Canadian journal of community mental health = Revue canadienne de santé mentale communautaire

Published by NRC Research Press
Online ISSN: 0713-3936
Publications
Article
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."
 
Article
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.
 
Article
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.
 
The classification of misdemeanors (a "misdemeanor sheet") used at the Regal Road School project during the academic year 1926-1927. From "Studies in the Mental Hygiene of Children I. Behavior of Public School Children: A Description of Method," by W. E. Blatz and E. A. Bott, 1927, Pedagogical Seminar and Journal of Genetic Psychology, 34, pp. 562-563. Copyright 1927 by Clark University Press. Reprinted with permission.
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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).
 
Article
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.
 
Article
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).
 
Article
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.
 
Article
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.
 
Article
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.
 
Article
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
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.
 
Article
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.
 
Article
In Ontario, many people are calling for recovery to become the overarching philosophy and goal of the mental health system. Mental health service organizations are key to promoting recovery, but relatively little has been done to understand what recovery means at the organizational level. This paper describes the context, conduct, and findings of a participatory action research project designed to explore recovery in Alternatives, an organization in Toronto providing mental health services.
 
Article
This article examines the question of how universities can be encouraged to address the mental health concerns of GLBT-SQ people and communities from a perspective of solidarity. In so doing, the authors take a case study approach, using Project Interaction: The Gay, Lesbian, Bisexual and Two-Spirit Initiative of McGill University's School of Social Work, to critically reflect upon the challenges arising from the development of an alternative organization within academia. The purpose of this reflection is to highlight how normal operations at work on university campuses, and within health and allied health curriculum, can be disrupted with the goal of providing momentum for the creation of affirmative space, the advancement of educational initiatives, and the building of opportunities for social change.
 
Article
Within the Regional Plans for the Organization of Services, Quebec's mental health reform has tried to redistribute power and influence to mutual aid groups for consumers and their families. However, it has failed to provide them with the financial resources that would allow them to exert that new power. The groups don't have enough personnel to fill the decision-making positions accorded to them under the regional plans while, at the same time, continuing to provide services to consumers. Real partnership requires equality in resources. Social integration being the product of an interaction between consumers and citizens, citizens are the forgotten actors of the interaction. We fail to support them when they are faced with behaviours that they find strange and disturbing. Attitudinal and behavioural changes are interrelated and concomitant; that is, the transformation of citizens' prejudice into acceptance is helped by consumers' efforts to adopt less offensive behaviours.
 
Article
Current understanding of youth aged 15-24 experiencing mental health problems is limited. Through a qualitative analysis of the subjective experiences of 7 male and 6 female youths, 4 core categories emerged as stages that described the participants' process of mental illness: emergence, loss, adaptation, and recovery. Results showed that youth experiencing mental health problems felt stigmatized and labelled, and experienced multiple losses of identity, family, career choices, and educational and social standing. Participants reported that having mental health problems disrupted their transition from adolescence to young adulthood; however, these data reveal how youth adapt and recover. Implications of the findings in this study will be useful in identifying youth-focused interventions that may help professionals assist youth more effectively in their recovery process.
 
Article
This article presents the results of an exploratory study funded by the Social Sciences and Humanities Research Council of Canada. The objectives of this research were to explore (a) the perception by elderly women caregivers of the shift to ambulatory care; (b) their use of coping behaviours in the face of this major change within the health care system; and (c) their perceptions of health care services. In a theoretical framework of stress and coping, and using standardized questionnaires and open-ended questions, 40 home interviews were initially conducted with elderly women, each of whom was caring for her spouse after his discharge from hospital. Additional data were collected through focus groups. Quantitative and qualitative analyses revealed that elderly women caregivers perceive ambulatory care in a positive manner and as a change involving challenges only when they feel in control of the health care situation and when the care does not necessitate specialized abilities. When the care to be provided is complex and requires continued involvement and specific competence on the caregiver's part, the situation results in insecurity for elderly women. Caregivers use cognitive coping strategies to deal with their problems and are not inclined to use formal services in their social support network. Participants in this study wished to be better informed about the health care system in general ("how the system works") so that they could acquire a sense of predictability. Other expectations of elderly women caregivers concerned the importance of continuity in health services delivery, better preparation for the transition from hospital to home and availability of psychological support for themselves. These results suggest a critical analysis of the present paradigm guiding health care services, in which family caregivers are considered as resources or coworkers instead of coclients.
 
Article
In Ontario, those dependent on substances are no longer eligible for welfare payments based on an addiction disability. While the impact of this program has not been assessed, evidence from a similar policy shift in the USA suggests deleterious effects on the health and social functioning of about half of those who lose this form of social support. A review of the research on the chronic-illness view of addiction, the fostering of stigma by exclusionary social policies, and the negative effects on mental health and homeless status associated with the loss of welfare benefits leads to the conclusion that this is an ill-advised policy for Ontario. Its continuation there, and its extension to other provinces, is not recommended.
 
Article
Concerns still exist among lesbian-, gay-, bisexual-, transgendered-, and queer-identified individuals (LGBTQ individuals) about their reception and treatment by psychiatric service providers. The Psychiatric Service at the University of Toronto and the Office of LGBTQ Resources and Programs convened a committee to address expanding the capacities of the Service related to the needs of LGBTQ and questioning students. In this paper, we describe the committee's role, initiatives, and successes and discuss challenges encountered in the process. The model of community development drawn from in this work can be adapted for use in other community health settings.
 
Article
Many studies indicate that a large number of addicts commit crimes and, conversely, many offenders are addicts. Individuals who fall into both these categories show clear bio-psychosocial problems. With few resources at their disposal, professionals from both the Department of Health and Social Services and the Department of Public Security feel uncomfortable trying to help these individuals. This study presents the results of 6 focus groups on the types of services that should be offered to addict-offenders. Results indicate that proper assessment of the addiction and the addict-offender's motivation to undertake rehabilitation is essential. Another crucial element is an open channel of communication among the various professionals involved in the case management and treatment of these individuals. Finally, a good reference system is needed. However, the authors insist on the caution that must prevail when control and help are provided together in a concerted effort.
 
Article
In September 1997, a new family mediation law came into force in Quebec. This law allows couples with children to be provided with the services of a professional mediator while their application for separation, divorce, child custody, spousal or child support is being negotiated and settled or an existing decision is being reviewed. This article presents and discusses the results of a study that compares the practices and results of family mediation under this law with the previous situation. According to the data, the law provides greater access to mediation for low-income couples.
 
Article
The main purpose of this study was to compare psychological and social problems among chronically ill school-aged children to those observed in a group of healthy children of the same age. On the basis of the data collected, it was also possible to compare self-perception and social functioning problems between the 2 groups of children, as well as to identify the contributing factors explaining the observed differences in psychosocial adaptation between these 2 groups. Three measures were used to assess psychological and social problems. Mental health problems were measured by the Dominique (Valla, Bergeron, Bérubé, Gaudet, & Saint-Georges, 1994). Self-Perception and Social Functioning were assessed by the Self-Perception Profile (Harter, 1985) and the Rating Scale of Child's Actual Behavior (Harter, 1985). Information on characteristics of the child and his or her family was also collected. Sixty children aged 6 to 11 and diagnosed as having juvenile diabetes or asthma, 59 control children, and the children's parents participated in this study. A chi-square test and multivariate analysis of variance were used to compare the 2 groups of children. Results indicate that children with diabetes and asthma do not present more psychological and social problems than other children of the same age. Results also suggest that age is the only variable indicating a higher proportion of mental health problems among chronically ill children. Results are discussed and compared to those of previous studies from which the conceptual frame-work of this study was developed.
 
Article
This study was undertaken to gather information on the social representations of teenage pregnancy among adolescents, aged between 15 and 17. Eighteen focus groups were conducted among 150 boys and girls. The data were subjected to a qualitative content analysis. Results show that youths did not form homogeneous groups. The points of view expressed gave rise to 4 dimensions (emotive, reflexive, psychobiological, economic-social) and 4 positions (negative, positive, ambivalent and dynamic). From these dimensions and positions, 4 representations of teenage pregnancy were identified: pregnancy as a problem, pregnancy as a project, pregnancy as a source of tension, and pregnancy as a source of power. This study illustrates the importance of educative strategies such as going beyond alarmist preventive messages, opening dialogue with and between youngsters, and promoting social support and mutual aid.
 
Article
The aim is to report on the development and preliminary validation of an instrument, VIFFA (Violence faite aux Filles dans les Fréquentations à l'Adolescence), on female victimization in the context of dating violence in adolescence. Objectives are twofold: to document the psychometric qualities of this self-report and to propose an instrument adapted to the context of young teens. The instrument refers to concepts of physical, emotional, and sexual abuse. Questioning in two phases is used to achieve proper understanding of the concept studied and to help select the partner to whom they refer in the second detailed phase. Girls were questioned on violence sustained and boys on violence inflicted. The total sample included 331 boys and 377 girls; their mean age was 14.6 years. A social desirability questionnaire was used to evaluate discriminant validity and the results indicate that the adolescents' answers were not distorted by social desirability. The factorial analyses resulted in 4 slightly different factors for girls and boys. With regard to the girls (violence sustained), the factors included Verbal and Emotional Abuse, Physical Abuse, Control through Jealousy and Sexual Abuse. With the boys (violence inflicted), the factors were Psychological Abuse, Jealousy and Sexual Abuse, Severe Physical Abuse and Minor Physical Abuse. Validation studies indicate that the instrument has adequate psychometric qualities and is adapted to the context of adolescence. An innovative aspect is the place given to items concerning jealousy.
 
Article
In the past two decades there has been a significant increase in adolescent pregnancy and childbearing across North America. Research has shown that both mother and child remain at high risk for physical, psychological, social, and economic consequences of premature parenthood and its accelerated role transition. Although considerable research has examined adolescent parenthood, the literature lacks theoretical integration. The stress and coping model is proposed as a theoretical context to explain developmental outcomes of adolescent motherhood. This model suggests that diminished psychological and social coping resources of adolescent mothers influence negative parent-child interactions and result in ineffective parenting behaviours concomitant with parenting stress, thus increasing the likelihood of high risk outcomes for both parents and children.
 
Article
Seventy at-risk adolescent girls in 7 residential facilities were interviewed over a 12-month period. The girls were asked questions regarding experiences, thoughts, and feelings about physical and verbal fights with friends and parents. Results showed that many of these girls reported different reasons for starting and escalating verbal and physical fights, they had more negative feelings for verbal fights than for physical fights, and had similar thought processes during both kinds of fights. More girls acknowledged responsibility for starting fights with parents than they did with peers. Implications of the results for treatment of female young offenders and the development of public policy are discussed.
 
Article
This paper discusses a period in the life of a stepfamily that has not been widely studied until now: the period immediately preceding and immediately following the move towards a blended family. This period is studied from the viewpoint of adolescents living through it. Here, the blending of a family is examined as a family transition; its "paranormative" character brings up issues that pertain especially to the children's adjustment. Twenty-six semistructured interviews were carried out with adolescents between the ages of 11 and 17. Among the main results was the observation that 2 events in particular mark this transition: the announcement of future cohabitation and the cohabitation itself.
 
Article
A number of studies have established that adolescents are attracted to games of chance and gambling, and have confirmed that excessive gambling is not a phenomenon of adulthood alone. In Quebec, the proportion of high school students who are struggling with gambling problems is estimated at 2.6% (Ladouceur, Boudreault, Jacques, & Vitaro, 1999). So far, few researchers have studied adolescent populations that are at greater risk of developing gambling problems. The present study was carried out among 104 adolescents in difficulty, ranging in age from 12 to 19 and served by the Centre jeunesse de Québec. It assesses the prevalence of excessive gambling and the problems associated with it. The results indicate that 92.3% of adolescents had bet at least once during the previous year and 40.4% bet every week. The prevalence of excessive gambling was established at 7.7%. Girls were found to gamble as frequently as boys and to experience as many gambling problems. In addition, habitual gambling was found to be associated with the consumption of psychotropic substances, delinquent behaviour and school absenteeism. The discussion puts the results obtained in perspective and emphasizes the need for establishing gambling prevention programs among at-risk youth.
 
Article
The needs of lesbian and gay adolescents for service provision are discussed in this paper. These needs are identified through research investigating milestones in the coming-out process. In addition, the way in which the research results influenced community development initiatives is described. The social context in which the research was conducted is also described.
 
Article
Stakeholders in rural and mid-size urban communities were asked to share their views concerning factors that affect the mental health of older adults, and indicate how, and how well, these factors were addressed in their community. The identified factors clustered into six categories: clinical, physical, organizational, educational, psychosocial, and spiritual. Additional factors impacting care providers and caregivers and their ability to support the mental health of older adults also emerged. Similarities and distinct differences between rural and urban communities were reported and call for innovative strategies to meet the needs of seniors, particularly those living in rural areas.
 
Article
The purpose of this research is to examine the effectiveness of a project aimed at the vocational rehabilitation of individuals suffering from chronic psychiatric disabilities. Gastown Vocational Services (GVS) is a specialized vocational rehabilitation program, under the auspices of Greater Vancouver Mental Health Service Society. The project consisted of three distinct phases and utilized a gradual, step-by-step rehabilitative approach to achieve vocational success. The first phase of the GVS project included comprehensive vocational assessment and work-readiness skill training. Participants in this phase met in small groups for three hours, three times a week for a 12-week period. The second phase involved supported work-experience placements in the community. These placements were two to five months in duration. The final phase included assistance in seeking employment, job re-training, or educational programs. Assessment measures were taken before participants began the program, immediately after the 12-week job preparation program, and at six-month follow-up. Seventy-three individuals participated in the training program over a two-year period. Their progress was compared to 18 individuals comprising a Waiting List Control group. The results showed significant improvement in the Intervention group on measures of assertiveness, work behaviour, depression, income, and employment status. No changes were evident in the Waiting List Control group.
 
Article
This study explored the service needs of families with a parent with an affective illness. Focus-group and individual interviews were conducted at selected locations across Canada with individuals who had an affective disorder, their partners, and their adult children. A total of 67 participants were recruited. Corresponding service providers were mailed a questionnaire which asked information regarding these families' needs, the service provider's role with these families, and what prevented or assisted them in addressing those needs. A total of 419 service providers participated in the study. There was congruence between family-identified needs and the needs identified by service providers. However, there remains a large disparity between the knowledge of needs and having these needs met. The results of this study identify the gaps in service provision and make recommendations for changes in the areas of service, education, and policy-making.
 
Article
Voices, Opportunities & Choices Employment Club (VOCEC) is a non-profit "umbrella" corporation that facilitates the development of affirmative businesses to create jobs for consumers of mental health services. To date, 5 independent businesses have been developed by transforming the resources of sheltered workshops within Kingston Psychiatric Hospital and 2 businesses have been established in collaboration with a local public library. This paper provides a description of VOCEC, including an overview of the affirmative business approach, the structure of the organization, and the process of business development. Personal reflections provide insights into the experiences of consumers, staff, and Board members associated with the corporation.
 
Article
The present survey examines the barriers associated with the delivery of mental health services to the elderly as perceived by mental health professionals. The sample consisted of 139 professionals of the New Brunswick Mental Health Commission. The results reveal that the mean percentage of elderly clients in the practice of mental health professionals is low. The percentage of elderly clients in the practice of mental health professionals was positively correlated with training in gerontology. The attitudes of the respondents toward the elderly were either positive or neutral rather than negative. In addition, the results show that the barriers perceived by the professionals to explain the low utilization rates differ in order of importance from those acknowledged by the elderly. The lack of human resources was identified as the major barrier to the development of specific consultation services to the elderly. Finally, the implications of these results for the development of mental health consultation services for the elderly are examined.
 
Article
The main purpose of this study was to obtain an overview of consumer/survivor participation in the operation of community mental health agencies in Metro Toronto. This article describes, from the viewpoint of agency executive directors, the nature and extent of consumer/survivor involvement and the difficulties encountered in implementing it. It appears that while involvement is increasing in specific, measurable ways in many agencies, the actual impact of consumers/survivor input on agency philosophies, policies, and practices is, at best, unclear. Agency directors tend to account for this in terms of the failure of consumers/survivors to "fit in" and meet agency expectations. Drawing on the literature on consumer/survivor involvement, the author suggests that the more fundamental problem is the continued imbalance of power between consumers/survivors and agency staff and the failure of agencies to create an environment conducive to meaningful consumer/survivor participation. There is, however, a high degree of interest in receiving support to address the issues encountered in developing partnerships with consumers/survivors.
 
Article
This paper aims to illustrate and emphasize the relevance of Frank Riessman's futurist new paradigm for human services which proposes a restructuring that enables those who ordinarily receive help to function as providers of help. Some of the best known mutual-aid programs are briefly presented, followed by a more detailed description of pilot projects which have used the mutual-aid principle with multi-problematic clientele. Most of these pilot projects took place in the province of Québec and aimed at bridging the gap between public services and local communities by linking with informal support systems. Two specific modalities of mutual aid are discussed: pairings between clients and pairings between clients and natural helpers. The integration of mutual-aid strategies within clinical practice is not easy because of the important changes it requires of the professional both at the practical and the organizational level.
 
Top-cited authors
Geoffrey Nelson
  • Wilfrid Laurier University
Harvey Skinner
  • York University
Debra Pepler
  • York University
John Lord
  • Centre for Community Based Research, Kitchener, Ontario, Canada
Christopher Bagley
  • University of Southampton