Determinants of mental health professionals' attitudes towards recovery: A review.

OBJECTIVE: The attitudes of mental health professionals towards consumers' recovery are far more pessimistic than what is needed for the recovery-orientation to truly permeate systems of care. It has become pressing to depict determinants for these attitudes and how they evolve during professionalization. This, in the hopes to adjust not only medical education, but also ongoing training of professionals. METHODS: A systematic search of PubMed and PsycINFO databases was conducted, yielding a net 15 303 records. Twenty-two publications from specific educational journals and reference lists were added. Finally, thirty-four full texts were read, from which twenty-two articles were included. RESULTS: From the reviewed studies emerged five main determinants: profession, education, age, clinical experience, and nature of the contact with consumers. Traditional clinical placements during residency, negative experiences with acute patients, younger age and the professional attitudes of psychiatrists seem to all be determining factors for professionals' pessimistic attitudes towards recovery. CONCLUSIONS: This review found specific determinants for attitudes in recovery and four out of five can be acted upon. For a recovery-orientation to be implemented across our mental health system, we formulate recommendations within the Canadian context for revision of curriculum, recovery-specific training, and operationalisation through state/provincial technical assistance centers.

OBJECTIF: L'attitude des professionnels en santé mentale envers le rétablissement des clients est beaucoup plus pessimiste qu'il ne le faut pour qu'une approche axée sur le rétablissement s'intègre réellement aux systèmes de soins. Il est urgent de décrire les facteurs déterminants de ces attitudes et la façon dont ils se développent durant le parcours professionnel, dans l'espoir d'adapter non seulement l'enseignement de la médecine, mais également la formation continue des professionnels. MÉTHODES: Une recherche systématique des bases de données PubMed et PsycINFO a été réalisée et a identifié 15 303 enregistrements nets. Vingt-deux autres publications ont été incluses, provenant de revues spécifiques en éducation médicale et des listes de référence. La lecture des titres et résumés des enregistrements a retenu 34 articles. Après lecture intégrale de ces derniers, vingt-deux articles ont été sélectionnés pour cette revue. RÉSULTATS: L'examen des études a révélé cinq principaux facteurs déterminants : la profession, l'éducation, l'âge, l'expérience clinique et la nature du contact avec les clients. Les stages cliniques traditionnels durant la résidence, les mauvaises expériences avec les patients en phase aiguë, un âge plus jeune et les attitudes professionnelles des psychiatres semblent tous être des facteurs déterminants de l'attitude pessimiste qu'entretiennent les professionnels envers le rétablissement. CONCLUSIONS: Cette revue de littérature a révélé des facteurs déterminants précis en ce qui a trait aux attitudes envers le rétablissement et il est possible de donner suite à quatre sur cinq d'entre eux. Afin de mettre en œuvre une approche axée sur le rétablissement dans l'ensemble de notre système de soins en santé mentale, nous avons formulé des recommandations pour la révision des programmes d'enseignement applicables au contexte canadien, la formation centrée sur le rétablissement et l'opérationnalisation de ces recommandations par l'entremise de centres de soutien technique dans les états ou provinces.

[The Institute Philippe-Pinel and the department of Psychiatry of the University of Montreal: intricate paths]. / L'Institut Philippe Pinel et le Département de psychiatrie de l'Université de Montréal : des parcours intriqués.

The Institute Philippe-Pinel (IPPM) and the Département de psychiatrie de l'Université de Montréal, who are both celebrating their 50 years, have intricated paths and a long history of collaboration. Since its conception (1964), the Institute Philippe-Pinel was planned to become a site for training and teaching in the bosom of the Université de Montréal.Unique in its mission to offer state of the art psychiatric care and forensic assessments to patients presenting a high risk of violence, the Institute Philippe-Pinel, throughout the years, was also able to leave its mark by the way of academic teaching to psychiatric residents and trainees of all disciplines, of organizing national and international conferences, of research and by the publication of numerous articles and books in the field of forensic psychiatry.With, from its beginning, psychiatrists at its helm, the Institute Philippe-Pinel has at all times greatly contributed to the academic activity of the department. Highly committed psychiatric clinicians and professors were always involved at all levels of the psychiatric department. With the coming of the forensic subspecialty, the commitment and influence can only continue.

Impact of parental emotional support and coercive control on adolescents' self-esteem and psychological distress: results of a four-year longitudinal study.

This study aims at investigating the impact of parental practices on youths' adjustment. In all, 605 adolescents completed questionnaires at ages 14, 16 and 18. Self-esteem, psychological distress as well as parental emotional support and coercive control were measured. Analyses based on individual growth models revealed that self-esteem increased with age, but psychological distress remained stable over time. Boys reported higher levels of self-esteem and lower levels of psychological distress than girls. Maternal and paternal emotional support reinforced self-esteem over time. Maternal coercive control undermined self-esteem, but only at ages 16 and 18. Psychological distress decreased with parental emotional support but increased with parental coercive control at ages 14, 16 and 18. Overall, these results indicate that positive parental practices are related to youths' well-being. These findings support the importance of establishing intervention strategies designed to promote best practices among parents of teenagers to help them develop into well-adjusted adults.