Are UN Peacekeepers at Risk for Suicide? Wong, Albert; Escobar, Michael; Lesage, Alain ...
Suicide & life-threatening behavior,
Spring 2001, Letnik:
31, Številka:
1
Journal Article
Media reports connecting UN peacekeeping duties by Canadian soldiers to their subsequent suicide prompted this study of peacekeeping as suicide risk. In a case‐control design we retrospectively ...compared 66 suicides in the Canadian military between 1990 and 1995 with two control groups: (a) 2,601 controls randomly selected from the electronic military database and (b) 66 matched controls with complete personnel and medical data. We found no increased risk of suicide in peacekeepers except among a subgroup of air force personnel. Here confounding individual factors, isolation from supports, and possibly inadequate preparation for deployment elucidated their suicides. Theater of deployment (e.g., Bosnia) did not affect the suicide rate. Military suicides experienced psychosocial stresses and psychiatric illness more often than their matched controls. We conclude that although peacekeeping per se does not increase overall suicide risk, military lifestyles may strain interpersonal relationships, encourage alcohol abuse, and contribute to psychiatric illness and suicide in a minority of vulnerable individuals irrespective of peacekeeping assignment. Careful selection, and preparatory military training that encourages intragroup bonding and mutual support, may protect against suicide risk.
This paper shows how a global and person-centered approach can be used to support a participatory research agenda that would be as 'user-led' as possible. One aspect of applying such a participatory ...approach to research on mental health services is discussed: the role of mental health service users engaged as research partners in a participatory research initiative with policy and decision makers and researchers. The results of a survey and a focus group are discussed. Their collective interpretation suggests that this initiative became more in line with the principles of participatory research as the engagement of service users grew over time. Thirty possible research themes were identified by this group, and would guide future research collaboration. This evolution may be due to commentaries from some service users such as this: 'For the first time, we are also on the upper end of the microscope, no longer the only ones underneath the lenses'.
L'Estrie est une région du Québec qui n'a jamais eu d'hôpital psychiatrique et s'avère donc un exemple extrême de désinstitutionnalisation. Comment parvient-on à y soigner et à héberger les personnes ...les plus gravement malades? Ce système a-t-il des conséquences néfastes? Les auteurs présentent ici une étude de cas jumelant des données qualitatives et quantitatives pour élucider ces questions. Ils ont repéré 36 patients souffrant de troubles mentaux très graves (prévalence 12,4/100 000). Cette région n'exporte pas ces cas les plus graves et parvient en général à les accueillir dans un réseau de petites et moyennes ressources d'hébergement. Par contre, les auteurs ont pu identifier une certaine dérive vers le réseau carcéral; les cas à double ou triple diagnostics n'accèdent pas facilement aux soins; faute d'alternative, les patients à potentiel chronique de violence stagnent parfois à l'hôpital dans des lits de courte durée (prévalence 1,6/100 000). Il semble donc possible d'éliminer le recours à un hôpital psychiatrique pour les patients souffrant de troubles mentaux très graves à condition de prévoir pour eux des milieux de vie très encadrés et de longue durée (besoin: 10-20 places/100 000).
Cet article s’intéresse à l’adoption au Québec d’une pratique basée sur l’évidence scientifique, l’Integrated Psychological Treatment (IPT) auprès des personnes atteintes de schizophrénie, et à la ...pérennité de cette pratique dans neuf milieux cliniques en contexte de transformation des services. Une équipe de recherche du Centre de recherche Fernand Seguin de l’Hôpital Louis-H. Lafontaine a observé l’implantation et le maintien de l’IPT dans neuf milieux cliniques. L’article présente les facteurs qui ont contribué, sur une période de cinq ans, au maintien (ou non) de l’IPT dans ces milieux. Il soulève une question importante sur la pérennité des approches spécialisées et spécifiques à une clientèle dans des contextes de transformation des services.
Mental health services are in the midst of change in different countries. In Quebec (Canada), the government has adopted a Mental Health Action Plan (2005-2010). In this context, 2 psychiatric ...institutions have developed and implemented a mental health services organization model based on diagnosis-related mental health programs and support for frontline services. This article presents the impact on health care providers of implementation of diagnosis-related mental health programs in the context of transformation of mental health services.
OBJECTIVE: Most research on depression with reversed neurovegetative
features (hypersomnia, hyperphagia, and weight gain) has been based on
site-specific clinic-based samples. The goal of this study ...was to delineate
the epidemiology of reversed symptoms in a large community sample and to
use other symptom patterns for comparison. METHOD: Interviewers assessed
8,116 subjects across Ontario, aged 15-64 years, by using the World Health
Organization Composite International Diagnostic Interview. Individuals who
met the DSM-III-R criteria for major depression, current or lifetime, were
classified into four groups on the basis of lifetime neurovegetative
symptoms: episodes of typical symptoms only, episodes of reversed symptoms
only, neither type, or both types (fluctuating-symptom group). The groups
were compared on demographic characteristics, comorbidity, disability, and
health care utilization. RESULTS: Of the 653 individuals with lifetime
major depression, 11.3% had episodes of reversed symptoms only, and another
5.8% were classified as fluctuating. Most of the differences among the four
groups were due to the unique characteristics of the groups with neither
type of episode or a fluctuating pattern; individuals who had experienced
only reversed symptoms were remarkably similar to those who had had only
typical symptoms. The fluctuating-symptom group had high rates of
comorbidity, substance abuse, and health care utilization. CONCLUSIONS:
Several popular beliefs about depression with reversed features did not
hold true for this community sample. Identifying individuals who fluctuate
between reversed and typical episodes may be important in studies of major
depression, in particular when reversed neurovegetative symptoms are a
consideration.
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