De l'innovation au changement - Gouvernement du Québec

Projet 19
Development and Evaluation of Cultural Consultation Service in Mental Health, région de Montréal
Développement et évaluation d'un service de consultation culturelle en santé mentale
1. CLIENTÈLE VISÉE Les familles (enfants et adultes) : nouveaux arrivants, immigrants et réfugiés, les communautés culturelles établies depuis plus longtemps au
Québec et les communautés autochtones.
2. BUDGET ALLOUÉ 453 676 $
Type de projet : intervention - évaluation
3. CONTEXTE D’ÉMERGENCE
3.1 Pourquoi le changement The reports of the Federal Task Force on Mental Health Issues Affecting Immigrants and Refugees and of the Comité de Santé du Québec
indicated the need to develop culturally sensitive health care for all citizens . Despite the policy of equal access to care for everyone,
significant barriers to care continue to exist across Canada for Aboriginal peoples, immigrants, refugees and ethnocultural minorities by reason
of language, culture and ethnicity . Beyond the need for basic research on models of care for culturally appropriate and accessible mental
health services, there is a need to improve the process of diagnosis and treatment in cross-cultural psychiatry (Rogler, 1996).
3.2 Principales caractéristiques The principle objective of the service was to improve the accessibility and cultural appropriateness of mental health services for the
multicultural population of Montreal, including immigrants, refugees, and ethnocultural groups, as well as Aboriginal peoples.
The specific objectives of the project were: 1) to facilitate access to cultural expertise in mental health by developing a network of clinicians,
databases and internet resources, 2) to offer ongoing professional training and to promote the development of competency in intercultural
intervention among mental health practitioners, particularly those who offer front line or primary care services
NOTE : On évalue et décrit les résultats de trois différents modèles de service, dont un seul a été implanté à l’aide de la subvention du FASS.
Les objectifs et les résultats seront identifiés comme suit : Jewish General Hospital (JGH : Service I), the Montreal Children’s Hospital (MCH :
Service II), et Hôpital Jean-Talon (HJT : Service III)
The project had three main activities corresponding to our major goals:
I. A new Cultural Consultation service was established at the Jewish General Hospital. Specialized cultural consultation services were then
evaluated and compared at the Montreal Children’s Hospital, the Jewish General Hospital, and Hôpital Jean-Talon.
II. A database of community organizations, professionals and resource persons with expertise in culture and mental health was prepared and
a website for access to this information was created.
III. A comprehensive review and systematic comparison of training programs in culture and mental health was conducted and training activities
devised for specific groups of practitioners.
The JGH has used a consultation-liaison model and emphasized integrating the perspectives of medical anthropology with conventional
psychiatric, cognitive behavioural and family systems perspectives.
The MCH has emphasized a pluralistic approach and focused on providing flexible services for immigrant and refugee children, especially
those who have suffered organized violence. It has worked closely with schools and community organizations to integrate community
resources and perspectives.
The HJT has adapted an ethnopsychoanalytic model that uses a multicultural group of clinicians and people accompanying the patient to
reframe the problem from multiple points of view, and mobilize the cultural frames of reference of the patient and his or her entourage.
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