Mental Health

Abstract

Abstract

Où être enterré quand on a fait sa vie entre deux pays ? Selon quels rituels ? Comment garantir la transformation d’un défunt en un ancêtre lorsque de nombreuses cérémonies ne peuvent pas être réalisées dans le pays de migration ? Traces et mobilités posthumes prolonge ces interrogations en explorant le rôle – important et à chaque fois singulier – joué par la prise en charge des défunts venus d’ailleurs, dans la façon dont les communautés migrantes se projettent dans l’avenir.

Les huit chapitres qui composent cet ouvrage restituent l’épaisseur des expériences vécues face à la mort en contexte migratoire, en Amérique latine, au Japon, au Canada, mais aussi en Espagne, en Russie et au Sénégal. Aux contributions des chercheuses et des chercheurs en anthropologie, histoire et sociologie, fondées sur des enquêtes ethnographiques ou archivistiques, s’associent les voix des professionnels de l’univers de l’intervention sociale. Ensemble, elles éclairent la gestion quotidienne des morts « étrangers ». Traces et mobilités posthumes donne ainsi à voir les contours de nouveaux horizons, de futurs rêvés des défunts avec les vivants, qui se dessinent à travers le traitement de funérailles et de deuils en migration.

Ouvrage dirigé par Carolina Kobelinsky et Lilyane Rachédi, avec les contributions de José Alavez, Marc-Antoine Berthod, Juliette Cleuziou, Caroline Coulomb, Félicien de Heusch, Grégory Delaplace, Karim Fedji, Filippo Furri, Florence Galmiche, Mathieu Grenet, Josiane Le Gall, Amelia León Correal, Françoise Lestage, Lætitia Marquié, Catherine Montgomery, Jordi Moreras, Jean-Hugues Lamy, EdwardOu Jin Lee, Ariadna Solé Arraràs et Javorka Zivanovic.

Cadre de la recherche : Comme la migration, particulièrement lorsque forcée peut affecter psychologiquement les enfants, la consultation en santé mentale jeunesse (SMJ) peut faire partie du parcours des familles migrantes. Alors que de rares articles décrivent cette expérience pour les familles et les jeunes (école secondaire), celle des enfants (école primaire) reste encore moins explorée.

Objectif : Cet article se penche sur les données d’entretiens intégrant jeux et dessins menés auprès de 20 enfants de 15 familles migrantes ayant consulté en SMJ (dont certaines réfugiées, demandeuses d’asile ou sans statut). L’objectif est d’explorer l’expérience des enfants en intégrant une méthode d’analyse innovatrice basée sur l’art.

Méthodologie : Nous proposons une méthode herméneutique combinant la psychiatrie transculturelle, la psychologie humaniste et l’interprétation des données par la création littéraire. En cohérence avec ces ancrages, les données d’entretien sont présentées de manière narrative sous la forme d’exemples. L’interprétation des données inclut la création d’un texte littéraire intitulé Jungle et religion.

Résultats : L’interprétation fait ressortir trois volets de l’expérience des enfants : 1) l’expérience migratoire et la fragilité qu’elle implique, 2) le recours à l’art et au jeu comme moyens d’apprivoisement du trauma, et 3) l’idéalisation de l’intervention.

Conclusion : L’expérience comprise des enfants met en lumière à la fois la confusion/peur induite par la migration et la place compensatrice que l’intervention peut prendre, et qui crée la possibilité de vivre des espoirs déçus, mais aussi celle de reconstruire le monde pour l’enfant.

Contribution : L’interprétation des résultats basée sur l’art et la création littéraire a permis de traduire l’expérience des enfants plus justement et de mieux la représenter en langage écrit, alors qu’elle nous a principalement été transmise par les enfants en paroles, en jeux et en images.

Abstract

Background:Based on experiences with the COVID-19 pandemic, postsecondary institutions were most affected by the restrictions. Students, especially international students, have borne the brunt associated with in-person learning restrictions imposed by public health recommendations. Canada is among the top 3 countries hosting international students (ISs), including Francophone students in provinces such as Quebec and other anglophone regions. Academic restrictions were accompanied by other measures such as quarantine, self-isolation, social distancing, and travel ban, to cite some. This has had a wide-ranging impact on these ISs. The resulting psychological distress and burden may have a much greater impact on Francophone ISs in anglophone settings, many of whom had ordinarily limited access to active offers of care in French in addition to cultural barriers and low literacy of the health care system. In order to take advantage of the effectiveness of eHealth as a pertinent and promising avenue, our project intends to build a web-based application that is cost-effective, user-friendly, anonymous, and capable to prompt interactive interventions as a first-line resource for psychological distress. In fact, internet applications have been increasingly used for the management of psychological distresses, and internet-based cognitive behavioral therapy is one of the preferred methods to prevent or control them.

Objective:The aims of this study are to (1) design, implement, and maintain Psy-Web for the psychological support of ISs and (2) analyze the results of the implementation of the Psy-Web platform, the additional resources solicited, and the results obtained.

Methods:This interventional project will use a sequential mixed design in the exploratory phase (phase 1) including the construction of the Psy-Web platform. A quantitative prospective component (phase 2) will include the intervention content of the Psy-Web platform. In total, 105 ISs participants (study group) and 52 ISs (control group), based on a ratio of 1:2, will be considered. The control group participants include those who did not use the web platform.

Results:The project is at the data collection stage (phase 1). Psy-Web will be built in accordance with the DMAIC (Define, Measure, Analyze, Improve and Control) model with the perspective of boosting its robustness. As a first-line resource to prevent psychological distress and ultimately improve their academic performance, Psy-Web is an innovative opportunity for high education managers. The project involves a multisectoral and a multidisciplinary partnership.

Conclusions:The project will develop a promising web-based solution to prevent psychological distress. Ultimately, Psy-Web will be operable in multiple languages including French.

International Registered Report Identifier (IRRID):PRR1-10.2196/47059

JMIR Res Protoc 2023;12:e47059

Abstract

Keywords: 

Youths Afghan refugees; Iran; educational pathways; formal education; exclusion

bstract

Introduction

Dans un contexte où les inégalités d’accès aux soins psychiatriques sont de plus en plus reconnues comme un enjeu préoccupant de santé publique dans les pays de la région subsaharienne, et alors que les représentations sociales associées aux troubles mentaux exercent une influence notable sur cet accès aux soins, celles-ci ont suscité jusqu’à présent peu de travaux. Dans cet article, nous appréhendons les entités nosologiques populaires et leurs principales caractéristiques en milieu urbain au Burkina Faso. Pour ce faire, 7 groupes de discussion et 16 entretiens individuels ont été menés auprès de différents acteurs dans la ville de Bobo-Dioulasso. Une analyse thématique a permis d’identifier deux entités nosologiques populaires. Le terme Kougolobana renvoie à une altération du cerveau associée à l’envoûtement par des entités surnaturelles et s’exprime sporadiquement ; alors que le terme Fatoya renvoie à une condition incurable causée par la commission d’actes transgressifs de différentes natures. Nos résultats mettent en lumière l’influence mutuelle des registres traditionnels et biopsychosociaux dans la construction de ces entités nosologiques. Ces résultats permettent d’amorcer une réflexion sur la place centrale qu’occupe la notion de transgression dans les représentations sociales des troubles de santé mentale dans la ville de Bobo-Dioulasso.

Background

Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education.

Objectives

The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys.

Method

The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location.

Results

A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health.

Conclusion

Attending school is essential for children’s mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.

Inequalities in access to psychiatric care are increasingly recognized as a serious public health issue in sub-Saharan Africa. In these countries, little information is available regarding social representations of mental disorders, although these can have a significant influence on access to care. In this article, we examine the popular nosological entities and their characteristics in urban Burkina Faso. To do so, 7 focus groups and 16 individual interviews were conducted with various actors in the city of Bobo-Dioulasso. A thematic analysis revealed two popular nosological entities. The term Kougolobana refers to an alteration of the brain associated with bewitchment by supernatural entities and is expressed sporadically; whereas the term Fatoya refers to an incurable condition caused by the commission of transgressive acts of various kinds. Our results highlight the mutual influence of traditional and bio-psycho-social registers in the construction of these nosological entities. These results allow us to reflect on the centrality of the notion of transgression in the social representations of mental health disorders in the city of Bobo-Dioulasso.

Les troubles mentaux et plus largement les souffrances psychologiques et sociales sont aujourd’hui un des problèmes majeurs de santé dans le monde. Au regard de la charge mondiale causée par ces troubles, l’Assemblée mondiale de la Santé a adopté en mai 2012 une résolution préconisant une réponse globale coordonnée au niveau des pays pour répondre aux besoins de prise en charge des troubles mentaux. Ainsi, dans la perspective d’une recherche visant à améliorer la santé mentale et parvenir à promouvoir la santé pour tous (Patel & Prince, 2010), la présente étude s’intéresse à comprendre les représentations sociales et culturelles de la santé et de la maladie mentale, à la lumière de la dépression et du suicide en contexte africain.

2La dépression est classée comme un trouble mental courant présent à travers le monde et les cultures sous différentes manifestations (Bellanger et al., 2001). La dépression est une affection fréquente dans le monde qui touche environ 322 millions de personnes soit environ 4.4 % de la population mondiale (OMS, 2015). Le nombre total de personnes vivant avec la dépression a augmenté de 18,4 % entre 2005 et 2015. Elle est souvent décrite comme se caractérisant par une tristesse, une perte d’intérêt ou de plaisir, des sentiments de culpabilité ou de dévalorisation de soi, un sommeil ou un appétit perturbé, une certaine fatigue et des problèmes de concentration. La dépression peut perdurer ou devenir récurrente, entravant ainsi de façon substantielle l’aptitude d’un individu à fonctionner au travail ou à l’école ou à faire face à sa vie quotidienne. Elle peut également dans certains cas conduire au suicide (OMS, 2020).

3La dépression affecte outre l’individu atteint, son entourage, et représente également un lourd fardeau social et économique. Dans sa publication « Dépression : parlons-en » de mars 2017, l’OMS met en avant non seulement la souffrance des personnes atteintes de maladies mentales, mais également le coût socio-économique important de ces maladies. En effet, selon ce rapport, la perte économique mondiale relative au manque de reconnaissance et d’accès aux soins en cas de dépression ou autres troubles mentaux comme l’anxiété se chiffrerait à 1 000 milliards de dollars américains par an. Ce fardeau, pesant sur les familles, les employeurs et les gouvernements. En raison de son impact sur le fonctionnement humain et de sa propension croissante actuelle, la dépression se présente comme la première cause d’incapacité dans le monde (OMS, 2020).

4Selon la forme, la dépression peut être durable ou récurrente. Elle résulte d’interactions complexes entre les facteurs sociaux, psychologiques et biologiques. La forme majeure de dépression fortement corrélée au risque de suicide est la dépression durable (Shea et al., 2008). De plus, la dépression et l’anxiété semblent être des facteurs de risque pour le suicide en association avec des facteurs individuels et contextuels (Turecki & Brent, 2016).

5Les dépressions majeures, les addictions, la schizophrénie, les troubles bipolaires et les personnes souffrant de troubles sévères de la personnalité de type état limite sont également à risque d’idées suicidaires et de suicide (Fawcett et al., 1993).

6Le comportement suicidaire associé à la dépression majeure, est souvent conceptualisé le long d’un spectre allant de pensées suicidaires à la tentative de suicide et à la mort, en passant par l’élaboration de projets suicidaires (Findlay, 2017). En 2015, on estime que 788 000 personnes sont décédées dans le monde des suites du suicide ce qui représente 1,5 % de tous les décès, plaçant le suicide au niveau des vingt principales causes de décès. Le taux de suicide varie en fonction de l’âge, du sexe et du niveau socio-économique des régions. Selon les données recueillies par l’OMS, le suicide représente aussi 50 % des morts violentes chez les hommes 71 % chez les femmes et il est la deuxième cause de mortalité chez les 15-29 ans. Dans les pays les plus riches, trois fois plus d’hommes que de femmes décèdent par suicide, contre 1,5 fois dans les pays à revenu faible et intermédiaire. Le suicide prélève ainsi un lourd tribut en vies humaines.

7Diverses études ont traité de la question de la dépression, du suicide et leurs représentations pour les communautés culturelles (Rodiguez et al, 2022). Dans notre étude, nous souhaitons spécifiquement nous intéresser aux représentations sociales associées à la souffrance psychologique, notamment la dépression, afin de soutenir des stratégies de préventions et d’interventions concernant le suicide non stigmatisantes et centrées sur les communautés (Rivera et al., 2021).

8À noter qu’en dépit des avancées scientifiques en matière de traitement des maladies mentales, dans les pays à revenus faible ou intermédiaire, entre 76 % et 85 % des personnes ne bénéficient d’aucun traitement (OMS, 2020). Le manque de ressources, la pénurie de soignants qualifiés, les erreurs de diagnostics, la stigmatisation sociale et le tabou liés aux troubles mentaux sont autant d’obstacles à l’accès et à l’administration de soins efficaces. Ces considérations subjectives pourraient être des indicateurs du comportement des individus, notamment leur choix de solliciter ou non l’aide des spécialistes ou même à commettre des actes comme le suicide.

9Plusieurs auteurs ont proposé une définition du concept des représentations sociales. Toutefois, la définition qui répond le mieux aux besoins de notre étude est celle de Jodelet (1989) qui définit les représentations sociales comme des phénomènes complexes (éléments informatifs, cognitifs, idéologiques, normatifs, croyances, valeurs, attitudes, opinions, images, etc.) organisés sous la forme d’un savoir disant quelque chose sur l’état de la réalité toujours activée et agissant dans la vie. Cette définition prend en considération différents concepts tels que l’environnement social aussi bien que l’aspect comportemental qui en découle.

10Ainsi, notre question de recherche est de savoir si les représentations sociales de la dépression et du suicide exercent une influence sur ceux-ci, le but étant de découvrir les meilleures pratiques de prévention, intervention et postvention.

Purpose

To elicit stakeholder perspectives on the findings from our scoping review on youth participation in mental health policymaking, we conducted a global consultation with young people and adults directly involved in mental health policymaking.

Method

Forty-four stakeholders from 16 countries, including 15 young people, 9 policymakers and 20 facilitators of youth participation, took part in individual interviews and/or focus groups. They were asked about how the review findings contrasted with their own experiences in mental health policymaking. The transcribed data were thematically analyzed.

Results

All participants viewed lived experience as valuable in identifying policy gaps. Youth pointed out that children and youth with disabilities, diverse sexual orientations, and/or gender identities were often excluded, and spoke about feelings of being an “accessory”, illustrating a lack of power-sharing in a tokenized policymaking process. Adult participants’ accounts highlighted the challenges inherent in policymaking such as the need for political knowledge and institutional time constraints. A range of cultural, socio-economic, and political barriers to youth participation, that were often context-specific, were identified.

Conclusions

The diverse perspectives of stakeholders extended the review results. Based on our findings, we recommend that adults and institutions: (1) recognize lived experience as expertise in shaping mental health policies; (2) include diverse groups; (3) reduce tokenistic relationships through the creation of safer spaces, adult feedback, co-production, and social accountability; and (4) adopt an intersectional approach to address cultural, socio-economic, and political barriers to participation. Methodologically, our work demonstrates why stakeholder consultations are an essential component of scoping reviews.

L’implantation de réseaux de services intégrés jeunesse (RSIJ) au Québec et ailleurs dans le monde témoigne de la volonté des décideurs de répondre de façon efficace aux problématiques de santé globale des jeunes de 12 à 25 ans. Cette évaluation a eu pour objectif d’analyser le contexte de mise en œuvre et l’efficacité de ce modèle. Les questions d’évaluation s’articulaient autour des facilitateurs et des obstacles à la mise en œuvre d’un RSIJ; son efficacité (sur le plan de l’amélioration de l’état de santé et du bienêtre des jeunes et de leur trajectoire) et de son efficience (coûts-avantages, coûts-efficacité; coûts-utilité). L’évaluation s’intéressait également aux variations éventuelles de la mise en œuvre et de l’efficacité dans le cas où les services sont offerts à des jeunes de la diversité ethnoculturelle. Cinq réseaux de services intégrés à l’international ont été étudiés (headspace, Australie; Youth One-Stop Shop, Nouvelle-Zélande; Jigsaw, Irlande; Foundry, Canada; Prépsy, France). La revue de la littérature systématique a permis, entre autres, d’identifier neuf (9) composantes clés dans la mise en œuvre et la prestation des services dans les RSIJ qui ont été validées en consultation avec les jeunes et des intervenants.

L’implantation de réseaux de services intégrés jeunesse (RSIJ) au Québec et ailleurs dans le monde témoigne de la volonté des décideurs de répondre de façon efficace aux problématiques de santé globale des jeunes de 12 à 25 ans. Cette évaluation a eu pour objectif d’analyser le contexte de mise en œuvre et l’efficacité de ce modèle. Les questions d’évaluation s’articulaient autour des facilitateurs et des obstacles à la mise en œuvre d’un RSIJ; son efficacité (sur le plan de l’amélioration de l’état de santé et du bienêtre des jeunes et de leur trajectoire) et de son efficience (coûts-avantages, coûts-efficacité; coûts-utilité). L’évaluation s’intéressait également aux variations éventuelles de la mise en œuvre et de l’efficacité dans le cas où les services sont offerts à des jeunes de la diversité ethnoculturelle. Cinq réseaux de services intégrés à l’international ont été étudiés (headspace, Australie; Youth One-Stop Shop, Nouvelle-Zélande; Jigsaw, Irlande; Foundry, Canada; Prépsy, France). La revue de la littérature systématique a permis, entre autres, d’identifier neuf (9) composantes clés dans la mise en œuvre et la prestation des services dans les RSIJ qui ont été validées en consultation avec les jeunes et des intervenants.

The aim of this article is to shed light on the levers and obstacles of the co-creation process encountered during the first steps of the implementation of a demonstration project in youth mental health in Quebec, in the context of an expansion of youth integrated service networks. Using a qualitative approach, the role of the various stakeholders involved (community partners, service providers, youths) is described in such a way as to highlight the co-creation issues the actors were confronted with between the design and implementation phases. We report on a formative and developmental evaluation, which is still ongoing. In this sense, this article seeks to clarify the lessons learned on the process of co-creation of public action.

Purpose

Social adversity experiences have increased during the pandemic and are potential risk factors for both depression and support for violent radicalization (VR). However, the cumulative and independent effects of various social adversity experiences on support for VR have yet to be explored. This paper examines the cumulative and independent effects of COVID- and non-COVID-related discrimination, exposure to violence, traditional and cyberbullying victimization on support for VR. In addition, we investigate whether depression mediates the relationship between these forms of social adversity and support for VR.

Methods

A total of 6003 young adults (M_age = 27, SD_age = 4.40, range 18–35) living in metropolitan areas in Canada responded to an online survey. We used multivariable regression models, controlling for socio-demographic characteristics, to infer covariate adjusted associations between social adversity measures and support for VR. Additionally, we conducted a formal mediation analysis to estimate the proportion mediated by depression.

Results

There was a cumulative relationship between experiences of social adversity and support for VR (β = 1.52; 95% CI: 1.32, 1.72). COVID-related discrimination and cyberbullying victimization were independently associated with stronger support for VR. Depression partially mediated the effect of cumulative social adversity, COVID-related discrimination and cyberbullying on support for VR.

Conclusion

Prevention programs during the present pandemic should prioritize decreasing discrimination and providing psychosocial support to depressed young adults who experience social adversity. Practitioners should prioritize developing programs that foster digital literacy skills and critical thinking among young adults to address the concerning impact of cyberbullying on support for VR.

Objectives

High mortality rates, anxiety and distress associated with Ebola virus disease (EVD) are risk factors for mood disorders in affected communities. This study aims to document the prevalence and risk factors associated with depressive symptoms among a representative sample of individuals affected by EVD.

Design

Cross-sectional study.

Setting

The current study was conducted 7 months (March 11, 2019 to April 23, 2019) after the end of the ninth outbreak of EVD in the province of Equateur in the Democratic Republic of the Congo (DRC).

Participants

A large population-based sample of 1614 adults (50% women, Mage=34.05; SD=12.55) in health zones affected by the ninth outbreak in DRC.

Primary and secondary outcome measures

Participants completed questionnaires assessing EVD exposure level, stigmatisation related to EVD and depressive symptoms. The ORs associated with sociodemographic data, EVD exposure level and stigmatisation were analysed through logistic regressions.

Results

Overall, 62.03% (95% CI 59.66% to 64.40%) of individuals living in areas affected by EVD were categorised as having severe depressive symptoms. The multivariable logistic regression analyses showed that adults in the two higher score categories of exposure to EVD were at two times higher risk of developing severe depressive symptoms (respectively, OR 1.94 (95% CI 1.22 to 3.09); OR 2.34 (95% CI 1.26 to 4.34)). Individuals in the two higher categories of stigmatisation were two to four times more at risk (respectively, OR 2.42 (95% CI 1.53 to 3.83); OR 4.73 (95% CI 2.34 to 9.56)). Living in rural areas (OR 0.19 (95% CI 0.09 to 0.38)) and being unemployed (OR 0.68 (95% CI 0.50 to 0.93)) increased the likelihood of having severe depressive symptoms.

Conclusions

Results indicate that depressive symptoms in EVD affected populations is a major public health problem that must be addressed through culturally adapted mental health programs.

Information is needed on the relationship between coronavirus disease (COVID-19) social distancing restrictions and their relationship with mental health. In particular, there is limited investigation into how COVID-related adversities have positively mobilized individuals. We use latent class analysis (LCA) to identify subtypes of positive and negative aspects of the experience of COVID-19 social distancing and the association of these subtypes with mental health. We conduct an online survey of COVID-19 and mental health with 3,183 adults residing in Quebec, Canada, during the first wave of the epidemic. We use LCA to identify subtypes of positive and negative aspects of social distancing. We use logistic and linear regression to estimate the associations between class membership and self-reported impact of COVID-19 on mental health and scores on the Hopkins Symptom Checklist-10 (HSCL-10). We identify five classes of individuals in regards to perceived positives and negatives of social distancing related to COVID-19, named Low Impact, Freedom/Flexibility, Safety, Family/Home, and Hardships. Sociodemographic variables including age, gender, race/ethnicity, and self-reported mental health prior to COVID are associated with class assignment. Latent classes are associated with both outcomes (p < .001). Individuals in the Hardships class have greater odds of reporting a significant impact of COVID-19 on mental health, OR = 2.09, 95% CI = [1.53, 2.86], p < .001, and have higher scores on the HSCL-10, β = .32, 95% CI = [.23, .42], p < .001, than those individuals in the Low Impact group after adjusting for sociodemographic characteristics. Gender, age, and self-reported mental health prior to COVID-19 are independently associated with both outcomes (p < .001). We discuss study implications for public health programming and interventions to promote the mental health of at-risk populations during the pandemic. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

En hématologie-oncologie pédiatrique, les technologies et les avancées médicales génèrent de multiples voies quant aux possibilités thérapeutiques. Ces possibilités et les espoirs qu’elles suscitent s’invitent comme acteurs dans la prise de décision. Parallèlement, les complications inhérentes aux traitements de pointe (greffes hématopoïétiques) sont nombreuses et la mort, une éventualité. À partir d’histoires d’enfants, de parents et de cliniciens, recueillies au cours d’une enquête ethnographique réalisée dans une unité d’hématologie-oncologie dans un hôpital pédiatrique à Montréal, nous discutons du processus de prise de décision lors de pronostics sombres et des défis posés par le passage d’une trajectoire thérapeutique à visée curative à celle ayant une perspective palliative. Nous questionnons la prise de décision partagée (patient/famille/médecin) et le rôle moral des cliniciens dans un contexte où les « morts spontanées » surviennent rarement et où l’option de prolonger la vie à tout prix rivalise avec la médecine palliative.

In a number of ways, dance can express and transform interpersonal and social bonds. This article explores this idea, drawing on a dance project conducted in Montreal in 2017 in a multi-ethnic neighborhood facing issues of poverty. The project was based on the premise that intergenerational and intercommunity ties both echo and transform each other. This article will describe the framework in which the project took place and discuss the challenges it raised, particularly in terms of animation and artistic process. Finally, we will reflect on the way that the dynamics between centrality and marginality were revealed in the project.

Violent radicalization is the result of a multidimensional process determined by a complex interplay among cultural, social and individual variables. However, empirical evidence on the risk and protective factors involved in the process of violent radicalization is still scarce. Even less is known on early determinants in terms of primary prevention. In the present chapter, we argue the importance of a Positive Youth Development (PYD) approach to the study of violent radicalization, aimed at fostering youth strengths across multiple levels of functioning. In support of our argument, we present findings from a broad quantitative project on the determinants of sympathy for violent radicalization among youth in Québec (Canada). The findings suggest that supporting connection (e.g., social support, plural group identities and religiosity) and confidence (e.g., positive future orientation) represents an effective way of providing youth with valid alternatives to violent radicalization.

The present study examines the moderating role of total, intrinsic, and extrinsic religiosity in the relation between perceived discrimination and sympathy for violent radicalization (VR) among college students in Quebec, Canada. A total of 931 students responded to an online questionnaire and were included in this study. Linear mixed-effects models were conducted to account for the clustered nature of the data, and moderation was assessed via interaction analysis using cross-product terms in the models. Findings indicated that both intrinsic and extrinsic religiosity had a protective role in the link between perceived discrimination and sympathy for VR and buffered the effects of sadness in response to discrimination on sympathy for VR, but not the effects of anger in response to discrimination. These results provide evidence of the protective role of religiosity in Canada, a social context characterized by an increase in religious discrimination, but which also supports religious diversity.

Objectives
This study explored the perspectives of mental health practitioners serving LGBTQ+ forced migrants, LGBTQ+ individuals, and forced migrants not identifying as LGBTQ+ to understand the clinical frameworks guiding their practice and how they approached clients whose identities were similar to or different than their own.
Methods
Twenty-eight mental health practitioners from three Canadian cities participated in qualitative interviews. The sample comprised practitioners serving LGBTQ+ forced migrants (n=11); forced migrants not identifying as LGBTQ+ (n=9); and non-migrant LGBTQ+ clients (n=8). Thirteen providers identified as white; 3 as Middle-Eastern/North African, 3 as Latinx, 1 as West African, 1 as Indigenous, 1 as West Asian, and 1 as Other. Data were analyzed using constructivist grounded theory.
Results
Practitioners across all three 3 sample groups used similar approaches, whether or not they worked with clients whose sexual orientations, gender identities, racial/ethnic backgrounds, or migration status were different than their own. Practitioners described using an
eclectic approach, incorporating cultural competence, cultural humility, and LGBTQ+- affirmative and anti-oppressive practices in their work. Practitioners also noted that lack of training for ancillary providers could lead to discrimination that negatively impacts clients, making establishing a therapeutic relationship challenging.
Conclusions
Findings suggest that the concepts of cultural humility, cultural competence, and affirmative practice may not be mutually exclusive. The similarities in practice approaches across provider samples point to the salience of integrating these clinical practice concepts and frameworks when working with LGBTQ+ forced migrants, LGBTQ+ individuals with diverse cultural backgrounds, and forced migrants who do not identity as LGBTQ+.

Using a retrospective sample, the authors sought to determine whether Black patients with first-episode psychosis (FEP) in Canada were at a higher risk for coercive referral and coercive intervention than non-Black patients with FEP. Methods: Retrospective data from patients referred to an FEP program in 2008?2018 were collected via chart review (N=208). The authors used chi-square and logistic regression analyses to explore the relationships among race-ethnicity, diagnosis of psychosis, and coercive referral and intervention. Results: Results showed that Black persons of Caribbean or African descent with FEP were significantly more likely to be coercively referred (?2=9.24, df=2, p=0.010) and coercively treated (?2=9.21, df=2, p=0.010) than were non-Black individuals with FEP. Age and violent or threatening behavior were predictors of coercive referral. Ethnoracial status, age, and violent or threatening behavior were predictors of coercive intervention. Conclusions: This study contributes to the dearth of research on Black Canadians and offers insight into factors that may place patients with FEP at risk for coercive treatment. More research is needed to explore the role that ethnoracial status may play in hospital admissions and to uncover the role of racial prejudices in the assessment of danger.

This article introduces a thematic issue of Transcultural Psychiatry that presents recent work that deepens our understanding of the refugee experience—from the forces of displacement, through the trajectory of migration, to the challenges of resettlement. Mental health research on refugees and asylum seekers has burgeoned over the past two decades with epidemiological studies, accounts of the lived experience, new conceptual frameworks, and advances in understanding of effective treatment and intervention. However, there are substantial gaps in available research, and important ethical and methodological challenges. These include: the need to adopt decolonizing, participatory methods that amplify refugee voices; the further development of frameworks for studying the broad impacts of forced migration that go beyond posttraumatic stress disorder; and more translational research informed by longitudinal studies of the course of refugee adaptation. Keeping a human rights advocacy perspective front and center will allow researchers to work in collaborative ways with both refugee communities and receiving societies to develop innovative mental health policy and practice to meet the urgent need for a global response to the challenge of forced migration, which is likely to grow dramatically in the coming years as a result of the impacts of climate change.

This paper addresses the well-being of children in Switzerland, Canada and Estonia, as they experienced the lockdown imposed by governments after the state of international public health emergency, declared by the World Health Organization on 30 January 2020. Suspension of school or starting with distance learning, cessation of extracurricular activities, closure of playgrounds, parks, shopping centres and loss of daily contacts with friends completely transformed children’s lives. The surveys conducted by the authors in individual ways, were all inspired by their membership to the Children’s Understandings of Well-Being network and involved the participation of 403 children aged 7–17 years old (229 girls and 174 boys). They present the emerging trends from the children’s narratives focusing on their experience of the lockdown in relation to family life, school life, contacts with friends, and in relation to space, time and self. During the lockdown leisure activities and hobbies, followed by life with friends and school life challenged relational well-being the most, while family life opened up new perspectives and generational solidarity. Staying at home and decreased physical activity impacted on the physical health of children, missing direct contacts with friends and teachers put social relations to test, fear of the virus decreased feeling safe and secure, and the lockdown restricted participation in society. The findings underline the relational nature of their well-being. More in-depth studies are needed to highlight the widening of inequalities and the balance between protection and participation of children.

This survey reflects the experiences of 2124learners in Grades 4 and 6 across Khomas region (Namibia). It provides evidence of how children feel about their homes, schools,neighbourhoods, friends, and families. This initiative is part of a larger project that spans over 40 countries and includes more than 126, 000 children!

Objective:
This article aims at filling some gaps in the literature regarding conditions conducive to high-quality collaborative care in youth mental health (YMH) for migrant families. It focuses on the factors that are susceptible to foster the engagement of migrant families in the services, by examining the clinical encounter, as well as sociopolitical and institutional dimensions.

Methods:
Using a multiphase mixed methods design, it sequentially follows qualitative and quantitative results regarding migrant families within the different projects of a research program on collaborative care in YMH in culturally and socioeconomically diverse neighborhoods, done in Montreal during the last decade. These results come from data collected through questionnaires, semi-structured interviews, focus groups, participatory observation and documentation, with research participants being children, adolescents and parents from migrant families, clinicians and managers.

Results:
The results suggest that the sociopolitical and macro institutional system finds its way into the clinical space by influencing the process of care. In particular, successive reforms of the health system challenge institutions and YMH teams in their capacity to create a favourable environment for continuity of care and interinstitutional partnership and interprofessional collaboration, factors associated with families’ engagement into care. This engagement is also dependent on the representations of mental health and services that migrant families hold. These representations are shaped by their experience of the services, but also by what their sociocultural environment and the public discourses allow them to imagine of these services. This calls for the integration of cultural and sociopolitical dimensions within the concept of engagement. Finally, results also suggest that schools are playing an important role to foster engagement in mental health care.

Conclusion:
The quality of mental health care for migrant children and adolescent relies on the engagement of families, as well as on the mutual engagement of clinicians and of their institutions. Political contexts where tensions between majority and minority groups are present can also act as barriers to the care. Given that migrant families are engaging less in the services compared to non-migrant families, these considerations call for an important review of avenues to facilitate engagement of migrant families into collaborative care YMH services. This article suggests certain avenues to promote this engagement.

The need for the services of a healthcare interpreter to treat allophone patients is, today, indisputable. The scientific literature demonstrates such a need in all medical specialties. In mental health, the situation is particularly sensitive when a psychological assessment requires the services of an interpreter.

Objectives:
To explore the best practices highlighted in the previous literature for working with an interpreter in mental health and apply them to the specific context of psychological assessments.

Methods:
A synthesis of key research recommendations for communicating through an interpreter was conducted.

Results :
A compilation of best practices for ensuring quality psychological assessment when working in partnership with an interpreter is provided, focusing on key issues to consider when assessing linguistically and culturally diverse patients. This compilation is organized in 3 stages: before, during and after the consultation. For example, the need to prepare for the consultation with the interpreter (briefing), the impossibility of requesting “word-for-word” interpreting (except in very special cases), and the need for a debriefing with the interpreter to complete the assessment.

Discussion:
Mental health professionals can optimize their collaboration with interpreters in psychological assessment by applying this three-step model, which will improve cross-cultural communication.

The objectives of this paper are to explore the impact of psychological trauma and migration on a mother’s ambivalence regarding her relationship with her child and to explore the effect on the child’s “continuity of being.”