Dans cet article, l'auteur définit un mode d'intervention de type proactif en santé mentale qui est actuellement expérimenté dans le cadre d'un projet-pilote. L'approche proactive remet en question la pratique qui consiste à réagir à des demandes urgentes de services, formulées alors que la situation s'est déjà fortement détériorée et que les ressources du réseau social sont absentes ou dépassées. L'auteur décrit d'abord les obstacles au développement de cette approche proactive, caractérisée par une grande visibilité et une grande accessibilité des praticiens, qui offrent des services avant qu'ils ne leur soient sollicités. Il illustre ensuite des modes d'intervention dont le but est d'apporter du soutien aux citoyens et aux aidants naturels.In this article, the author describes a mode of intervention defined as proactive in mental health care, in the case of an existing pilot project. This type of intervention contrasts with the reactive mode, which is characterized by reactions to urgent requests for services when a situation has deteriorated badly and social network resources are either absent or irrelevant. The author outlines the obstacles to developing such a proactive mode. This approach, which requires a high degree of visibility and accessibility on the part of the practician, involves providing services before they are even requested. Finally, the author examines certain types of proactive interventions whose objective is to offer support to members that are close to the individual
This paper reports an evaluation study of a pilot project held in a “CLSC” (Local Community Health Centre) located in a rural community. The intervention design is based on multidisciplinary teams created to meet specific local community needs. Mental health intervention is part of community-based approach open to all kinds of requests for support. Practitioners in the field give support not only to the individual with a mental health problem, but also to existing self-help networks in the community. The intervention is also designed to change the relationship between a professional, seen as the one who provides services, and a client, defined as a consumer. The term “client” gains a wider meaning, and collaborative work with informal self-help networks induces a closer relationship between the community and the practitioner. The practitioner is more open to local community values and adjusts his or her practice to match variable contexts. The evaluation study has expanded knowledge on this type of intervention design, on its impact upon service demand, intervention modalities, and service management and organization. This project was coupled with a similar project in an urban environment and was financed by the Health and Social Services Ministry in Québec.
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