhood. We conclude that supporting existing strengths promotes wellness in holistic, culturally appropriate, and empowering ways.
Using a subset of youth from a sample of 3,636 Canadian adolescents, the present study examined sexual orientation and victimization experiences in high school. A total of 130 adolescents indicated they were gay, lesbian, bisexual, or questioning their sexual orientation. Significantly more adolescents identified as bisexual (N = 50) or questioning (N = 68) than as gay or lesbian (N = 12). Sexual-minority and questioning youth were more likely than heterosexual youth to be victims of bullying, peer sexual harassment, and peer or dating-partner physical abuse. Implications of victimization on questioning and sexual-minority adolescents' mental health are discussed.
Screening protocols that can be used to identify domestic violence are lacking (Gendron, 1987), as are studies evaluating the effects of using these protocols. With the objective of screening domestic violence, the Saint-Hubert CLSC has developed a protocol by in collaboration with the Centre de recherche interdisciplinaire sur la violence familiale et la violence faite aux femmes (CRI-VIFF). Evaluation of the domestic violence screening protocol established at the Saint-Hubert CLSC indicates that the number of cases in which domestic violence was detected was 3 times higher after the screening protocol was put in place, and 15 times higher at the Saint-Hubert CLSC than at the CLSC used as a comparison site.
This paper evaluates Responsible Choices for Men, a 14-week therapy group for abusive men based on feminist perspectives using narrative methods. Pre-test and post-test information was available for 76 program completers measuring physical and non-physical abuse, self-esteem, perceived stress, family relations, depression, assertiveness, and sex-role beliefs. The men significantly improved on all variables. A further focus was following up with 22 group members, contacted 5 to 28 months post treatment and asked to complete the same measures. The results indicated not only maintenance of the post-group changes, but continued improvement. Clinical implications and recommendations for group programming with abusive men are presented.
The Substance Abuse Bureau of the Ontario Ministry of Health recently launched the Ontario Addictions Treatment Services Rationalization Project to increase the capacity of existing services and restructure the service delivery system. One of the recommended strategies was to shorten the length of stay of residential treatment from four to three weeks. Concerns have been expressed by some service providers that this policy change is not consistent with available empirical evidence. This paper reviews relevant research evidence and suggests a new role for residential treatment of substance abusers.
Adult lesbian survivers of childood sexual abuse were interviewed using grounded and structured methods to explore the interaction between being, or coming out as, a lesbian and healing from childhood sexual abuse (CSA). A history of CSA was found to render coming out as a lesbian more complicated and often more difficult. Having or developing a lesbian identity caused significant changes in respondents' social support networks and spiritual beliefs and communities, afforded many opportunities for greater healing, and in the balance seemed to facilitate the healing process. Implications for program planning and service delivery are briefly discussed.
This study explores the contribution of personal characteristics in the knowledge and skills gains of children taking part in the child abuse prevention program ESPACE. The program is an adaptation of the widely implemented American Child Assault Prevention Program (CAP). A group of 107 fourth-grade children completed a knowledge questionnaire and a video vignette measure designed to evaluate preventive skills in abusive and potentially abusive situations. Children were also invited to complete questionnaires evaluating individual characteristics such as self-esteem, locus of control and self-efficacy. The results highlight the importance of certain individual variables such as the child's gender, self-efficacy and perception of athletic competence in the acquisition of sexual abuse preventive skills.
This study examines the relationships among maritally abused women's educational level, their satisfaction with social support, their children's perceived maternal support, and their children's global self-worth (GSW; Harter, 1985a). The participants, 38 pairs of maritally abused women and their children (aged 7 to 13 years), were recruited through women's shelters and community counselling facilities. The study found that children who have a sense of being emotionally supported by their mothers have a positive sense of self-worth. The hierarchical regression analyses show that children's perceived maternal support has a unique contribution to children's GSW above and beyond their mothers' educational level and mothers' satisfaction with social support (R2 = .31).
While some studies have documented the mental health symptoms of battered women, we know little of the extent to which shelter residents present with mental health and substance abuse symptoms, or the effect of these issues on other residents, staff, and children. Further, it is not clear whether shelter staff feel sufficiently trained to safely and adequately address such concerns. The current survey was an effort to document what proportion of shelter residents present with severe symptomatology and its effect on the shelter environment. The survey was completed by 158 staff from 23 of Alberta's 30 shelters. Since shelters are one aspect of a community network of services, it was of interest to identify how well mental health and substance abuse services complement each other and whether shelters have developed strategies to better connect with other agencies.
Many women with serious mental health issues also deal with abuse and have difficulty accessing services. Despite the fact that groups have been found to be one of the most useful tools in healing from the effects of abuse, many professionals see women with serious mental health issues as unable to benefit from counselling and, in particular, from groups for abused women. This study indicates that, when mental health issues are addressed and the group structures and expectations are modified to allow women control over their participation, serious mental health issues are not a barrier to participation in groups.
In a qualitative study, 35 women who had lived with violent partners were interviewed regarding their experience making decisions about their relationships to their abusers. This paper explores their stories, integrating the common themes with reports from other studies. The insights of the women participating in this and other research support an ecological understanding of the tough choices they face--a framework which respects the role of environmental factors (demands and resources) in helping or constraining choices at the same time as it recognizes the importance of powerful mediating factors (beliefs, values, and a sense of personal efficacy).
This article discusses the effects of family breakdown--and the resulting issues of custody and access--on children. It explores trends in child custody and access and issues surrounding those trends, particularly in terms of the benefits and limitations of joint custody. It then identifies the contextual problems of family breakups (including the relative poverty experienced by mother-led families, the unreliability of financial support from fathers, the complications for children which result from step-parent figures, including serial partners of their parents, the implications of interparental conflict, the need to fully address suspicions and/or allegations of abuse by one parent against another, and the problem of Parental Alienation Syndrome). Typical responses of children to family breakup are then considered, including feelings of loss, guilt, and responsibility, and a sense of divided loyalties--particularly in light of intense or violent parental conflict. And finally, recommendations are made to minimize the detrimental effects of family breakup on children: (a) allowing children choice and flexibility, (b) exploring the benefits of mediation for families, (c) promoting parental co-operation, and (d) encouraging an ongoing relationship with the nonresidential parent.
This article explores the use of mental health care services by ethnoracial people in Canada and distinguishes between the reasons for underutilization of services by ethnoracial groups and the barriers which prevent ethnoracial groups from accessing services. Research focusing on Canadian race relations is reviewed to reveal how they are paralleled in the functioning of mainstream mental health care organizations. Existing policies and attitudes are then considered in relation to how they support or impede interventions to increase accessibility to services. Finally, frameworks for organizational change based on multiculturalism and anti-racism are presented, and the advantages and disadvantages of both are articulated.
Asian Canadians consistently underutilize mainstream mental health services. This study investigates how the definition and meaning of mental illness relates to barriers Asian Canadians find in accessing mental health services. Personal interviews were conducted with 60 Asian Canadians in a northern community in the province of British Columbia. Content analyses revealed six themes that defined a mental health problem: (a) feeling a lack of purpose in life, (b) feeling lonely, (c) difficulties understanding and dealing with a new environment, (d) high anxiety levels, (e) descriptions of mental health problems as somatic illnesses, and (f) perceptions of mental illness as serious and potentially not treatable. It was also found that poor English language ability and a lack of understanding of mainstream culture were major barriers to accessing mental health facilities. Findings of this study provided valuable insights concerning Asian immigrants' hesitancy accessing and utilizing mainstream mental health facilities. The many poignant personal anecdotes illustrate that the migration and adaptation processes can be painful and full of anguish. Unless their experiences are better understood and accepted, many Asian Canadians will likely remain outside of the available mainstream mental health facilities.
This study gathered data from adolescent girls in four regions (Ottawa, North Bay, Toronto, Windsor) concerning key issues in the prevention of depression in young women. Using a participatory methodology, a team of young women worked with researchers to design and conduct focus groups with 48 adolescent girls across Ontario. Major themes emerging from the focus group data fell into five categories: (a) symptoms, (b) contributing factors, (c) alleviating depression, (d) prevention, and (e) barriers to receiving help. These findings should be considered when designing programs targeting depression in young women in order to maximize the accessibility and effectiveness of such initiatives.
Article 8 of the Act Respecting the Protection of Persons Whose Mental State Presents a Danger to Themselves or to Others (Québec, 1997) introduced a new legal framework requiring a linkage between police departments and crisis intervention services to prevent involuntary hospitalizations. Through telephone interviews, observation sessions, and documentary analysis, the authors studied the implementation of article 8 in 16 Québec administrative regions. Results pertain to organizational consequences for the health and police sectors and methods of collaboration between the two sectors. They cast light on the difficulties of implementing article 8 and suggest conditions for the success of initiatives aimed at reducing unjustified recourse to the legal system and hospitalization in cases of persons with mental health problems.
This article examines the use of action research strategies over a four-year period in developing and evaluating a prevention program for children and their families. This research has taken place in a low-income multi-cultural neighbourhood in Sudbury. Strategies to foster participation and the practical relevance of findings are described, both for the initial proposal development stage, and for the period after a local program was funded as part of a multi-site evaluation project. After reviewing the challenges inherent in doing action research within a multicultural neighbourhood, and within a multi-site design, we discuss which strategies have worked, and what remains to be resolved.
