The ability to detect mental disorders varies greatly among general practitioners in primary health care. The aim of this study was to determine the factors underlying the differences between general practitioners in the ability to recognize mental disorders in Finnish patient populations. The group studied consisted of 1000 randomly selected adult patients of primary care facilities in the city of Turku. The Symptom Checklist (SCL-25) was used as the reference method in the identification of psychiatric cases. According to the SCL-25, one fourth of the sample had mental disorders. A good recognition ability was associated with postgraduate psychiatric training and qualification as a specialist in general practice. Surprisingly, Balint group training, which is a method intended to improve the ability of general practitioners to manage their patients' mental health problems, was associated rather with poor than good detection ability.
To systematically survey Alberta psychiatrists and lawyers regarding their knowledge of, attitudes toward, and experiences with the Criminal Code provisions regarding mentally disordered offenders to better understand the lack of impact in practice patterns.
A survey design was used, and 2 questionnaires, 1 for lawyers and 1 for psychiatrists, were developed and mailed out.
Out of 245 surveys sent to psychiatrists, 141 were returned, giving a response rate of 57%. The number of lawyers practising criminal law could not be determined, and 5273 surveys were sent to all lawyers on the Law Society of Alberta mailing list. Of these, 564 were returned, giving an overall response rate of 11%. The response rate for lawyers practising criminal law is unknown. Overall, lawyers were younger than psychiatrists. Most of the respondents in both groups were men. Overall, attitudes toward offenders with mental illness were very similar among lawyers and psychiatrists. Compared with lawyers, psychiatrists had significantly more correct responses to the items assessing knowledge. With a highest possible knowledge score of 27, the average score was 16 (SD 5.7) for psychiatrists and 13 (SD 7.23) for lawyers.
The lack of familiarity with many of the key provisions among psychiatrists and lawyers is worrisome and suggests the need for educational materials to improve knowledge of the Criminal Code provisions governing mentally disordered offenders.
To generate hypotheses regarding influential factors that have contributed to the practice of geriatric psychiatry by geriatric psychiatrists.
Using the Delphi technique, designed to generate ideas and consensus, a sample of members of the Canadian Academy of Geriatric Psychiatry (CAGP) was asked to provide ideas on what factors were influential in their decision to devote a significant part of their practice to geriatric patients. These items were then synthesized into a questionnaire and rated for their degree of influence by the same group of psychiatrists.
A total of 41 items were rated according to their degree of influence. The most influential items were related to geriatric psychiatry residency training experiences that were perceived to be positive or adequate. Supervision characteristics and interest in the medical psychiatric nature of the field were also deemed influential.
This study generates the hypothesis that the nature of the educational experience during psychiatry residency has a significant influence on the practice of geriatric psychiatry.
The Swedish Psychiatric Association, in collaboration with the Department of Psychiatry, University of UmeÃ¥, Sweden, and the Pan American Health Organization/WHO, has obtained economic support from the Swedish Agency for International Development (ASDI), to organize training seminars for young psychiatrists from Central America. The program will continue until 1995 with an option to pursue further studies leading to a master or other post-graduate degrees. The overall purpose is to strengthen the knowledge in epidemiology and community mental health, along the lines set by the "Caracas Declaration" of a cadre of young leaders in the field of psychiatry in Central America.
There has been increasing concern among candidates and psychiatrists regarding the Canadian written and oral certification examinations. Views of candidates and psychiatrists have been obtained. The results presented in this survey were obtained through a questionnaire that was completed by 64 past and present Royal College examiners. General support for the establishment of guidelines for the selection of examiners, for increased emphasis on the use of in-training evaluations and for the need of clear operational criteria for examiners and candidates was voiced. Finally, the evaluation model that most responding examiners favoured included re-introducing one part essay into the written examination. Overall, although finding it exhausting, most examiners enjoy examining and are satisfied with the present system. Recommendations concerning improvements to the present system are presented.
Ontario is currently experiencing a nursing shortage crisis. Recruitment and retention of nursing staff are critical issues. In response, retention strategies have been developed by the Ontario Ministry of Health and Long-Term Care. The Late Career Nurse Initiative is one such strategy. This innovative program encourages nurses age 55 and older to remain in the workforce by providing opportunities to use their nursing experience in less physically demanding alternate roles for a portion of their time. The Royal Ottawa Health Care Group has developed a clinical coach program in forensics that matches these veteran nurses with new graduates or nurses new to forensic psychiatric nursing. The program has resulted in retention rates of more than 91% after 1 year. This article provides background about the program and highlights its outcomes.
In Canada, in recent years, there has been increased interest in the issue of subspecialization in psychiatry. One hundred and forty-four members of the Section on Psychosomatic Medicine of the Canadian Psychiatric Association responded to a survey about their opinions on teaching, training, continuing education, and designation of consultation-liaison (C-L) psychiatry as a subspecialty. Fifty-five percent of respondents agreed that C-L psychiatry should receive designation as a psychiatric subspecialty, 35% were opposed, and 10% did not give an opinion. The results also indicated that formal teaching in C-L psychiatry has increased, particularly over the past 20 years; that training in C-L psychiatry is believed by many to have been inadequate, regardless of when the training took place; and recent graduates were more likely than psychiatrists graduating more than 10 years ago to agree that C-L psychiatry should be designated as a subspecialty. Psychiatrists who devote more of their time to the care of patients with combined medical and psychiatric illness were also more likely to favor subspecialty designation. Factors unique to Canada that may influence attitudes toward psychiatric subspecialization include the number and geographic distribution of psychiatrists, their educational background, and governmental funding priorities.