Volume 32 • Number 3 • September 2013
Articles
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Reversed Shared Care in Mental Health: Bringing Primary Physical Health Care to Psychiatric Patients
Because of the significant comorbidity between mental and physical health conditions, it is imperative that access to high-quality primary physical health care be available for those with severe mental illnesses. Recognizing a gap in care, North York General Hospital (NYGH) developed and piloted a new service that built on the benefits of collaborative and shared care and the importance of co-location and service integration. In this reversed shared care clinic, access to primary physical health care was provided to patients of NYGH 's mental health department. Descriptive findings demonstrate the implementation of the service and patient demographics.
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The present study assessed the effects of an intervention that was designed to provide on-site, predischarge housing assistance for psychiatric clients. Participants included clients from acute (n = 219) and tertiary (n = 32) care hospital sites. Data were collected from hospital and shelter databases. Results revealed that in the majority of cases, the intervention reduced the number of individuals discharged to homelessness or no fixed address. In addition, the costs of implementing and maintaining the intervention were less than the increased medical costs associated with homelessness and housing individuals in shelters.
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Les études montrent avec constance que les mères d'enfants ayant un trouble du spectre de l'autisme (TSA) présentent des niveaux particulièrement élevés de détresse. Cette étude vise à identifier les déterminants sociaux de la santé pouvant contribuer au développement des symptômes dépressifs de ces mères. Les analyses statistiques effectuées sur un échantillon de convenance de 112 mères de jeunes enfants ayant un TSA conduisent vers un modèle composé de 5 variables permettant conjointement d'expliquer 41 % de la symptomatologie dépressive des mères. Les implications de ces résultats sur les services offerts aux familles d'enfants ayant un TSA seront plus amplement discutées.
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This qualitative study asked individuals with schizophrenia to identify environmental factors in a psychiatric facility that influence their diet, physical activity, and ultimately weight. Participants took photographs of environmental elements they perceived to be obesogenic within the hospital and then participated in a semi-structured interview during which they were asked about the identified environmental elements. The Analysis Grid for Environments Linked to Obesity (ANGELO) framework was used for the analysis of data. Participants recommended individual and environmental approaches to address obesity. The ANGELO framework is a useful tool for identifying obesogenic factors, a process that can inform environmental interventions in psychiatric settings.
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With the advent of online mental health care, concerns related to online practice are emerging among mental health professionals. This paper assesses and organizes the current status of several professions in Canada—including medicine, nursing, psychology, counselling, and social work—on the issue of practice via the internet, so that these professions may be productively compared and considered. Psychology, social work, and counselling have few stated e-health policies within their regulatory colleges, and those that do exist are conservative and tend towards restricting mental health practice online. The remaining hurdle for e-health, including online psychosocial care development, is cross-provincial practice—which, in turn, appears to rest on the definition of “where therapy resides” in the event of legal action.
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La recherche psychologique sur l'expérience universitaire des mères monoparentales de minorités visibles s'avère presque inexistante. C'est pourquoi la présente étude explore les facteurs de risque et de résilience associés à leur adaptation et leur succès scolaire, à l'aide d'une recherche participative favorisant l'utilisation de méthodes mixtes (2 questionnaires, soit la Mesure de stress psychologique et l’Échelle de satisfaction de vie, et des entrevues de groupe). Huit mères étudiantes ont participé à un premier groupe focalisé. Ces séances de discussion ont ensuite été analysées qualitativement selon l'approche phénoménologique interprétative (API). Une fois les résultats préliminaires obtenus, les participantes ont été convoquées à un second groupe focalisé pour valider ces derniers. À la lumière de ce processus de recherche participative, 2 thèmes émergent de leur discours: (a) l'expérience maternelle et (b) l'acculturation, soit l'adaptation et l'intégration à la société d'accueil et au milieu universitaire. Ces résultats ont été mis en commun avec ceux des questionnaires, révélant un faible niveau de stress psychologique et un niveau moyen de satisfaction de vie. La théorie du cours de la vie et le modèle écosystémique nous servent de cadre de référence dans l'interprétation des résultats.
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The occupations of a mother are significantly disturbed or restricted when her child is diagnosed with schizophrenia. Emerging family-centred practice models consider the role of mothers as caregivers, but do not adequately address their personal needs. This qualitative study explores the occupational challenges faced by mothers as they navigate the experience, highlighting the impact of the devastating experience of having a child diagnosed with schizophrenia, and draws attention to the need for improved methods of knowledge translation if research findings are to better guide services for them.