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Despite the emerging body of literature on the benefits of youth peer support, there is also evidence that peer support can have unintended negative impacts on peers themselves. It is important to explore what aspects of the peer role contribute to these difficulties in order to mitigate risks. This paper uses a participatory approach to examine the unique attributes of youth peer practice and the related challenges. We conducted semi-structured interviews and focus groups with both peer and non-peer staff from a community-based youth mental health program that provides peer support services (N = 29). Thematic analyses were completed using QSR NVivo. Analyses capture the defining features and related challenges of the peer support role (self-disclosure, boundaries, role confusion and dynamic recovery), and risk factors that affect peers (stigma, exposure to harm and burnout). This paper contributes to the literature on peer support as well as youth participatory evaluation. The findings will be useful to support the development of improved organizational contexts for peer practice and more effective peer support programming. [ABSTRACT FROM AUTHOR]

Healthcare systems and health professionals are facing a litany of stressors that have been compounded by the pandemic, and consequently, this has further perpetuated suboptimal mental health and burnout in nursing. The purpose of this paper is to report select findings from a larger, national study exploring gendered experiences of mental health, leave of absence (LOA), and return to work from the perspectives of nurses and key stakeholders. Given the breadth of the data, this paper will focus exclusively on the qualitative results from 53 frontline Canadian nurses who were purposively recruited for their workplace insight. This paper focuses on the substantive theme of "Breaking Point," in which nurses articulated a multiplicity of stress points at the individual, organizational, and societal levels that amplified burnout and accelerated mental health LOA from the workplace. These findings exemplify the complexities that underlie nurses' mental health and burnout and highlight the urgent need for multipronged individual, organizational, and structural interventions. Robust and timely interventions are needed to restore the health of the nursing profession and sustain its future. [ABSTRACT FROM AUTHOR]

As a registered psychotherapist and art therapist, my clinical training was primarily based on North American clinical approaches influenced by traditional Euro and western‐centric clinical theories of human behavior. I completed my training feeling certain that traditional clinical mental health practices were not an appropriate fit for racialized communities and could have negative implications for their healing and well‐being. As clinicians, it is our moral obligation to support and enhance the quality of life for marginalized groups. We can do this by challenging our values and knowledge that have been defined and influenced by structures (i.e., education, training, etc.) embedded in these colonial teachings. For this paper, I used a heuristic self‐inquiry research method to investigate these concerns. I interviewed other racialized psychotherapists practicing in Turtle Island (currently mostly occupied by the political entities of Canada and the United States) with the aim to learn how and if decolonization can be used in therapy practice. With this research, I (1) identified a gap in care for racialized communities, (2) questioned if or how a decolonizing approach to care should be considered, (3) explored my discomfort with practitioners in the field that claim their position on decolonizing therapy, practice, and approaches, and lastly (4) propose other ways of knowing that can inform new ways of practicing therapy. The results of this research helped to problematize the language and use of decolonizing therapeutic practices while learning about other concepts that may be relevant yet distinct, such as principles of coloniality/decoloniality. Those of us, therapists or researchers, wanting to disrupt the current practice of therapy need to work together, share knowledge, and challenge each other, so that we can transform the way we practice as psychotherapists. This paper is my contribution to this conversation. Highlights: I interviewed racialized psychotherapists to learn how and if decolonization can be used in therapy.Traditional psychology can lead to ineffective mental health care for racialized communities.I propose other ways of knowing that can inform new therapy practices for racialized communities. [ABSTRACT FROM AUTHOR]

This collaborative paper explores the interconnections between climate change and the mental health and well‐being of Indigenous women in Western Canada. As the impacts of climate change intensify globally, vulnerable populations, particularly Indigenous communities, face disproportionate and multifaceted challenges. Centering on Indigenous women in Western Canada, this study explores how the climate crisis magnifies Indigenous communities' mental health disparities. Drawing from the Indigenist feminist research approach, the investigation focuses on Indigenous women's lived experiences, perceptions, and land‐based coping strategies amidst climate challenges, while simultaneously addressing the unique social, cultural, and historical factors influencing their mental health vulnerabilities within the context of climate change. The findings shed light on the complex relationships between environmental degradation, ongoing colonial impacts on traditional practices, and the mental well‐being of Indigenous women. Concluding with implications for policy and community‐led interventions, this research contributes to the discourse on the intersectionality of climate change impacts and mental health, particularly focusing on Indigenous women in Western Canada. [ABSTRACT FROM AUTHOR]

Purpose: Research on intimate partner violence (IPV) is generally focused on female survivors. However, in Canada, about half of all self-reported victims of IPV are men and 1 in 5 calls to police for domestic violence are for male victims. This paper takes a comparative approach to understanding survivors' experiences of IPV. Methods: Across Canada, 110 female and 45 male survivors of IPV were recruited through media, social media, and listservs for a survey and interviews in 2017. Results: Findings indicate areas of similarity (healthcare needs; difficulty accessing formal support; fear of false accusations) and areas of difference (availability of formal support; types of violence experienced most often; interactions with the justice system). Women and men reported similar types of IPV, with women experiencing higher rates of sexual violence, stalking, and damage to property. Women and men reported similar physical and mental health consequences following IPV. Men were less satisfied than women with the response of the justice system, and both female and male participants encountered gender bias within the justice system. Some women reported being turned away from services that were at their maximum capacity, and men reported difficulty identifying IPV-related services for male survivors. Conclusions: Findings can be used by frontline service providers and the justice system to ensure that services are gender-inclusive and gender-sensitive. [ABSTRACT FROM AUTHOR]

Epidemiology of mental disorders emerged in the post-1945 era at the intersections of different areas of knowledge. Given its ambitions, the Stirling County Study provides an instructive case study. It is also a good example of how the epidemiology applied methodological skills from social sciences. This paper aims, first, to reconstruct one of the first episodes in the development of psychiatric epidemiology. Its second purpose is to provide a detailed description of interdisciplinarity at work, and to examine its effects. After explaining some of the major features of the Stirling County Study, I emphasize the links between some of the first results, particularly regarding young people as a population at risk, and the job market after the Great Depression. [ABSTRACT FROM AUTHOR]

The purpose of this discussion paper is to explore the existing literature from Canada on transitioning from military to civilian life for veterans of recent deployments. A number of topics relating to the transition experience emerged: interpersonal readjustment, emotional including mental health needs, school needs, and social needs. Implications for nursing will be discussed in terms of veterans as a cultural group and culturally competent nursing care. Recommendations for future nursing research include how well current services are meeting the needs of the younger, more recent veterans transitioning to civilian life; conducting longitudinal studies on the impact of transitioning to civilian life for veterans and their families; comparing the transition experience at an international level; developing a transition model that situates the veteran culture as the overarching framework for testing and understanding the experience of transitioning to civilian life. [ABSTRACT FROM AUTHOR]

Building upon two previously published research papers exploring Canadian media reporting of childhood in the first wave of the pandemic, this paper investigates how constructions of childhood evolved from the first wave to the fourth wave of the pandemic. This qualitative research is guided by the central research question: Over the span of 2 years, from 2020 to 2022, what changes are evident in discourses reported within media focused on the impact of the COVID-19 global pandemic on Canadians under the age of 18 years? Findings from this study suggest that in the fourth wave young people were constructed as innocent victims of pandemic restrictions framed through an adult-centric lens; noticeably absent were representations of young people under the age of 18 in their voices. A key recommendation emerged from this study: any future research investigating the impact of the pandemic on young people under aged 18 years must include their full participation. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic disproportionately affected those who face historical and ongoing marginalization. In centering pandemic experience of recent immigrant women in the accommodation and food services sector in Canada, we examine how their precarious work translated to experiences of work precarity and wellbeing. This paper illuminates how pre-existing and ongoing marginalization are reproduced during a health crisis for those at the intersection of gender, race, migration, and labour inequities. Using semi-structured interviews and systematic analysis using the Work Precarity Framework, we found that the pandemic exacerbated pre-existing socio-economic marginalization and resulted in unique experiences of work precarity. The latter was experienced as precarity of work (unpredictable work hours and job or employment insecurity), precarity from work (inadequate incomes), and precarity at work (physical, psychological, and relational unsafety). Work precarity stood out as a social determinant of health in relation to its outcome of degraded mental health and wellbeing. Recognizing the role of policies in producing, reproducing, and distributing precarity, we recommend policy directions to reduce social inequities in pandemic recovery. [ABSTRACT FROM AUTHOR]

Rates of mental health problems and disorders in children and youth have been increasing for at least three decades, and these have escalated due to the pandemic and multiple other societal stressors. It is increasingly recognized that students and families frequently struggle to receive needed care through traditional locations such as specialty mental health centers. Upstream mental health promotion and prevention strategies are gaining support as a public health approach to supporting overall population well-being, better utilizing a limited specialty workforce, and reducing illness. Based on these recognitions, there has been a progressive and escalating movement toward the delivery of mental health support to children and youth "where they are," with a prominent and more ecologically valid environment being schools. This paper will provide a brief review of the escalating mental health needs of children and youth, advantages of school mental health (SMH) programs in better meeting these needs, example model SMH programs from the United States and Canada, and national and international SMH centers/networks. We conclude with strategies for further propelling the global advancement of the SMH field through interconnected practice, policy, and research. [ABSTRACT FROM AUTHOR]

Accessible Summary: What Is Known on the Subject?: Economic and educational opportunities are usually the principal driving forces for migration.There is a large body of quantitative research studies, mainly from the U.K., supporting the high prevalence of psychiatric disorders, mainly psychotic disorders, in Afro‐Caribbean immigrants which increases across generations.The process of migration and acculturation can present significant risk factors for psychiatric disorders in immigrants.Research involving members of the Black community is generally conducted with the perception that Blacks are a homogenous group, ignoring the cultural and ethnic differences among the subgroups. What the Paper Adds to Existing Knowledge?: It provides a broadened understanding of the experiences, thoughts and feelings of Afro‐Caribbean immigrants, and the factors within the processes of migration and acculturation that negatively impacts their mental health.It provides context to the volume of quantitative studies indicating a high prevalence of psychiatric disorders, particularly psychotic disorders, in Afro‐Caribbean immigrants and their offspring. What Are the Implications for Practice?: Nurses conducting mental health evaluations and assessments for members of the Black community should be culturally competent. Cultural competence entails an understanding of cultural beliefs, race, ethnicity and values. Additionally, knowledge of the effects of migration and acculturation as mental health risks is also important to improve mental health outcomes.Cultural competence will help reduce health disparities by increasing trust in the health care system and providers, not only for Afro‐Caribbean immigrants, but all immigrant groups. Introduction: There is evidence to support migration as a significant risk factor for psychiatric disorders in immigrants. Unfortunately, as an immigrant group, little is known about the mental health of Afro‐Caribbean immigrants and the factors that threaten their mental health. Aim: To explore the perceived effects of migration on the mental health of Afro‐Caribbean immigrants. Methods: A qualitative narrative synthesis was employed to interpretively integrate 13 primary qualitative research findings. Eleven of the primary studies were conducted in the U.K., one in the U.S. and one in Canada. Results: The themes gleaned: (1) experiences of racism, (2) generational conflicts, (3) feelings of powerlessness, (4) limited socioeconomic resources, (5) unfulfilled expectations, (6) fragmented family and community and (7) ignoring cultural/ethnic identity. Discussion: The findings broadened the understanding and experiences of Afro‐Caribbean immigrants and their mental health vulnerabilities as they navigate through migration and acculturation. Implications for Practice: Addressing the mental health of Afro‐Caribbeans will require health care providers to: (1) be cognizant of their immigrant status; (2) understand how migration and acculturation influence the mental health of immigrants; (3) be aware of the ethnocultural differences among Black subgroups. [ABSTRACT FROM AUTHOR]

Compared to research conducted with nondisabled samples, little is known about the relation between mental health and physical activity (PA) in individuals with a spinal cord injury (SCI). Despite this population being more at risk of experiencing anxiety and depression and less likely to engage in PA, few studies have investigated other factors that may impact this association in this population such as anxiety sensitivity (AS). AS is a fear of physiological arousal sensations, and importantly has been shown to be negatively associated with PA in people without disabilities. It is unknown if the changes to how one experiences physiological sensations after a SCI impacts the relation between AS and PA. Objective: This study investigated which forms of PA are predicted by anxiety and depression and whether AS is predictive of PA in this population. Research Method: 98 participants with a SCI (both paraplegia and tetraplegia) completed an online questionnaire that had measures of PA, AS, and anxiety and depression. Results: It was found that symptoms of anxiety were significantly associated with mild-intensity PA. Interestingly AS was positively associated with moderate-intensity PA. Conclusions: The results of this study show that the relation between mental health and PA in this sample may not mirror what has been found in people without disabilities. More research is needed to replicate these findings as well as to investigate other potential mechanisms that may be relevant for people with a SCI. Impact and Implications: The results of this paper provide important insights into the association between physical activity and mental health for people with a spinal cord injury (SCI). The results of this paper suggest that research looking at this association in people who do not have disabilities may not be generalizable to people with a SCI. [ABSTRACT FROM AUTHOR]

This paper presents findings from an investigation of nature-based practices, from the perspectives of 10 academics/educators from six nations. Participants engaged in a focus group exploring the prevalence and inclusion of nature in social work practice and education. While the study focused on individual members' experiences and perspectives, the findings highlight important context-specific factors for including nature within social work to reconnect humans with nature for health, well-being, healing, and justice. An Integrative Environmental Model for social work is proposed to assist future practice and education. [ABSTRACT FROM AUTHOR]

In Canada, there are vast differences between the state of accommodation/housing, health, social inequalities, education and economic conditions for people in the northern and southern regions of the country. Overcrowding in Inuit Nunangat is a direct result of the promises made by past government policy that led to Inuit people settling in sedentary communities in the North on the understanding that they would be provided with social welfare. However, these welfare programmes proved to be either insufficient or non-existent for Inuit people. Therefore, Inuit are living in overcrowded homes in Canada, resulting in a severe housing shortage, poor-quality housing and homelessness. This has led to the spread of contagious diseases, mould, mental-health issues, gaps in education for children, sexual and physical violence, food insecurity and adverse challenges for the youth of Inuit Nunangat. This paper proposes several actions to ease the crisis. First, funding should be stable and predictable. Next, there should be ample construction of transitional homes which could be used to accommodate people before moving them into proper public housing. Policies regarding staff housing should be amended, and if possible, these vacant staff houses could provide shelter to eligible Inuit people, which could help lessen the housing crisis. The advent of COVID-19 has made the issue of affordable and safe housing more serious because without safe housing, the health, education and well-being of the Inuit people in Inuit Nunangat are in peril. This study focuses on how the governments of Canada and Nunavut are dealing with this issue. [ABSTRACT FROM AUTHOR]

The military lifestyle can be defined by a triad of unique stressors: frequent relocation, parental absence, and risk of injury, illness and/or death of a serving member. Research has suggested that this unique triad of stressors can impact the mental health of children and youth living in military families. However, research focusing on the mental health of children and youth living in military families overwhelmingly focuses on the American context. Due to key contextual differences, it is unclear to what extent the American findings are representative of military-connected children and youth living in other geographical contexts, such as Canada. A large qualitative study was conducted to explore the mental health of military-connected children in Canada from three perspectives: child, parent, and service provider. This paper reports on the service provider findings. Using individual semi-structured interviews, data were collected from 11 service providers. Data analysis was guided by qualitative content analysis. Two main themes emerged: (1) the mental health of children living in military families may be impacted by the military lifestyle stressors, and (2) the mental health of children living in military families can be impacted by the accessibility and availability of mental health services. While this qualitative study builds upon recent Canadian work that has considered the service provider perspective, additional research is needed to better understand the experiences of service providers who support military-connected children and youth. Highlights: American research shows that the military lifestyle factors can impact the mental health of military-connected children. The mental health of military-connected children has yet to be extensively explored in Canada. The mental health of children living in Canadian military families may be impacted by the military lifestyle stressors. The mental health of Canadian military-connected children can be impacted by the accessibility and availability of mental health services. Our findings can help build capacity and knowledge for service providers who support Canadian military-connected children. [ABSTRACT FROM AUTHOR]

This paper examines the longitudinal effects of the COVID-19 pandemic on older adults (65+) with multimorbidity on levels of depression, anxiety, and perceived global impact on their lives. Baseline (2011–2015) and Follow-up 1 (2015–2018) data from the Canadian Longitudinal Study on Aging (CLSA), and the Baseline and Exit waves of the CLSA COVID-19 study (April–December, 2020) (n = 18,099). Multimorbidity was measured using: a) an additive scale of chronic conditions; and b) six chronic disease clusters. Linear Mixed Models were employed to test hypotheses. Number of chronic conditions pre-pandemic was associated with pandemic levels of depression (estimate = 0.40, 95% CI: [0.37,0.44]); anxiety (estimate = 0.20, 95% CI: [0.18, 0.23]); and perceived negative impact of the pandemic (OR = 1.04, 95% CI: [1.02, 1.06]). The associations between multimorbidity and anxiety decreased during the period of the COVID-19 surveys (estimate = −0.02, 95% CI: [−0.05, −0.01]); whereas the multimorbidity association with perceived impact increased (OR = 1.03, 95% CI: [1.01, 1.05]). This study demonstrates that pre-pandemic multimorbidity conditions are associated with worsening mental health. Clinicians treating mental health of older adults need to consider the joint effects of multimorbidity conditions and pandemic experiences to tailor counseling and other treatment protocols. [ABSTRACT FROM AUTHOR]

Background: Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. Methods: Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. Results: Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. Conclusion: There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth. [ABSTRACT FROM AUTHOR]

Objective: Previous research has evaluated the sources of post-secondary student stress, but has failed to explore whether stressors fluctuate over time. The purpose of this research was to use the Post-Secondary Student Stressors Index to examine whether stressors changed significantly and meaningfully over the course of an academic year. Due to the timing of data collection, results also provide context around students' experiences of stress during the COVID-19 pandemic. Method: Cross-sectional data was collected at 3 time points via online surveys over the course of the 2020–2021 academic year from >10,000 students. Participants attended 15 post-secondary institutions across Canada, representing 9 provinces and 1 territory. Validated instruments were used to assess levels of stress, distress and the severity of student-specific stressors. Kruskal–Wallis ranked tests and multiple pairwise comparison analyses were conducted to assess whether the mean severity of stressors changed over time. Standard effect sizes were calculated using Cohen's d. Results: Mean levels of stress and psychological distress were high at the start of the study and remained high across time points. A similarly high level of stress was observed on average for student-specific stressors. While significant differences in mean severity were observed over time for some stressors, standardized effect sizes were negligible, suggesting little meaningful change and consistent levels of chronic stress over the course of the academic year. Conclusions: This is the first paper to examine trends in student-specific stress using a nationwide sample of Canadian post-secondary students during the first year of the COVID-19 pandemic. Patterns observed in student-specific stressors reflected changes likely to be indicative of the pandemic, including the most severe stress associated with academics, finances and concerns for the future. Implications for future research are discussed, in particular, the importance of examining stressors related to COVID-19 and their impact on student mental health. [ABSTRACT FROM AUTHOR]

Black youths experience poor mental health especially due to anti‐Black racism. Research related to Black youths have been conducted on Black youths with little or no participation or engagement rather than with Black youths. This paper presents information from a dialogue on decolonizing nursing research. I draw on interviews and conversation cafes with around 120 Black youths in Canada to identify strategies for decolonizing research with Black youths. First, I reflect on my relations with the Indigenous land in which the study was conducted as well as my positionality as a Black woman. In this paper, I discuss how community based participatory action research can integrate capacity building component, amplify youth's voices and capitalize on the agency of youths as fruitful actors. I also reflect on the opportunities and benefits of decolonizing nursing research. [ABSTRACT FROM AUTHOR]

A key public health response to the COVID-19 pandemic is the mandate to stay home and practice physical distancing. In Canada, with essential activities such as grocery shopping, outdoor exercise and transportation, people need to be able to safely navigate dense, urban spaces while staying at least two metres or six feet apart. This pandemic has exacerbated the health inequities across neighbourhoods in cities like Toronto, Canada which are often segregated along racial and income lines. These inequities impact who has access to urban infrastructure that promotes health and quality of life. Safety in a time of COVID-19 goes beyond just exposure to the virus, it is complicated by notions of who belongs where, and who has access to what resources. The built environment has a role in maintaining and promoting physical and mental health during this pandemic and beyond it. This paper puts forwards three considerations for built environment interventions to promote health equitably: (i) addressing structural determinants of health and embedding anti-racist intersectional principles, (ii) revisiting tactical urbanism as a health promotion tool and (iii) rethinking community engagement processes through equity-based placemaking. This paper outlines four built environment interventions in Toronto, Canada that seek to address the challenges in navigating urban space safely in the short term, including street design that prioritizes pedestrians, protected cycling infrastructure, access to inclusive green space and safe, affordable housing. Longer-term strategies to create health-promoting urban environments that are equitable are discussed and may be valuable to other cities with similar urban equity concerns. [ABSTRACT FROM AUTHOR]

• Many mental health disorders first emerge during early childhood or adolescence. • Wait times for children's mental health services have been an international and widespread problem. • Long wait times prolong the emotional distress of children and/or adolescents and their caregivers which can exacerbate mental health difficulties. • The majority of research in this area has been conducted in the United Kingdom and Canada and focus on one waitlist strategy. • Common strategies include alternative service delivery models, increasing system capacity, and improving intake and assessment processes. Background: Although many mental health disorders first emerge during early childhood or adolescence, there is a significant gap between demand and availability of mental health resources, leading to long waitlists for services. Objective: The objective of this scoping review was to identify and characterize the research literature related to the range of waitlist management strategies that have been implemented in outpatient child and adolescent mental health care. Methods: Electronic databases reviewed included: Medline (Ovid), Embase (Ovid), PubMed, PsychINFO, SCOPUS, CINAHL, and ISI Web of Science. Grey literature databases included: OpenGrey, Conference Papers Index, and Proquest Digital Dissertations. Articles were screened by two reviewers in two steps: first by title and abstract, then full text level. Data were extracted using an a-priori developed data extraction framework, which was piloted and modified iteratively. Results: A total of 119 papers related to waitlist interventions in child and adolescent mental health were reviewed. Of these 119 papers, 11% were reviews, summary, or theoretical papers; 8% used a randomized control trial design and 2.5% were trial protocols. Most studies used less rigorous designs, such as uncontrolled before-and- after designs. The large majority focused on just one waitlist strategy each. The most commonly used approaches included: prioritization/triage and initial assessment; brief consultation and advice or brief therapy approaches; group-based models; interim services; increasing capacity; and strategies to decrease non-attendance. Most studies were conducted in the United Kingdom or Canada. Discussion: While mental health systems are complex, most studies examining waitlist initiatives explored the implementation of single initiatives. It is unlikely that a single waitlist strategy can be effective in managing wait times for children's mental health. Rather, consistent and systemic approaches to address wait times that consider the impact of the reduction approach on the patient, the program, and the community are needed. [ABSTRACT FROM AUTHOR]

Trans and non-binary youth (TNBY) face high levels of interpersonal and social adversity as well as disproportionate rates of mental health issues such as depression, self-harm and suicidal ideation. Among protective factors, context plays a key role. In addition to parental support, access to gender-affirming medical care begins to emerge as crucial for young people needed them. This paper compares, through thematic analysis, the experiences of TNBY with regard to access and experiences to care in Canada, Switzerland, England, and Australia. It identifies similarities and differences in barriers to access to care, as well as impacts of gender affirming care on young people and their well-being. The article concludes with a discussion on the importance of prompt and easier access to gender-affirming medical care, of training of professionals, and a hypothesis about the role of context in TNBY well-being. [ABSTRACT FROM AUTHOR]

Rationale: Implementation of strengths model case management is increasing internationally. However, few studies have focused on its implementation process, and none have specifically addressed the implementation experience of direct‐service practitioners. Objective: This paper presents factors that facilitate and impede the successful implementation of the strengths model, with a specific focus on practitioners who deliver the intervention directly to service recipients. Method: To address this objective, a qualitative study of seven mental health agencies that implemented the model was conducted, involving a combination of participant observations and qualitative semistructured interviews with case managers, team supervisors, and senior managers. Qualitative data were analyzed using open coding followed by axial coding. Finally, the findings were aligned with an adapted Consolidated Framework for Implementation Research. Results: Implementation of the strengths model involved a significant change in practice for case management practitioners. The results confirm that at the beginning of implementation, the strengths model was perceived as complex and not always adaptable to on‐the‐ground realities. With time, and with support from management, ongoing training and supervision sessions, and reflection and discussion, practitioners regained feelings of competence and resistance to the model diminished. The use of the model's structured team‐based supervision tools was fundamental to supporting the implementation process by enabling an interactive and concrete training approach. Conclusions: The more an approach leads to changes in daily practice and is perceived as complex, the more concrete support is needed during implementation. This article highlights the importance of attending to a practitioner's sense of personal effectiveness and competence in the adoption of new practices. [ABSTRACT FROM AUTHOR]

In countries like Canada with significant immigrant populations, immigrant youth can have various experiences that impact their identity and mental health outcomes. This paper presents findings from a study that examined the perceptions of mental health among African immigrant youth living in Canada and the factors that affect their mental health outcomes, including identity-related factors. An interpretive description design was used and eight participants were recruited. Data were gathered through in-person and phone interviews. The paper focuses on the migration factors that affect African immigrant youths' mental health. Three subthemes emerged from participants' experiences: (a) social support; (b) discrimination and othering; and (c) identity and cultural shock. Using critical theory and intersectionality, the study showed that African immigrant youths' identity and mental health were influenced by deeper socio-political and historical factors. [ABSTRACT FROM AUTHOR]

This paper used a structural perspective to examine unmet healthcare needs in women at risk for eating disorders in Canada utilizing the Canadian Community Health Survey. The results revealed that body dissatisfied women had reported significantly higher unmet needs compared to body satisfied women (χ 2(1) =29.31, p <.05). Body dissatisfied women were also more likely to identify structural reasons for unmet needs. Considering the high costs associated with eating disorders, barriers creating inequitable health services need to be addressed in clinical practice, organizational structures, policy, and in research to improve treatment pathways. [ABSTRACT FROM AUTHOR]

Migrants, that is people who experience forced displacement or move based on being lesbian, gay, bisexual, trans, two-spirit, queer, and intersex (LGBTQI+), experience increased trauma and stigma when compared to heterosexual and cisgender people. The aim of this paper is to highlight LGBTQI+ migrants' experiences of health and social care encounters in Canada. Gadamerian hermeneutics and an intersectionality lens was used to understand LGBTQI+ migrants' experiences. A total of 16 semi-structured individual interviews were conducted with LGBTQI+ migrants. Themes of stigma and discrimination were identified as (1) "I never went back": Stigma as an exclusionary experience, (2) "Is [your country of birth] really that bad": Fear, safety, and cultural stigma, and (3) "The circle ... is not going to fix my life": LGBTQI+ migrants' call for affirming care. Results suggest that health and social care practices are stigmatizing and discriminatory which negatively impacts LGBTQI+ migrant mental health. Salient practices for promoting mental health included affirming LGBTQI+ identities and orientations through health and social care practices that are culturally safe as well as trauma and violence informed. [ABSTRACT FROM AUTHOR]

Stigma of mental illness contributes to silence, denial and delayed help seeking. Existing stigma reduction strategies seldom consider gender and cultural contexts. The Strengths in Unity study was a multi-site Canadian study that engaged Asian men in three stigma reduction interventions (ACT, CEE, psychoeducation) and mobilized them as Community Mental Health Ambassadors. Our participants included both men living with or affected by mental illness (LWA) as well as community leaders (CL). This paper will: (1) describe the baseline characteristics of the Toronto participants including their sociodemographic information, mental illness stigma (CAMI and ISMI), attitudes towards social change (SJS), and intervention-related process variables (AAQ-II, VLQ, FMI, Empowerment); (2) compare the differences among these variables between LWA and CL; and (3) explore factors that may correlate with socio-economic status and mental health stigma. A total of 609 Asian men were recruited in Toronto, Canada. Both CL and LWA had similar scores on measures of external and internalized stigma and social change attitudes, except that LWA had more positive views about the acceptance and integration of those with mental illness into the community on the CAMI, while CL had a higher level of perceived behavioral control on the SJS. Group differences were also observed between LWA and CL in some process-related variables. Exploratory analysis suggests that younger and more educated participants had lower stigma. Our findings underscore the importance of engaging both community leaders and people with lived experience as mental health advocates to address stigma. [ABSTRACT FROM AUTHOR]

Objectives: Differences in health among migrant groups are related to the length of stay in host countries. We examined the health of people reporting Caribbean ethnic origins within and outside of Canada; and the possible associations between length of stay and poorer physical and mental health outcomes. Method: Analyses were conducted on population data collected in Canada (2000/2001, 2003, 2005), Jamaica (2005) and Guyana (2005). Physician-diagnosed and self-rated health measures were used to assess physical and mental health statuses. Results: Rates of chronic conditions were generally higher among people reporting Caribbean ethnic origins in Canada compared to those living in the Caribbean region. Self-rated fair or poor general health rates, however, were higher among participants in the Caribbean region. Higher rates of any mood disorders were also found among Caribbean region participants in comparison to those in Canada. Logistic regression analyses revealed that new Caribbean immigrants (less than 10 years since immigration) in Canada had better physical health than those who were more established. Those who immigrated more than 20 years ago showed consistently better health conditions than those who had immigrated between 11 and 20 years ago. This healthy immigration effect, however, was not present for all chronic conditions among all Caribbean origin migrant groups. Moreover, mood disorders were highest among new immigrants compared to older immigrants. Conclusions: When and where ethnic Caribbeans migrate to and emigrate from matters in health statuses. These results have implications for policies related to health and well-being in support of ethnic Caribbean origin individuals who relocate to Canada. The paper concludes with suggestions for future studies regarding the health of ethnic origin Caribbeans living within and outside their regions of birth. [ABSTRACT FROM AUTHOR]

This paper introduces an integrative (or braided) approach to Indigenous youth mental health, designed in response to a synthesis of knowledge from three systematic literature reviews and four informant consultations with mental health providers in various disciplines. The braided approach includes core principles of Indigenous Healing models (IH), Child and Youth Care (CYC) approaches, and Dialectical Behaviour Therapy (DBT) practices. The purpose of this approach is to best serve the mental and spiritual health needs of Indigenous youth across Canada during the COVID-19 pandemic. Findings of this research project informed the design and implementation of an online Indigenous youth mental health program, which is discussed in relation to the research. [ABSTRACT FROM AUTHOR]

The purpose of this paper is threefold: firstly, to provide a brief overview of current practice in workplace mental health and introduce an emerging role for occupational therapy in this field (i.e., practicing at the organizational level where "clients" are workplaces or organizations, and not individual workers); secondly, to present the findings from a small qualitative study which describes this emerging role from the perspectives of occupational therapists who have worked in this area; and thirdly, to provide suggestions for future work which could advance this emerging role for occupational therapy world-wide. Previous research suggests that there is an increasing interest among employers to address workplace mental health through organizational initiatives and that occupational therapists are beginning to consult on the topic. Occupational therapists in our small qualitative study described their role in organizational workplace mental health as one which involves adopting a business lens, practicing in an organization-centred manner, and focusing on population health promotion. Suggestions for future work to advance this emerging role include identifying the fundamental elements of the business lens, investigating models and frameworks to guide organization-centred practice, evaluating the short-, medium-, and long-term outcomes of interventions, exploring the fit between an occupational perspective and workplace mental health, and examining the impact of COVID-19 on current practice. [ABSTRACT FROM AUTHOR]

Two guidelines about opioid use in chronic pain management were published in 2017: the Canadian Guideline for Opioids for Chronic Non-Cancer Pain and the European Pain Federation position paper on appropriate opioid use in chronic pain management. Though the target populations for the guidelines are the same, their recommendations differ depending on their purpose. The intent of the Canadian guideline is to reduce the incidence of serious adverse effects. Its goal was therefore to set limits on the use of opioids. In contrast, the European Pain Federation position paper is meant to promote safe and appropriate opioid use for chronic pain. The content of the two guidelines could have unintentional consequences on other populations that receive opioid therapy for symptom management, such as patients with cancer. In this article, we present expert opinion about those chronic pain management guidelines and their impact on patients with cancer diagnoses, especially those with histories of substance use disorder and psychiatric conditions. Though some principles of chronic pain management can be extrapolated, we recommend that guidelines for cancer pain management should be developed using empirical data primarily from patients with cancer who are receiving opioid therapy. [ABSTRACT FROM AUTHOR]

Over the last decade, the problem of sex trafficking has become an alarming global concern. Reports suggest that half of active cases of sex trafficking involve female children and youth. This paper considers the mental health impact of sex trafficking on illegalized female trafficked youth under the age of 29 who live in Canada without legal immigration status. It will draw on a qualitative research, including individual interview and survey questionnaires, to explore the lived conditions and mental health outcomes of illegalized trafficked youth in the Greater Toronto Area. Sex trafficking is a gender and human rights violation, as well as a total control over an individual's body, sexuality, and livelihood. Trafficking negatively impacts the social determinants of health and mental health of trafficked persons. This paper provides three recommendations to improve mental health conditions of illegalized trafficked youth. [ABSTRACT FROM AUTHOR]

• Awareness: develop and evaluate the impact of digital strategies in helping veterans and their families acquire mental health knowledge. • Motivation: increase engagement with mental health literacy initiatives through a documentary performance featuring ex-servicemen and actors. • Action: implement and evaluate a psycho-educational program in partnership with the University of British Columbia, Canada (Balfour et al., 2014). • Synthesize an approach to effective interventions in arts-based practice with returning veterans and their families. The rich history of arts, mental health and military work dates back to the First World War. The article describes an arts-based four-year research project focussed on work with returning military personnel and their families dealing with mental health issues. The Difficult Return , funded by an Australian Research Council Discovery grant, consisted of three distinct interventions: an online mental health awareness campaign; a documentary-play designed to motivate military audience to seek help; and a ten-day intensive psychotherapeutic program utilising enactments. The paper will outline key concepts used, methods, approach and the implications for further research. In the paper, I argue that arts-based mental health projects need to combine multi-disciplinary approaches that embrace complex paradigms, and that a variety of integrated arts approaches may be efficacious in building communities of interest, that in turn can interact, contribute and collaborate together to build good mental health. [ABSTRACT FROM AUTHOR]

The unique challenges of the correctional healthcare environment are well-documented. Access to community-equivalent care, voluntary informed consent of offenders with mental disorder, violence risk, suicide risk, medication misuse, and clinical seclusion, confinement and segregation are just a few of the challenges faced by correctional psychiatric services. This paper shares experiences for dealing with the ongoing challenges for psychiatrists working in the field. It provides an overview of the current state of mental healthcare in the federal correctional system in Canada, the legislative framework and initiatives aimed at addressing the healthcare needs of federal inmates. [ABSTRACT FROM AUTHOR]

Background The COVID-19 pandemic has led to large proportions of the labour market moving to remote work, while others have become unemployed. Those still at their physical workplace likely face increased risk of infection, compared to other workers. The objective of this paper is to understand the relationship between working arrangements, infection control programs (ICP), and symptoms of anxiety and depression among Canadian workers, not specifically working in healthcare. Methods A convenience-based internet survey of Canadian non-healthcare workers was facilitated through various labour organizations between April 26 and June 6, 2020. A total of 5180 respondents started the survey, of which 3779 were assessed as employed in a full-time or part-time capacity on 2 March 2020 (prior to large-scale COVID-19 pandemic responses in Canada). Of this sample, 3305 (87.5%) had complete information on main exposures and outcomes. Anxiety symptoms were measured using the Generalised Anxiety Disorder screener (GAD-2), and depressive symptoms using the Patient Health Questionnaire screener (PHQ-2). For workers at their physical workplace (site-based workers) we asked questions about the adequacy and implementation of 11 different types of ICP, and the adequacy and supply of eight different types of personal protective equipment (PPE). Respondents were classified as either: working remotely; site-based workers with 100% of their ICP/PPE needs met; site-based workers with 50–99% of ICP/PPE needs met; site-based workers with 1–49% of ICP/PPE needs met; site-based workers with none of ICP/PPE needs met; or no longer employed. Regression analyses examined the association between working arrangements and ICP/PPE adequacy and having GAD-2 and PHQ-2 scores of three and higher (a common screening point in both scales). Models were adjusted for a range of demographic, occupation, workplace, and COVID-19-specific factors. Results A total of 42.3% (95% CI: 40.6–44.0%) of the sample had GAD-2 scores of 3 and higher, and 34.6% (95% CI: 32.–36.2%) had PHQ-2 scores of 3 and higher. In initial analyses, symptoms of anxiety and depression were lowest among those working remotely (35.4 and 27.5%), compared to site-based workers (43.5 and 34.7%) and those who had lost their jobs (44.1 and 35.9%). When adequacy of ICP and PPE was taken into account, the lowest prevalence of anxiety and depressive symptoms was observed among site-based workers with all of their ICP needs being met (29.8% prevalence for GAD-2 scores of 3 and higher, and 23.0% prevalence for PHQ-2 scores of 3 and higher), while the highest prevalence was observed among site-based workers with none of their ICP needs being met (52.3% for GAD-2 scores of 3 and higher, and 45.8% for PHQ-2 scores of 3 and higher). Conclusion Our results suggest that the adequate design and implementation of employer-based ICP have implications for the mental health of site-based workers. As economies re-open the ongoing assessment of ICP and associated mental health outcomes among the workforce is warranted. [ABSTRACT FROM AUTHOR]

Developing meaningful indicators to track youth mental health (MH) is important to support the development and evaluation of responsive mental health promotion (MHP) initiatives that address the socio-economic determinants of youth MH. Development of relevant indicators is challenged, however, by the lack of knowledge regarding the relations among socio-economic factors and youth MH. Thirty diverse young people from a Canadian metropolitan area were engaged within a process of social praxis to explore their experiences of the inter-relationship between their socio-economic environments and their MH and their processes of seeking to realize their MH. Participants emphasized 'needs' as foundational to MH, whereas 'wants', driven by materialistic and wealth-oriented values and social norms, constrained their MH. Their reflections on the inter-relations among their MH and socio-economic processes highlight eight inter-related MH needs within the Canadian socio-economic context. In this paper, we present these needs and show how these needs, young people's affective states, and their access to resources within co-evolving socio-economic processes (to enable their needs) illustrate the fundamental inter-relation between young people's MH and socio-economic processes. We identify implications for measuring youth MH within MHP practice, including the importance of iterative indicator frameworks that include measures of young people's access to resources to enable their MH needs and their degree of distress. [ABSTRACT FROM AUTHOR]

This study presents select findings from the quantitative arm of a mixed-method community-based study. The study examines ethnic identity, self-esteem, resilience, and mental health in immigrant and Canadian-born Pakistani youth from a systems perspective. Sixty-one youth aged 18–24 years participated in a survey; among these, 28 completed the survey online and 33 completed the paper-based version. Youth reported on demographics, physical health, mental, and social health, and completed the 4-item Current Self-Esteem Scale (CSE), the 15-item Multigroup Ethnic Identity Measure (MEIM), and the Child and Youth Resilience Measure (CYRM-12). Descriptives' analysis was applied to the numeric items and content analysis was applied to open-ended questions. Among the sample, 34% youth were male and 66% females, 69% were Pakistani-born, and 20% were Canadian-born. About 36% of the youth had been in Canada for 5 years or less, and 10% reported 5–10 years of stay. Eighty percent of youth (n = 46) reported good to excellent mental health, and 74% felt stressed on most days. Scores for self-esteem (CSE) [6.5 (2.13 SD)], Ethnic Identity MEIM [3.14 (0.21 SD)], and resilience (CYRM-12) [4.23 (0.23 SD)] were moderate to high. Academic success and religious and family connectedness were found to have a positive effect on youth sense of self. Higher levels of ethnic identity and higher rating on mental health in our sample suggests the healthy immigrant effect. [ABSTRACT FROM AUTHOR]

Bibliometrics and scientometrics are novel closely related scientific fields measuring and analyzing scientific publications in a certain area. Although spirituality, religion and health (S/R&H) field has been a growing study area in recent years, only a few bibliometric studies have been conducted on published literature in S/R&H. In this study, we aimed to perform bibliometric and scientometric analysis of the documents published in the Journal of Religion and Health, which is one of the most significant and productive journals in spirituality, religion and health field, during the period of 1975 to 2016. We used Thomson Reuters Web of Science database for the publication analyses. A total of 2683 papers were found and most of them were original articles (1655, 62.1%) followed by book reviews (780, 29.3%) and editorial materials (169, 6.3%). We found that the USA was the most productive country with 1665 papers and 62.45% of total literature followed by Australia and Canada. Cornell University in the USA was found to publish the highest number of documents with 73 papers and to cover 2.74% of the total literature followed by Duke University and Weill Cornell Medical College. A total of 2973 keywords were detected to be used. Most used five keywords were “religion,” “spirituality,” “religiosity,” “health” and “mental health” (n = 253, 250, 97, 71 and 41 times, respectively). Our bibliometric and scientometric study of one of the most important leading journals in S/R&H area may encourage researchers to carry out further studies in this field. [ABSTRACT FROM AUTHOR]

Homelessness has negative implications for mental well-being and quality of life. This paper identifies the quality of life variables that contribute to positive or negative wellbeing, reporting on a regression analysis from 343 individuals experiencing homelessness in Canada. Results indicate that a lack of sleep duration and quality reduced mental well-being for both genders, not having access to food and/or hygiene facilities decreased men's well-being, and engaging in illegal subsistence strategies, such as selling drugs, negatively impacted women's mental well-being. For persons experiencing homelessness, mental well-being and quality-of-life are gendered outcomes of their limited access to social determinants of health. [ABSTRACT FROM AUTHOR]

Single-session, or one-at-a-time, open-access care is central to the mental health care system transformation process now underway in several parts of Canada. Single-session principles align well with a mental health recovery strategy and the new Stepped Care 2.0 (SC2.0) model under consideration across Canada. SC2.0 provides a framework for integrating single-session open-access care within the broader mental health ecosystem. Through continuous co-design the model connects values and addresses inevitable tensions that arise when attempting system integration. Model development and scaling is still in the early stages. More work needs to be done, including both program evaluation and independent research. Continued critical attention is the only way to maximize impact at a population level. With open access to an array of resources, organized to meet people where they are in terms of readiness, functioning and capacity for engagement, population mental health is possible. This paper highlights the importance and effectiveness of open-access counseling in a stepped care framework. [ABSTRACT FROM AUTHOR]

A study regarding the role and uniqueness of psychiatric nursing was conducted with 94 participants from Manitoba, Canada. The primary theme of comprehensive knowledge of mental health, mental illness, and addictions was foundational for the application of the sub-themes of therapeutic relationship, holistic approach, recovery orientation, stigma reduction, and advocacy for change. Values, beliefs, and attitudes towards people with mental illness and addictions need to be instilled in psychiatric nursing students throughout their educational program to provide high quality, compassionate, and safe care. Implications for incorporation of the theme and sub-themes into psychiatric nursing curriculum are described in the paper. [ABSTRACT FROM AUTHOR]

Childhood adversity is known to have an enduring effect on health outcomes of victims. The objective of the study was to examine the association between childhood adversity and psychosocial health outcomes among immigrants in Canada. Using descriptive and inferential statistics and fitting negative loglog regression models to the 2014 General Social Survey, the paper examined the relationship between experience of childhood adversity (i.e. physical and sexual abuse before age 15) and its association with psychosocial health outcomes (i.e. psychological-mental condition and self-rated mental health) among immigrants in Canada. After accounting for relevant socioeconomic and demographic factors, the results show that physical abuse during childhood resulted in 29% and 31% increased likelihood of having a psychological mental condition and poor self-rated mental health, respectively. Also, sexual abuse during childhood was associated with 28% increased likelihood of poor self-rated mental health. In conclusion, the findings show that experience of physical and sexual abuse during childhood is associated with negative mental health outcomes in later life. [ABSTRACT FROM AUTHOR]

Serious mental illness (SMI) has long posed a dilemma to society. The use of community treatment orders (CTOs), a legal means by which to deliver mandated psychiatric treatment to individuals while they live in the community, is a contemporary technique for managing SMI. CTOs (or a similar legal mechanism) are used in every province in Canada and in many jurisdictions around the world in the care and management of clients with severe and persistent mental illness (most frequently schizophrenia) who have a history of treatment non‐compliance and subsequent relapse. Although there is ongoing controversy around CTOs, their use continues to be on the rise. René Girard's mimetic theory, in which he posits the social utility of the scapegoat mechanism, may shed some light on how established cultural patterns contribute to contemporary responses to SMI: how culture depends on the reproduction of certain narratives, and how these act to shape the identity of those involved. The CTO specifically can be seen to act as a scapegoating mechanism, wherein, by singling out and controlling individuals who appear to threaten social order, social order is restored. This paper reviews Girard's theory, looks at how it has been applied to SMI, and then considers how it may illuminate the social role of the CTO. This examination may provide mental health nurses with insight into the constructed identities of their patients, as well as the role of mental health care within broader cultural narratives. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known about the subject?: Immigrant women in Canada are at greater risk for post‐partum depression (PPD) than native‐born women.Immigrant women are less likely to have their care needs met as they face multiple barriers to care at both individual and system levels.To date, most PPD research has focused on individual barriers to care, with limited research examining organizational and system level barriers and the uniqueness of immigrant women's post‐partum health experiences. What this paper adds to existing knowledge?: This study provides unique insights into immigrant women's perceptions of what influences their post‐partum mental health and ability to access services for PPD.Factors contributing to immigrant women's PPD included several social determinants of health, particularly a lack of social support and limited knowledge about PPD and available services.Most helpful services acknowledge women's concerns, build trust, enact cultural competence and help with system navigation.Assessment approaches and organizational wait times created barriers to accessing care. What are the implications for practice?: Relationship building by providers is foundational to effective care for immigrant women with PPD.Findings highlight the need for mental health practitioners to improve cultural competence when working with diverse ethno‐cultural communities and for more effective assistance with system navigation, service integration and timely, flexible and accessible services.Findings have implications for the development of healthy public policy to address perinatal mental health issues amongst immigrant women. Introduction: Immigrant women in Canada are at greater risk for post‐partum depression (PPD) than native‐born women yet face multiple barriers to care at individual and system levels. Aim: To explore factors that contribute to PPD and health service accessibility, and the role of health services in supporting immigrant women with PPD. Methods: A qualitative interpretive descriptive design was used. Individual interviews were conducted with 11 immigrant women who had delivered a baby within the previous year and had experienced PPD. Inductive thematic content analysis was conducted. Results: Factors contributing to immigrant women's PPD included several social health determinants. Services were most helpful and accessible when providers acknowledged women's concerns, allowed time to build trust, provided culturally competent care and helped with navigating services. Assessment approaches and organizational wait times created barriers to care. Discussion: Immigrant women with PPD see relationship building by providers as foundational to providing effective support, enhancing coping and facilitating access to services. Improved communication with diverse ethno‐cultural communities and assistance with system navigation, service integration and timely, accessible services are needed. Implications for Practice: Findings can inform health service delivery models and the development of healthy public policy to address perinatal mental health issues amongst immigrant women. [ABSTRACT FROM AUTHOR]

Substance use among marginalized populations has historically been constructed as a social problem to be managed, cured, and eliminated. Much social science research concerning drug use among marginalized populations focuses on risks and harms, with little attention to positive aspects of substance use. In this paper we explore positive roles of drugs/drug use among marginalized people who use drugs. We draw on in-depth qualitative interviews conducted with 50 people who use drugs in Vancouver's Downtown Eastside neighbourhood. Forty-three participants reported positive aspects of drug use. Participant narratives revealed four main themes regarding the role and function of drugs and drug use in their lives: (1) pain relief and management; (2) alleviating mental health issues; (3) fostering social experiences; (4) pleasurable embodied experiences. Our findings show that despite known negative consequences of substance use, in many ways drug use was beneficial for these individuals. Our study demonstrates that given the opportunity, meaningful and useful conversations that shed light on why people take drugs is possible. By understanding why marginalized individuals choose to consume the drugs they do we can begin to engage in truly helpful conversations about how to reduce drug-related harm. [ABSTRACT FROM AUTHOR]

Cultural knowledge is currently being revitalized by Indigenous practitioners where land is understood as a relational component of healing and wellbeing. Land-based activities such as harvesting, education, ceremony, recreation, and cultural-based counselling are all components of this integrative practice. Land-based practices are centered in Indigenous pedagogy and recognize that identity is interwoven with and deeply connected to land. Formally cultivating this fundamental relationship increases positive mental health and wellness outcomes in Indigenous populations as assessed through a culturally relevant lens. This research paper articulates a cultural concept described here as "land-based" healing or wellness which has been understood and taught for millennia by Indigenous knowledge holders and has largely remained undefined within mainstream mental health promotion and intervention. In this study, qualitative narrative methods were used to document the experiences of eleven land-based program practitioners from three northern territories in Canada. As experts in this field, practitioners' narratives emphasized the need for a greater understanding and recognition of the value of land-based practices and programs within contemporary health and education systems. The development of working definitions, terminology, and framing of land-based healing and wellness practices as a common field is delineated from relevant literature and practitioner narratives in order to enable crosscultural communication and understanding in psychology. Land-based healing is presented as a critical and culturally appropriate method for mental health intervention and community resilience in northern Canada. [ABSTRACT FROM AUTHOR]

Peer support has a lengthy history in health and community services with particular prominence in areas such as addictions and mental health services. This growth in emphasis and evidence has not been mirrored in the area of youth peer support broadly nor peer support among homeless youth specifically. This situation has persisted despite the growing emphasis on youth lived experience engagement—including peer support. This paucity of literature framed the rationale for the present paper that provides a description of the structure, processes, and preliminary outcomes of an intentional peer support program delivered in the context of tertiary prevention of youth homelessness in a large Canadian urban setting. Pre-post findings for a cohort of 28 youth are reported in key mental health and community engagement domains and qualitative data from interviews with participants, peer supports, and staff are presented. These findings suggest that peer support would seem to be both a feasible and potentially impactful part of the repertoire of interventions from service to policy levels that are needed to address the complex and persistent global problem of youth homelessness. While promising, our work also suggests that peer support cannot be an afterthought-type element of programming but must be robust in process and structure to facilitate improvement for service recipients, the wellness of the peers, and the benefits for the team as a whole that results from effective peer engagement. [ABSTRACT FROM AUTHOR]

Indigenous peoples across the globe suffer a disproportionate burden of both mental and physical illness relative to Settler populations. A substantial body of research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on the political, historical, cultural basis of health disparities. This paper advances a theory of colonial trauma as a conceptual framework with which to understand Indigenous health and mental health disparities. Colonial Trauma is described as a complex, continuous, collective, cumulative and compounding interaction of impacts related to the imposition of colonial policies and practices which continue to separate Indigenous Peoples from their land, languages, cultural practices, and one another. The theory of colonial trauma is presented as useful a framework for understanding the links between persistent health disparities, the traumagenic nature of colonialism and the right of self-determination. [ABSTRACT FROM AUTHOR]

Background: Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. Methods: A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Results: Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4-20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children's negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children's substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Conclusions: Quantitative research investigating Indigenous children's mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children's familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children. [ABSTRACT FROM AUTHOR]

Background: The home and community care sector is one of the fastest growing sectors globally and most prominently in mature industrialized countries. Personal support workers (PSWs) are the largest occupational group in the sector. This paper focuses on the emotional health of PSWs working in the home and community care sector in Ontario, Canada. The purpose of this paper is to present evidence on the associations between PSWs' life and work stress and organizational practices of full-time and guaranteed hours, and PSWs' perceptions of support at work and preference for hours.Methods: Data come from our 2015 survey of 1543 PSWs. Dependent variables are life and work stress. Independent variables are: objective organizational practices of full-time and guaranteed hours, and subjective organizational practices of perceived support at work, and preferred hours of work. Descriptive statistics, correlations and ordinary least square regression analyses with collinearity tests are conducted.Results: Organizational practices of employing PSWs in full-time or guaranteed hours are not associated with their life and work stress. However, those who perceive support from their organizations are also the ones reporting lower life and work stress. In addition, those PSWs perceiving support from their supervisor report lower work stress. PSWs would like to work in their preferred hours, and those who prefer to work more hours report lower life and work stress, and conversely, those who prefer to work less hours report life and work stress.Conclusion: For PSWs in home and community care, perceived support from their organizations and supervisors, and employment in preferred hours are important factors related to their life and work stress. [ABSTRACT FROM AUTHOR]