Symposium: Our Past, Our Future Notre Passé, Notre Avenir

Abstract

Ayant pris depuis peu sa retraite comme professeur à t'Écote de Psychologie de l'Université Laval, Jérôme Guay poursuit ses activités de consultant auprès d'organismes de services publics et d'associations communautaires. En plus de ses activités comme formateur et consultant auprès d'équipes en santé mentale, il a aussi participé à la mise sur pied des projets visant une meilleure intégration des personnes psychiatrisées à la communauté, en y impliquant le citoyen et la citoyenne ordinaire. Within the Regional Plans for the Organization of Services, Quebec's mental health reform has tried to redistribute power and influence to mutual aid groups for consumers and their families. However, it has failed to provide them with the financial resources that would allow them to exert that new power. The groups don't have enough personnel to fill the decision-making positions accorded to them under the regional plans while, at the same time, continuing to provide services to consumers. Real partnership requires equality in resources. Social integration being the product of an interaction between consumers and citizens, citizens are the forgotten actors of the interaction. We fail to support them when they are faced with behaviours that they find strange and disturbing. Attitudinal and behavioural changes are interrelated and concomitant; that is, the transformation of citizens' prejudice into acceptance is helped by consumers' efforts to adopt less offensive behaviours. Dr. Leonard R. Denton's professional career has spanned the fields of education, social work, program evaluation, research, and clinical psychology, in both institutional and community mental health settings. He is an advocate for community mental health and prevention programs aimed at decreasing the risk of mental/emotional and social disorders. In 1971, Denton was the primary founder of Atlantic Behavioural Science Applications, an organization for promoting the use of scientifically derived knowledge in the planning, operation, and evaluation of human service programs. On three occasions, his volunteer efforts have been recognized by the Canadian Mental Health Association, the most recent in 1998 when he received the Dr. C.M. Hincks Award for the advancement of mental health. In the same year, he was given recognition in the Nova Scotia Legislature for his service and contribution to the mental health profession. A native Nova Scotian. Dr. Denton lives in Truro. Nova Scotia, where he operates a private practice. Analysing individual reactions—omnipotence or helplessness—to the question put forward in this symposium, the author observes that the same reactions are present in the mental health field. Investigation of these reactions shows that they alternate in time and are based on a quest for recognition. This quest follows a pattern: First, a group proclaims new knowledge which is based on a fantasy. Then, when this group obtains recognition with its corresponding power, making the transition from a position of impotence to one of power, the fantasy becomes an illusion of omnipotence which excludes others, triggering the cycle again in the excluded groups. This pattern could explain the evolution of the mental health field over the last four decades. Over the last few years, however, there have been some failures in this process, and the author suggests possible solutions to move beyond the impasse. Cyril Greenland is Professor Emeritus in the School of Social Work at McMaster University and is President of the Museum of Mental Health Services (Toronto) Inc. He served as Social Work Advisor in Mental Health to the Ontario Ministry of Health from 1960 to 1966. Abram Hoffer was born on a farm in Southern Saskatchewan in 1917 and has maintained an interest in food from the farm gate to the dinner plate. After obtaining a Ph.D. from the University of Minnesota and an M.D. from the University of Toronto, he become Director of Psychiatric Research for the Province of Saskatchewan in 1950 and Professor of Psychiatry in 1955. In 1967, he went into private practice in Saskatoon and moved to Victoria in 1976, where he continues to practice. Dr. Hoffer has published some 20 books and over 600 papers. He is Editor of the Journal of Orthomolecular Medicine and President of the Canadian Schizophrenia Foundation. His main interst is to see effective treatment provided for all schizophrenics—something which is not yet offered by modern psychiatry. Over the second half of the twentieth century, the way in which Canadian society treats people with mental challenges has changed radically, from exclusion and containment in asylums to reintegration and maintenance in the community. Now that deinstitutionalization is practically complete, the objective has increasingly shifted from reintegrating people with severe mental challenges in their communities to upholding their rights and ensuring that they have access to resources allowing them to assume their responsibilities and roles as citizens. This change of vision results in a completely different set of issues for community mental health. Given the prejudices surrounding mental illness, the capacity of community mental health professionals to play a mediating and facilitating role becomes a determining factor in successfully reestablishing and re-empowering people with severe mental challenges. The advances that have clearly been made give cause for hope, but in the context of the unwanted effects of deinstitutionalization and unfavourable socioeconomic conditions, significant obstacles still need to be overcome before people with severe mental challenges can participate fully in the life of the collectivity. Jill Stainsby issesconded from Riverview Hospital to be the community developer for the Mental Health Advisory Committee to the Vancouver/Richmond Health Board, and a Consumer Support Worker at the Vancouver Community Mental Health Services (V/RHB), in Vancouver, British Columbia. She is active in the mental health advocacy community in B.C. She recently sat on the B.C. Ministry of Health Minister's Advisory Council on Women's Health, where she chaired the mental health subcommittee. She is now on a provincial peer-support initiative committee. She identifies as a service provider, a family member, and a consumer/survivor. Ken Ross is the Assistant Deputy Minister for mental helath services in New Brunswick. Prior to assuming his current role, he was the Chair/Executive Director of the Mental Health Commission of New Brunswick, which was established as a crown agency in 1990 to reform mental health service delivery in the province. He is a past Chair of the Federal/Provincial/Territorial Advisory Network on Mental Health, a former provincial Executive Director of the Canadian Mental Health Association in New Brunswick, and a member of a Canadian consultation team to assist Latvia with the establishment of a national mental health policy and service strategy. Mr. Ross has made numberous presentations across Canada on reforming mental health systems. Paul E. Garfinkel, M.D. F.R.C.P.(C), a researcher, clinician, and administrator, is currently a Professor in the Department of Psychiatry, University of Toronto, and President and CEO of the Centre for Addiction and Mental Health. Although he has received grant support for investigations in a variety of fields—including affective disorders, schizophrenia, and stress—he is particularly well respected for his clinical and research expertise in the field of eating disorders. He established a comprehensive Eating Disorders Centre at Toronto General Hospital and authored, among many significant works, Anorexia Nervosa:A Multidimensional Perspective. He is external reviewer of 13 professional journals and serves on the Editorial Board of 7 others. David S.Goldbloom, M.D, F.R.C.P., is a Professor of Psychiatry at the University of Toronto and Physician-in-Chief of the Centre for Addiction and Mental Health, which was created in 1998 from the merger of the Clarke Institute of Psychiatry, the Addiction Research Foundation. Queen Street Mental Health Centre, and the Donwwood Institute. In addition to his clinical and research activities. Dr. Goldbloom has received an awará as an outstanding teacher within the Faculty of Medicine and has authored a number of scientific articles and book chapters related to eating disorders and general psychiatry, and has lectured extensively on a variety of related topics. John Lord is a community researcher, facititator of change, family member, and chair of the Welcome Home Initiative in Kitchener-Waterloo. He was a founder, and coordinator for more than a decade, of the Centre for Research and Education in Human Services. He also played a significant role in the development of materials for the framework/support initiative of CMHA (National) in the 1980s. His most recent book, written with Geoffrey Nelson and Joanna Ochacka, is entitled Shifting the paradigm in community mental health: Toward empowerment and community.