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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]

It is time to move beyond education about qualitative research theory and methods to using them to understand and improve psychiatric practice. There is a good fit between this agenda and current thinking about research use that broadens definitions of evidence beyond the results of experiments. This paper describes a qualitative program evaluation to illustrate what kind of useful knowledge is generated and how it can be created through a clinician-researcher partnership. The linkage and exchange model of effective knowledge translation described involves interaction between clinicians and researchers throughout the research process and results in mutual learning through the planning, disseminating, and application of existing or new qualitative research in decision making. [ABSTRACT FROM AUTHOR]

Background: Major depression makes an important contribution to disease burden in Canada. In principle, the burden of major depression can be reduced by the provision of treatment within the health care system. In a previous data analysis, the National Population Health Survey (NPHS) reported an increase in antidepressant (AD) use between 1994 and 1998. In this paper, the analysis is extended to 2000, and additional aspects of health care utilization are described.Methods: The NPHS provides a unique source of longitudinal data concerning major depression and its treatment in Canada. In this survey, probable cases of major depression were identified using a brief predictive instrument; health care utilization was evaluated using additional survey items; and the latest data release from Statistics Canada (that is, 2000) was used to make weighted estimates of the frequency of health care utilization in relation to major depression status.Results: The use of ADs has continued to escalate. These increases have been largest in men and in persons aged under 35 years. There has been an increase in polypharmacy: in 2000, almost 9% of persons taking an AD reported taking more than 1 AD medication-a tripling since 1994. The frequency of consultations with alternative practitioners has also grown. Although the overall proportion of persons with major depression who report consulting with health professionals about their mental health has not increased, the number of persons with major depressive disorder reporting 6 or more visits to nurses, social workers, and psychologists may have.Conclusion: The provision of AD treatment continues to expand in Canada. This probably represents a changing pattern of practice, because the frequency of professional consultation has not increased. More detailed data are required to evaluate the extent to which treatment needs are being met. [ABSTRACT FROM AUTHOR]

Objectives: Research on the mental health and service needs of homeless seniors has been scant. This paper reviews the available literature and presents findings of a Toronto survey in an effort to describe the demographics of homeless seniors, their level of impairment, and their mental and physical health needs.Methods: We searched the Medline, AgeLine, and PsycINFO databases, using the following key words: elderly homeless, elderly hostel users, and urban geriatrics. To better describe the service needs of the elderly homeless, we obtained demographic data from the Community and Neighbourhood Services Department and distributed a survey questionnaire to 11 Toronto hostel directors. The questionnaire elicited data relating to reasons for shelter use, problem behaviours, and mental health needs of those over age 65 years.Results: Although seniors represent a small percentage of the homeless population, their numbers are growing. The available literature suggests a high prevalence of psychiatric disorders and cognitive impairment in this population, with a greater proportion of older women than men having severe mental illness. Further, our survey suggests that the service needs of elderly hostel users in Toronto differ from those of their younger counterparts.Conclusion: The homeless elderly are the most vulnerable of this impoverished population. Although more research is needed to define their mental and physical health needs and ways of meeting them, their characteristics appear to be unique. Geriatric psychiatrists could play a significant role in evaluating and treating this population more comprehensively. [ABSTRACT FROM AUTHOR]