Population surveys were conducted, examining nonpsychotic psychiatric symptoms, life events, and problems in community living in Primrose, a community experiencing rapid growth in anticipation of the construction of a heavy oil extraction plant, and in Wolf Creek, a stable rural town. Psychiatric symptom levels were lower in the boom town than in Wolf Creek, but the Primrose symptom levels were comparable to those in Saskatchewan. More life events were experienced by Primrose residents who, despite lower symptom levels, had seen their physician more often for minor illnesses. The complaints about living in the town of Primrose matched those of boom town residents from elsewhere. There was no evidence to support the popular view that living in a boom town creates more nonpsychotic psychiatric symptomatology. The higher proportion of the boom town population using physician services for minor illnesses, the higher level of life events reported, and the high frequency of reported problems for families living in the boom town support suggestions that stress is associated with these conditions.
BACKGROUND: Mentally retarded persons have high prevalences of psychiatric disorders and often receive little professional help for them. MATERIAL AND METHODS: From a total of 48 mentally retarded inhabitants in a local community, 28 were selected on the basis of possible psychiatric problems. A psychiatrist diagnosed the persons and gave advice based on personal observation, contact with caregivers, and all available documentation. RESULTS: The estimated levels of functioning were adjusted for 19 persons. 32 new psychiatric diagnoses were detected. Milieu changes were recommended for 25 persons, and 26 changes in psychotropic medication were recommended. INTERPRETATION: Although the procedure is workintensive, the results justify the described approach.
Mental health reform was introduced as a public-sector policy response to identified deficiencies in the mental health services system. The reform agenda, which is underway in most provinces/territories, calls for greater accountability to mental health consumers, their families, and other stakeholders. This paper summarizes the major policy goals (which are the cornerstones of mental health reform) and suggests a series of high-level indicators to assess performance toward achieving these goals. Issues in the selection and measurement of performance indicators as markers of key goals are discussed. The proposed indicator set, while not a comprehensive framework, can provide a multi-dimensional appraisal of mental health system performance and help keep reform on course.
The Quebec Child Mental Health Survey (QCMHS) was conducted in 1992 on a representative sample of 2400 children and adolescents aged 6 to 14 years from throughout Quebec. Prevalences of nine Axis-I DSM-III-R (American Psychiatric Association, 1987) mental health disorders were calculated based on each informant (for 6-11-year-olds: child, parent, and teacher; for 12-14-year-olds: child and parent). Informant parallelism allows the classification of results of the demographic variables associated with disorders in the logistic regression models. This strategy applies to group variables (correlates of disorders) whereas informant agreement applies to individual diagnoses. Informant parallelism implies that results for two informants or more are in the same direction and significant. In the QCMHS, informant parallelism exists for disruptive disorders, i.e. in two ADHD regression models (child and parent) higher rates among boys and young children, and in three oppositional/conduct disorders regression models (child, parent, and teacher) higher rates among boys. No informant parallelism is observed in the logistic regression models for internalizing disorders, i.e. the patterns of association of demographic variables with anxiety and depressive disorders vary across informants. Urban-rural residence does not emerge as a significant variable in any of the logistic regression models. The overall 6-month prevalences reach 19.9% according to the parent and 15.8% according to the child. The implications of the results for policy makers and clinicians are discussed.
BACKGROUND: Co-operation between mental health care units and the social services is important in the case of people with social problems who also suffer from mental health problems. However, participation of patients and their families in the treatment process, and co-operation between them and the professionals, are also important. Communication between the professionals, patients and their family members, and the professionals is a crucial factor for co-operation. AIMS AND OBJECTIVES: The aim of this study was to elucidate the experiences and importance of co-operation for the patients. The data consisted of interviews with 22 mental health patients who were also clients of municipal social services. METHOD: The grounded theory approach was used, focusing on the informants' experiences of the integrated network and family-oriented model for co-operation. RESULTS: The findings indicate the importance of the participation of patients and their social networks in psychiatric care or the treatment process. Meetings should be characterized by open and reflexive discussions with all participants' points of view being included, so that fruitful co-operation is possible. However, some negative experiences were also reported, all of which were connected with the professionals' behaviour. CONCLUSIONS: Trust and honesty are essential elements in relations between professionals and psychiatric patients, but it cannot be assumed that they will develop naturally. It is the professionals' responsibility to adjust their behaviour so that these elements can be created in a mutual process between patients and professionals. Multidisciplinary teams are a necessity in family-oriented co-operation between psychiatry and social services, and in a satisfactory caring process. RELEVANCE TO CLINICAL PRACTICE: Nurses' work is often individually oriented and nurses are ruled by routines in their work. The mental health caring process should be seen as a shared process between the patient, his/her human environment and professionals for which nurses need skills to their interaction with patients and their social network.
Mental health of parents and their quality of life is likely to be affected when a child in the family has a psychiatric disorder. The purpose of this study is to assess quality of life and mental health of parents of referred children waiting for service at the only child psychiatric service in Iceland, with reassessment at least 3 months after first attendance to the service. In order to do so, 208 parents of 123 children waiting for psychiatric care were sent the Icelandic Quality of Life (IQL), the General Health Questionnaire (GHQ-30) and the CAGE screen for alcoholism. For reassessment, responders in the first phase were assessed again with the IQL and GHQ-30, at least 3 months after initiation of child psychiatric interventions. A total of 120 of the 208 parents (58%) responded in the first phase of the study, 49 fathers and 71 mothers. The mean (+/- s, standard deviation) standardized IQL T-score was for the fathers 51+/- 7.5 but significantly lower for the mothers or 45 +/-11.5 (P = 0.001) compared to normal sample of same-age women (T-scores of 50 are normal). Nearly 55% of women compared with 26% of men were psychiatric cases, scoring 5 or higher on the GHQ. According to a CAGE score of 2 and above 16% of fathers and 14% of mother abused alcohol. No significant change occurred in parents GHQ-30 or IQL before and after initiation of treatment. We conclude that mothers of children with mental disorders have poor quality of life, and high prevalence of mental disorders; hence child psychiatry clinics need to ensure that mothers receive appropriate care along with the child.
Sami children and adolescents are the indigenous youngsters in Norway, mainly resided in the arctic part of the country. While disadvantaged living conditions, risk behavior and psychososial health problems has been shown for children and youth from many indigenous groups worldwide, the research among Sami youngsters is sparse. However, recent research show that compared to the Norwegian majority group, Sami children and adolescents have just as good mental health as their majority peers. They also show less risk taking behavior as substance and drug use, have less eating problems and have a stronger body satisfaction. However, the smoking rates are high as for their Norwegian counterparts. Intragroup studies show that Sami adolescents grown up in Sami dominated areas, have a strong bicultural identification, are practicing more Sami cultural behavior and have a better mental health compared to Sami peers in marginal Sami areas. Ethnocultural factors have only a slight impact on behavior problems among young Sami and particularly among boys in the marginal Sami areas.