Seattle University Collaborative Projects - International Academy of ...

that emphasizes development and implementation of new methods for assessment and treatmentof patients presenting violent behaviors related to their mental illnesses, which are oftencomplicated by comorbid addictions. This session takes a critical look at this long-standingevolution at IPPM since its founding, in looking for better practices. Presenters will talk aboutthe past, the present and future outlooks regarding patients, staff and administration. This will bedone from clinical, legal and organizational standpoints. This paper will briefly describe thehistory of IPPM, its initial mission and most important changes over the past 40 years. Reasonsunderlying these changes over time will be addressed. The IPPM’s role in the development ofQuebec Forensic Psychiatry will be discussed as well as its role in Forensic Psychiatry ingeneral.The Transformation of Care Over Time: Organizational Perspectives andCurrent Treatment ProgramsMarion Lepage, Institut Philippe-Pinel, Montreal, Canada(marion.lepage.ippm@ssss.gouv.qc.ca)This paper will discuss organizational aspects related to current intervention and treatmentprograms. Some thoughts will be shared on the evolution of treatments over the last decades. Asin similar institutions around the world, changes have been imposed not only by new knowledge,but also by the arrival of new clienteles, new programmes and new treatments. For example,there were no female patients in IPPM until 1985. Their arrival in the Hospital was seen as apotential source of difficulties arising related to sexual activities between patients, and also to theunder or over-evaluation of women’s violence potential. We will also consider future trends,taking into account our current challenges, in an institution where security always remains a keyissue. This involves providing a safe environment for all patients, for the staff members and forthe general population. Indeed, security is sometimes put forward as a main consideration whennew policies are set. This creates turmoil in the clinical teams. It may cause resistance in theapplication of new rules. Other topics will include the assessment of quality of programmes, therecovery perspective, resistance to new politics and strategies, and new directions in thephilosophy of care. We will also consider the most efficient strategies to implement new policiesand the allies involved in the preparation of those changes. Since formal training and educationhave always occupied an important part of the institution’s mission, this topic will also becovered. The arrival of trainees in an institution by itself is a vehicle of change, questioningroutines and informal rules. Another excellent support for change is research, the results ofwhich will be better adopted by clinical teams if they are kept well informed and involved in theprocess.Clinical Practice over Time: The Maturing of Approach through 40 years ofAssessment and Treatment of Violent Patients153