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The following is a review of literature concerning the place of mindfulness, a non-judging present-moment awareness, and techniques by which to invoke it, in Canadian healthcare. Central to the discussion are the effects of mindfulness on personal and interpersonal wellbeing. A recent surge of research has found mindfulness to positively impact a wide range of measures of personal health including stress, anxiety, affect, and healthy lifestyle choices. At present, mindfulness-based interventions have been confirmed effective for the treatment of chronic pain, psoriasis, and a number of psychiatric illnesses, and are possibly helpful for the prevention of cognitive decline. Mindfulness also presents benefits to interpersonal relationships by promoting empathy, compassion and attentiveness reflected in the enhanced patient-centeredness with which mindful physicians conduct their clinical practice. As such, mindfulness training among healthcare providers is advocated for the improvement of quality of care as well as a means to mitigate work-related stress and burnout. The underlying mechanisms of the effects of mindfulness are also discussed, with emphasis on present-moment attentiveness and a disempowerment of one's maladaptive cognitions allowing the individual to act with intention and care rather than out of habit and impulse. Given the potential for mindfulness to promote health and enrich the practice of medicine, its increased utilization among patients, physicians, and the population at large is encouraged. [ABSTRACT FROM AUTHOR]

This article describes a two-phased research project that piloted a modified mindfulness-based stress reduction (MBSR) intervention developed specifically for a severely economically disadvantaged population. The terms severely economically disadvantaged (SED) and “severely marginalised” were used to describe the participants who experience socioeconomic disadvantage and social isolation as well as significant medical, psychological, physical, and learning challenges. Phase one of the project consisted of community focus groups to determine what types of mindfulness-based interventions would most benefit this population. Based on this feedback, the first author developed a modified MBSR intervention he called radical mindfulness training (or RMT). Phase two was a pilot study of RMT with 11 SED participants who accessed services at a local community health centre; eight participants completed the program, and seven of the participants completed Self Compassion and Satisfaction with Life scales and qualitative interviews. Results revealed an overall mean increase in self compassion and satisfaction with life after completing the program. Qualitative findings provided further evidence of the nature of the participants' perceived effectiveness of this program. The authors conclude that the findings from his limited exploratory study substantiate the need for further study of the RMT program. [ABSTRACT FROM AUTHOR]

Objective: Patients suffering from major depressive disorder (MDD) experience impaired functioning and reduced quality of life, including an elevated risk of episode return. MDD is associated with high societal burden due to increased healthcare utilization, productivity losses, and suicide-related costs, making the long-term management of this illness a priority. The purpose of this study is to evaluate the cost-effectiveness of mindfulness-based cognitive therapy (MBCT), a first-line preventative psychological treatment, compared to maintenance antidepressant medication (ADM), the current standard of care., Method: A cost-utility analysis was conducted over a 24-month time horizon to model differences between MBCT and ADM in cost and quality-adjusted life years (QALY). The analysis was conducted using a decision tree analytic model. Intervention efficacy, utility, and costing data estimates were derived from published sources and expert consultation., Results: MBCT was found to be cost-effective compared to maintenance ADM over a 24-month time horizon. Antidepressant pharmacotherapy resulted in 1.10 QALY and $17,255.37 per patient on average, whereas MBCT resulted in 1.18 QALY and $15,030.70 per patient on average. This resulted in a cost difference of $2,224.67 and a QALY difference of 0.08, in favor of MBCT. Multiple sensitivity analyses supported these findings., Conclusions: From both a societal and health system perspective, utilizing MBCT as a first-line relapse prevention treatment is potentially cost-effective in a Canadian setting. Future economic evaluations should consider combined treatment (e.g., ADM and psychotherapy) as a comparator and longer time horizons as the literature advances.