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
3.3 Objectifs de l’évaluation The CCS Project was designed to evaluate the impact of cultural consultation, to clarify its role and effectiveness, and to compare different
models of implementation.
Service I : The specific goals of this evaluation were: 1) to document the process of developing the service; 2) to identify gaps and barriers to
care in the general health care system; 3) to identify the types of cultural formulation used by consultants; 4) to evaluate the client satisfaction,
recommendation concordance and clinical outcomes of the intervention.
4. PROCESSUS DE MISE EN ŒUVRE
4.1 Modalités de mise en oeuvre Aucune information à ce sujet
4.2 Enjeux ou défis posés par
l’innovation
Service II : The overall goals of the evaluation of the MCH program were to draw out the specificity and limits of a transcultural approach in
child psychiatry and to outline the eventual contribution and the transferability of this specific vision to intervention in health, social service and
school milieus. The specific goals were: 1) to describe the clinical population of the Transcultural Clinic and document the evolution of
treatment modalities and outcomes; 2) to analyze the modes of conceptualization and intervention employed in complex cases of trauma and
first episode psychosis followed by the clinic.
Service III : Accordingly, the aim of the evaluation was to better understand the perspective of patients who received treatment at the
Jean-Talon clinic with this extended group psychoanalytic model. The goal was to identify the acceptability and impact of the intervention from
the patient’s point of view.
Aucune information à ce sujet
4.3 Conditions favorables ou facilitantes Service I : Most clinicians requesting consultations had heard about the service through word of mouth, and the rate of referrals gradually
increased over the course of the project.
Presentations to clinical services by CCS team members also increased awareness of the service and its usefulness.
4.4 Obstacles Service I : The cases represented an enormous diversity of countries of origin, languages, ethnocultural groups and religions. This demanded
a wide range of consultants, interpreters and culture brokers.
Because it was not usually possible to find a skilled clinician with the requisite language skills and cultural background knowledge, it was often
necessary to use 2 to 3 consultants to address the specific cultural and mental health issues raised by a case.
It was possible to find appropriate resources to conduct the consultation in most cases. However, ethnic matching was very approximate and it
was particularly difficult to find psychiatrists and child psychiatrists with skills needed to work with specific patients.
Patients were sometimes reluctant to meet with a culture-broker or consultant from their own background because the small size of the local
community made confidentiality impossible to maintain.
The same concerns about confidentiality applied to the use of interpreters during the consult. Given that the CCS strictly used interpreters
from the Régie régionale, the rules of confidentiality were clearly in place. Patients needed to be reassured about what this would mean.
Similarly, sometimes clients who were seeking asylum expressed concern about how information gathered during a cultural consultation might
affect their application for a refugee status.
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