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- OPEN ACCESSThis paper describes the development and psychometric testing of the Substance Use Wellness Tool, created to help raise awareness about alcohol and other substance misuse among university undergraduates. The tool is a self- and peer-reflection guide that students can use to monitor and alter their patterns of substance use. Exploratory and confirmatory factor analysis showed that the tool was unidimensional and that all 13 assessed domains were important. Cronbach’s alpha indicated the tool was highly reliable. Construct (convergent) validity for alcohol use with the 10-item AUDIT was also good, with strong correlations overall and within subgroups defined by gender, year of study, and university site.
- OPEN ACCESS
- Ivy-Lee L. Kehayes,
- Amanda Hudson,
- Kara Thompson,
- Christine Wekerle,
- Heather Stuart,
- Keith Dobson,
- Terry Krupa, and
- Sherry H. Stewart
Alcohol intoxication is often involved for both victims and perpetrators of sexual victimization. Yet, alcohol-involved sexual victimization research has mainly focused on female victims, excluding male victims. The current study addresses gaps in the literature by focusing on sex differences in the emotional harms (anxiety and depression symptomatology) experienced by sexual victimization victims when either the perpetrator or victim was drinking. Five-hundred-and-ten undergraduate drinkers (153 male; 357 female) participated. Models included two dichotomized predictors that occurred during participants’ first year of university (sexually victimized when the victim was drinking, sexually victimized by someone who was drinking), and two emotional outcomes (anxiety, depression). Age was controlled in all path analyses and sex was examined as a moderator. When predictors were examined in separate models, both predictors were associated with increased anxiety but not depression. These effects were significantly stronger among men. When both predictors were entered simultaneously, individuals who were victimized by someone drinking displayed increased anxiety, and this relationship was stronger among men than women victims. Being victimized when drinking was no longer associated with anxiety, consistent with prior findings that post-traumatic distress may be minimized when a trauma occurs while the victim is intoxicated. Results highlight the impact sexual victimization can have for both male and female victims, and point to the need for evidence-based policies to prevent emotional second-hand alcohol harms among male and female students alike. - OPEN ACCESSThis paper describes a project that took place at three large Canadian universities aimed at engaging male students to address alcohol misuse and associated mental health issues through a gendered and campus culture lens. Although considerable effort has been put into decreasing alcohol misuse on campuses, most of this effort has been aimed at individual factors, rather than targeting the cultural and gendered context through which most post-secondary students consume alcohol. Gender transformative and gender sensitive health promotion approaches were guiding frameworks for the project. In addition to discussing how gender theory was implemented in a post-secondary context, this paper also explores some of the key features that guided these projects including the Summit Model, social marketing, sharing narratives of alcohol misuse and mental health, and planning for sustainability. Key lessons learned in engaging male students to be involved in challenging gendered norms related to alcohol misuse on campus are discussed.
- OPEN ACCESSThe social norms approach to changing excessive drinking behaviour is predicated upon findings that overestimations of peer drinking predict one’s own drinking behaviour. Prior studies have yet to examine whether such social norms effects pertain equally to both genders. First-year students from a Canadian university (N = 1,155; 696 males, 459 females) were assessed for the relationship between misperceived drinking norms and hazardous drinking using the Alcohol Use Disorder Identification Test-Consumption scale (AUDIT-C). A significant positive relationship between the overestimated drinking frequency norm and hazardous drinking was determined for female students, where the odds of hazardous drinking increased by 1.92 (95% CI: 1.32–2.79) when the norm of other female students was overestimated. A non-significant association was found for male students, where the odds of hazardous drinking were unrelated to overestimation of the drinking norm of other male students. The null association for male students highlights a potential problem when using social norms interventions for alcohol reduction for males in the university context. Implications of these results for the utilization of the social norms approach to alcohol reduction are discussed.
- OPEN ACCESS
- Heather Stuart,
- Shu-Ping Chen,
- Terry Krupa,
- Tasha Narain,
- Salinda Horgan,
- Keith Dobson, and
- Sherry Stewart
The Caring Campus project was a three-year intervention research project funded by Movember Canada that fostered new awareness regarding the interconnection between gender, mental health, and substance (specifically alcohol) misuse on three university campuses in Canada, and encouraged new approaches to promote young men’s health. In this project, we demonstrated that male students are willing to assume leadership roles to promote mental health and healthier alcohol use to their peers and enact a social agenda for change. Empowerment strategies encouraged male students to enlist like-minded peers to advance men’s mental health and transform campus drinking cultures, including countering gender-based ideals and norms associated with mental health problems and substance misuse. There is now great potential to influence the way in which other post-secondary institutions approach mental wellness and substance misuse using the Caring Campus model, which uses student empowerment to catalyze change. - OPEN ACCESSThe United Nations Convention on the Rights of Persons with Disabilities (CRPD) is often recognized as emphasizing a “universalist” approach to difference that discourages the identification and segregation of particular groups based on their characteristics. This emphasis raises questions about Canada's Mental Health Courts (MHCs) and court-diversion programs that identify and respond to people with mental disabilities as a group and can be seen to reflect a “minority rights” approach to the accommodation of difference. These questions need to be addressed to ensure that Canada complies with its international obligations under the CRPD.
- OPEN ACCESSWe evaluated service access and match in Southeastern Ontario following community mental health funding increases using repeated samples drawn before and after the enhancements. Access to care increased by an estimated 12% (350 clients) between 2001 and 2006, but only about a third of clients were appropriately matched to their needed level of care. Service match increased slightly after the funding increases, but changes were non-statistically significant. Almost half of the clients remained underserviced and 20% were overserviced, suggesting that a more targeted and systematic approach to care planning is necessary to shift systemwide resources to client groups who are in the greatest need.
- OPEN ACCESSThis study presents findings of an evaluation of a community-based crisis service that used systems enhancement funding to modify services. In addition to developing timelier crisis services and increasing mobile capacity, the service adaptations focused on broadening the scope of the crisis service and addressing the follow-up needs of individuals served. While service development was guided by the research and best practice literature, there was little guidance available on how to address the latter two goals. The development of a transitional case management model integrated with crisis services was an innovation in service delivery. The evaluation used existing databases to compare crisis service delivery between two distinct periods (i.e., “old model” vs. “new model”). Study findings suggest that the new model did lead to the expected changes in service utilization patterns, specifically to increased service capacity, greater access to mobile crisis services, improved access to a broader community population, and more appropriate patterns of service delivery with respect to fewer days of crisis service and exit dispositions more consistent with crisis resolution. Rankings of acceptance of the new crisis service by the local service network varied greatly across service sectors, suggesting the need for more strategic community outreach efforts. The findings indicate that policy and funding opportunities within the mental health system need to be flexible and sensitive enough to address emerging issues in the field and to facilitate service innovations.
- OPEN ACCESSThe integration of treatment and psychiatric rehabilitation in mental health services is challenging to realize but essential for a mental health system that has endorsed recovery as its guiding vision. This paper advocates the use of tensions in practice as a means of reconciling integration issues and advancing recovery-oriented service delivery. The paper follows with three scenarios of daily tensions in practice that serve as a foundation for analyzing and ultimately reconciling tensions in integration. Finally, six guidelines covering a range of organizational, administrative, financial, and service delivery perspectives are provided to guide the development of integrated treatment and rehabilitation toward a recovery-oriented system.
- OPEN ACCESSThis qualitative study examined the delivery of Assertive Community Treatment from the perspective of service providers of 4 ACT teams in southeastern Ontario. Overall, providers were positive about their involvement with ACT. Eight tensions experienced in the context of delivering services emerged: negotiating governance structures; providing 24-hour coverage; balancing the clinical-administrative responsibilities of team leaders; accessing hospital beds; meeting local population needs; integrating treatment and rehabilitation; changing services to meet changes in the population being served; and implementing ambiguous ACT standards. Framing these challenges in the context of ACT structures and the broader community mental health system, the study suggests possibilities for the ongoing development of the model to facilitate the realization of the ACT vision.
- OPEN ACCESSOne hundred and eighty persons with serious mental illness (SMI) in eastern Ontario, receiving services from assertive community treatment teams in Brockville and Kingston were interviewed about substance use. Data were compared to survey findings for the Ontario population. Tobacco use was higher among both men and women in the SMI sample, but use of alcohol and drugs in the past 12 months was lower than population data. The frequency of alcohol use was significantly greater than drug use among the SMI sample.
- OPEN ACCESSVoices, Opportunities & Choices Employment Club (VOCEC) is a nonprofit “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.
- OPEN ACCESSThis research study portrays work initiatives for persons with serious mental illness in Canada. It considers 2 earlier papers on vocational programs and services to point out developments and current status in the field. Through a content analysis of documents collected from work initiatives across Canada, core values, models, and practices in the area of work integration are presented. Findings point to a consistent belief in the capacity of consumers to develop their work potential, to engage in the labour force, and to experience the many benefits of work. Results also reveal evidence of an increased emphasis on consumer initiatives, partnerships within the community, and negotiation of environmental factors, including workplace accommodations. Examples of work initiatives are provided, and suggestions for further research are offered.
