At the individual level, clinical risk factors for suicide among Inuit are similar to those observed in studies with the general population, and indicate a need for improved access to mental health services. The high rate of mental health problems among control subjects suggests the need for population-level mental health promotion.

<h4></h4> <p>This article presents research findings from the Rural and Isolated Working Group, one of six groups established by the Canadian Collaborative Mental Health Initiative (CCMHI). Funded through Health Canada&rsquo;s Primary Health Care Transition Fund, the goal of the CCMHI is to improve the mental health and well-being of Canadians by increasing collaboration among primary health care and mental health care providers, consumers, families, and caregivers. Qualitative data obtained from mental health care providers and consumers across all regions of Canada are presented in this article. Policy and regulation problems, barriers to mental health care access, service providers&rsquo; perspectives of the challenges to consumer involvement, and solutions for addressing these issues are discussed. The article concludes by identifying how this research has informed and influenced initial steps toward mental health promotion and treatment of mental illness in rural and isolated Canada.</p> <h4></h4> <p>Ms. Ryan-Nicholls is Associate Professor, Department of Psychiatric Nursing, School of Health Studies, Brandon University, Brandon, Manitoba, and a PhD candidate, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada; and Dr. Haggarty is Medical Director, Outpatient Department, St. Joseph&rsquo;s Care Group, and Associate Professor, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, Ontario, Canada.</p> <p>The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity.</p> <p>The authors acknowledge the Canadian Collaborative Mental Health Initiative, Health Canada&rsquo;s Primary Health Care Transition Fund, their employers, Rural and Isolated Working Group, and Dr. Nick Kates of McMaster University.</p> <p>Address correspondence to Kimberley D. Ryan-Nicholls, RPN, RN, BScN, MDE, Associate Professor, Department of Psychiatric Nursing, School of Health Studies, Brandon University, 270 18th Street, Brandon, Manitoba, Canada R7A 6A9; e-mail: <a href="mailto:nicholls@brandonu.ca">nicholls@brandonu.ca</a>.</p>

Objectives: In the shared care model, psychiatrists and physicians work in the same office areas, write their notes in the same casebooks, and can more rapidly exchange information about referrals and health conditions of their patients. We evaluated the impact of the introduction of a shared mental health care service, co-located with a primary care site, on wait times for mental health services in a northern Ontario city. Method: Chart reviews were conducted to examine a total of 3589 referrals for 5 mental health outpatient services (1 shared care and 4 existing services) from January 2001 to the end of June 2004. The shared mental health care service site was started in July 2001. Wait time was measured 6 months prior to and up to 3 years after the introduction of the shared care service. Results: The shared care site offered services more than 40 days sooner and also helped to reduce wait time on the nonshared care sites. After shared care began, the pre-existing, nonshared care services had wait times of about 13 days shorter during the 3 subsequent years. Conclusions: The shared care service maintained the lowest overall wait times, compared with the existing nonshared care services. The existing services experienced a decrease in the number of days waiting when the baseline wait time was compared with that of the following year. W W W Objectifs : Dans le modèle des soins partagés, psychiatres et médecins travaillent dans les mêmes bureaux, rédigent leurs notes dans les mêmes recueils, et peuvent échanger plus rapidement l'information sur l'aiguillage et l'état de santé de leurs patients. Nous avons évalué l'effet de l'introduction d'un service de soins de santé mentale partagés, installé au même endroit que des soins de première ligne, sur les temps d'attente des services de santé mentale dans une ville du nord de l'Ontario. Méthode : Une étude des dossiers a été menée pour examiner un total de 3589 consultations pour 5 services externes de santé mentale (1 de soins partagés et 4 services existants) de janvier 2001 à la fin de juin 2004. Le service de soins de santé mentale partagés a ouvert ses portes en juillet 2001. Les temps d'attente ont été mesurés 6 mois avant et jusqu'à 3 ans après l'ouverture du service de soins partagés. Résultats : Le site des soins partagés offrait des services plus de 40 jours plus tôt et contribuait également à réduire les temps d'attente des sites de soins non partagés. Après le début des soins partagés, les services de soins non partagés préexistants ont eu des temps d'attente de quelque 13 jours plus courts durant les 3 années subséquentes. Conclusions : Le service des soins partagés a maintenu les temps d'attente les plus faibles en général, comparativement aux services de soins non partagés existants. Les services existants ont connu une diminution du nombre de jours d'attente, lorsque les temps d'attente de départ ont été comparés avec ceux de l'année suivante.

A CD-ROM on suicide prevention was evaluated in an Inuit hamlet to examine if knowledge is acquired after viewing this multi-media format of education. Twenty-four respondents showed knowledge increased after viewing. Forty six percent had never used a computer yet 95% felt the technology could train counselors. Such technology may improve knowledge and skills in this cultural setting and perhaps may be useful in other cross-cultural environments.

No abstract

We investigated the association of suicidal ideation and behavior with depression, anxiety, and alcohol abuse in a Canadian Arctic Inuit community. Inuit (N = 111) from a random sample of households completed assessments of anxiety and depression, alcohol abuse, and suicidality. High rates of suicidal ideation within the past week (43.6%), and suicide attempts within last 6 months (30%), were reported. Ideation was more frequent among younger persons, whereas those favoring local native language were less likely to report a wish to die. Higher overall suicidality scores were associated with higher anxiety, and alcohol abuse, but not with depression or gender. Implications for future research are discussed.

No abstract

No abstract