Érudit's RSS Feed

L’ornithorynque et le thermomètre : réflexions sur les 30 ans du CR-IUSMM et les transformations contemporaines de la recherche en santé mentale

Emmanuel Stip and Lionel Cailhol

Transformer la santé mentale par la recherche : 30 ans d’engagement au Québec

Marc Corbière and Johana Monthuy-Blanc

Spiritualité et cortisol chez les personnes vivant avec une schizophrénie : une étude exploratoire

Ariane Poulin, Sonia Lupien and Consortium Signature
Objective Several factors can contribute to the recovery of people living with schizophrenia. According to service users living with schizophrenia, spirituality would be an important element in their recovery journey. Spirituality could serve as a coping mechanism to manage psychological stress. The objective of this exploratory study was to examine the relationship between spirituality and cortisol, a stress biomarker, among people living with schizophrenia compared to the general population. Method Participants were drawn from the Signature Project of the Institut universitaire en santé mentale de Montréal (IUSMM). The sample included 94 people living with schizophrenia and 95 control participants. Linear regressions were performed to examine the association between spirituality and cortisol. Results Individuals with schizophrenia accorded greater importance to spirituality than control participants, with a medium to large effect size. Spirituality was more important for women than men, regardless of the group. No significant differences were observed in cortisol concentrations. Lastly, spirituality had no effect on cortisol levels in either group. Bayesian analyses confirmed that the absence of effect was real and not due to a lack of statistical power. Conclusion This study highlights the clinical relevance and importance of integrating the perspective of those directly involved by confirming that people living with schizophrenia place great importance on spirituality. Furthermore, the findings suggest that the role played by spirituality in the recovery of people living with schizophrenia does not rely on a physiological mechanism. Therefore, it would be pertinent to explore the relationship between spirituality and other dimensions of recovery, such as psychological, social or cognitive aspects. A better understanding of the role of spirituality in the recovery of people living with schizophrenia would provide a better comprehension of how to mobilize it to support service users in their ongoing journey.

The use of AI scribes across medical fields and why psychiatry is lagging behind: A scoping review

Chloé Daignault, Justine Audelin-Rinfret, Marie Désilets, Arash Bahremand and André Do
Objective This scoping review aimed to examine the current available literature on the use of artificial intelligence (AI) scribes across all medical fields compared to their use in psychiatry.Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Five electronic databases (PubMed, MEDLINE, EMBASE, PsycINFO, and CINAHL) were systematically searched for studies published up to June 2025. Two reviewers independently screened titles and abstracts according to pre-established eligibility criteria using the PICOS framework. Full-text articles were then assessed for inclusion.Results A total of 1896 records were identified, of which 15 met the inclusion criteria. Most studies were conducted in outpatient, primary care, and procedural settings. Across studies, clinicians generally reported favorable acceptance and perceptions of AI scribes. Findings also suggested improved clinician well-being, reduced documentation time, better workflow efficiency, and positive patient experience. Results on documentation accuracy and quality were mixed. Critically, no eligible studies evaluated the use of AI scribes in psychiatry. Limitations included study heterogeneity, with wide variations in study design, sample size, and evaluation metrics.Conclusion The absence of empirical studies in psychiatry highlights a significant gap in the literature, particularly in contrast to the growing body of research across other medical specialties. Because of its unique clinical, ethical, and relational dimensions, dedicated research is needed to evaluate the feasibility, safety, and ethical implications of implementing AI scribes in psychiatric care.

Au Québec, la santé mentale sans les kinésiologues, c’est comme une cabane à sucre sans sirop

Samuel St-Amour, Ahmed Jérôme Romain and Paquito Bernard
Imagine a treatment improving physical AND mental health is identified by an important number of studies. Scientists continuously work on this treatment to analyze, improve, and understand it better. Imagine that this treatment is not only cheap but makes people save money when used. Imagine now that a large number of professionals are especially trained each year to administer this treatment but next to none are working in any health service centre nor pharmacy. This absurd situation is currently happening in Quebec. Despite the vast literature supporting the benefits of physical activity for mental health, kinesiologists are seldom involved in mental health care settings. Paradoxically, Quebec’s and Canada’s researchers have made important strides on this subject over the last decade. Indeed, teams worked to analyze physical activity’s effect on mental well-being, mental illness symptoms and comorbid metabolic disorders. But kinesiologists (physical activity and behaviour change specialists) are still chronically underemployed in mental health settings nonetheless. Today, fewer than 1 in 3 kinesiology graduates is fully employed in a position linked to their training (including a variety of fields outside of health services). Financing the implantation of kinesiologists in public health services would, therefore, be among the best use of public funds.

Blessures de stress post-traumatique chez les pompiers : rôle différentiel du type d’incidents critiques

Constance Boulé, Stéphane Guay, Eugénie Samson-Daoust and Steve Geoffrion
Objectives Firefighters are repeatedly confronted with critical incidents (CIs) at work, which are events that significantly disrupt an individual’s normal functioning (e.g. failed interventions, serious accidents, media criticism). Repeated exposure to such incidents increases their vulnerability to developing post-traumatic stress injuries (PTSIs). In Canada, approximately 30% of firefighters meet the clinical thresholds for at least one PTSI; the most commonly observed being depression, post-traumatic stress disorder (PTSD), anxiety, alcohol use, and suicidal ideations. The objectives of this study are to 1) describe the frequency of CIs that firefighters encounter at work and 2) identify the different types of CIs associated with PTSIs.Method This research is based on secondary use of cross-sectional data collected in 2018 as part of a partnership with a Quebec fire department. In this context, 690 firefighters responded to a survey designed to assess their overall psychological health. Participants reported on the CIs they had experienced during their careers. Standardized questionnaires were used to measure symptoms of depression, generalized anxiety, post-traumatic stress disorder, alcohol use disorder, substance use, and suicidal ideations.Results The results indicate that rare and serious incidents, particularly critical equipment failure, are strongly linked to various PTSI, while frequent incidents are associated with generalized anxiety and depression. Negative media criticism also appears to be a major stress factor associated with several PTSIs.Conclusion Given firefighters’ increased vulnerability to PTSIs, this study highlights the importance of considering the diversity of CIs encountered at work as well as the influence of contextual factors such as media criticism. It also emphasizes the need for transdiagnostic approaches and intervention measures rooted in the professional reality of these workers to better support their mental health.

Quinze ans d’engagement pour l’amélioration des pratiques en santé mentale : 3 initiatives soutenues par la recherche participative

Catherine Briand, Michel Perreault, Brigitte Vachon, Juliette Nadeau-Tremblay and Diana Milton
Continuous improvement of practices is a constant challenge for healthcare organizations, managers, and decision-makers. Despite knowledge of evidence-based data and recommended health practices, integrating best practices into care and services remains difficult and requires tailored support approaches. Over the past 30 years, several initiatives have been implemented to support the continuous improvement of practices in the field of mental health in Quebec. Within these continuous improvement processes, close collaboration with stakeholders at all stages of the process, under collaborative leadership, has been an essential component.Objectives The aim of this article is to present 3 initiatives supporting the continuous improvement of practices in the field of mental health in Quebec, which involved a participatory research approach as well as a close partnership of more than 15 years between researchers and managers.Method The article draws on 3 different initiatives supporting continuous improvement of practices in the mental health field, as described by the researchers involved. It takes an auto-ethnographic approach and cross-reflection with the aim of identifying points of convergence and findings from experience. The 3 initiatives are as follows: (1) the À portée de main program, supporting the implementation of practices that foster personal recovery; (2) the cross-training program, supporting exchanges and transformation of practices in concurrent disorders; (3) the COMPAS+ program, supporting quality improvement in primary care services. These initiatives involved different stakeholders.Results Several points of convergence were identified regarding the challenges and facilitators of such approaches. They highlight the importance of spaces for exchange and co-creation to enable a redefinition of ways of doing things, as well as what is referred to as “transformative learning.” They also illustrate the importance of participatory evaluative research in fostering reflective practice that leads to action and practice change.Conclusion This article provides an opportunity to engage in critical reflection on the complexity of continuous improvement initiatives in our healthcare systems. Despite structural reforms to Quebec’s healthcare system, managers and other stakeholders must be able to rely on the expertise of researchers and their ability to inject agility into systems that, unfortunately, are not very flexible. Close collaboration between managers and researchers deserves to be protected and better valued.

Vers le développement de technologies pour améliorer la prise de décisions cliniques : l’exemple de Tadeus

Marc J. Lanovaz and Johana Monthuy-Blanc
Although new technologies and artificial intelligence promise to improve mental health care, few scientifically validated applications are available, particularly in French. To address this issue, Centre de recherche de l’Institut universitaire en santé mentale de Montréal founded the Axel Center to accelerate the digital health strategy and to facilitate technological innovation for mental health research and care. The Axel Center thus addresses a tripartite ecosystem composed of research, clinical practice, and entrepreneurship. The purpose of this article is to introduce an example of an application developed in collaboration with the Axel Center and to present how the center can meet the needs of research teams. This example is Tadeus, a bilingual web application that allows mental health specialists and their partners (e.g. family members, caregivers, service recipients) to enter and share data to more rigorously monitor mental health interventions. In addition to presenting the application, the article discusses the challenges that can arise in the development, sustainability and dissemination of such applications, as well as how the Axel Centre can support research teams in overcoming these challenges.

Charge allostatique et dimensions transdiagnostiques des patients admis à l’urgence psychiatrique : un protocole de projet utilisant la Biobanque Signature

Robert-Paul Juster, Cécile Le Page, Nevena Chuntova, Enzo Cipriani, Clara Morin, Claudia Trudel-Fitzgerald, Marie-France Marin, Ahmed Jerome Romain, Steve Geoffrion, Stéphane Guay, Vincent Taschereau-Dumouchel, Stéphane Potvin, Naguib Mcchawar, Caroline Ménard, Eugénie Samson-Daoust, Charles-Édouard Giguère, Janick Boissonneault, Helen Findlay, Jasmine Boulette, Michelle Lonergan, Bahram Armoon, Alain Lesage, Alexandre Hudon, Christophe Longpré-Poirier, Emmanuel Stip and Consortium Signature
Objective People in acute crisis who seek psychiatric emergency services are clearly in great distress and likely already show signs of chronic stress. But how can we best measure chronic stress physiologically? Our study aims to assess allostatic load (AL), the “wear and tear” on biological systems that we can measure using different biological marker called biomarkers. Method We aim to assess biological and psychosocial dimensions related to psychiatric symptom changes among psychiatric emergency patients repeatedly evaluated at four-time points: (T1) 48-hours upon admission, (T2) end of hospitalization (about 2 weeks later), (T3) external follow-up (about 2 months), and (T4) 1 year later. We expect that (1) AL at T1 will distinguish psychiatric conditions, (2) higher AL will predict symptom trajectories over time, and (3) that combinations of modifiable risk and protective factors (e.g. health-related behaviors, psychosocial experiences) will boost or buffer these associations. We acquired funding in order analyze hair, saliva, and blood samples that have already been collected as part of the Signature Biobank that offers measures at T1 (N=1,984; 40% women; mean age 41 with a range from 18-81) as well as at T2 (n=685), T3 (n=606), & T4 (n=370). Results In the proposed project, we acquired funding to analyze biobanked tissues to index AL among all PEP and 149 healthy controls. Among subsamples with T2, T3, and T4 measures, we will assess prospectively changes in AL and psychiatric symptoms trajectories simultaneously. Conclusion From admission to remission, the study of psychiatric emergency patients is a unique opportunity to assess extreme profiles that can help refine precision medicine. The Signature Biobank will provide unique insights on the biological signatures of psychiatric conditions and changes over time while also providing unique knowledge and training opportunities for years to come supported by a transdisciplinary team.

L’Alliance en santé mentale du Québec : une stratégie de recherche qui porte fruit

Marc Hébert, Stéphane Guay, Naguib Mechawar, Marc Corbière and Martin Lepage

Le Répertoire des données et métadonnées de l’Alliance en santé mentale du Québec

Arina Ujevco, Cécile Le Page, Marc Corbière, Stéphane Guay, Martin Lepage, Marc Hébert, Robert-Paul Juster, Enzo Cipriani, Charles-Édouard Giguère, Lionel Cailhol, Pierre Orban, Stéphane Potvin, Andrée-Ann Baril, Thomas Beaudry, Sophie Blais-Michaud, Mallar Chakravarty, Alyssa Dai, Simon Ducharme, Pierre Marquet, Clara Morin, Naguib Mechawar, Jean-Baptiste Poline, Martin Roy, Claudia Savard, Sebastian Urchs and Vincent Taschereau-Dumouchel
Objectives In the era of artificial intelligence, our understanding of mental health challenges depends heavily on our ability to generate and analyze large-scale datasets. Accordingly, the Data Valorization Axis of the Québec Mental Health Alliance (ASMQ) was established in 2024 to create a comprehensive repository of open mental health data and metadata in Québec. This initiative’s mandate is to facilitate the indexing and discoverability of data and metadata collected in Québec, notably at the 3 main mental-health research centers of the Fonds de recherche du Québec: the Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM), the Centre de recherche CERVO and the Centre de recherche Douglas. Methods To build the Alliance repository, researchers and clinicians at ASMQ affiliated institutions were directly invited to index the datasets available in their laboratories. Nine databases were identified, and some are currently accessible via online-sharing platforms: Neurobagel, Maelstrom, and the Atlas of Longitudinal Datasets. Here, we present a description of the data contained in the various databases. Results To date, the data and metadata of 11,570 participants (26% psychosis and schizophrenia, 21% personality disorder, 19% mood disorder, 12% substance use, 10% bipolar disorder, 9% anxiety disorder) across 8 biobanks and datasets have been shared online through the Alliance repository. The biobank metadata includes various demographic (e.g. age, sex, gender, level of education), medical (e.g. psychiatric and physical diagnoses, medication use), psychosocial (e.g. social functioning, quality of life, depressive symptoms), anthropometric (e.g. height, weight), metabolic, behavioral (e.g. sleep, consumption of non-food products), cognitive (e.g. performance on neurophysiological tests), and medical-imaging data. Additionally, general information on governance and procedures for accessing and contributing new data to the repository is provided. Impact The Québec Mental Health Alliance repository enhances the visibility and accessibility of mental-health data in Québec, facilitating the sharing and dissemination of domain-specific data and metadata. The repository also aims to facilitate the harmonization of access procedures and experimental protocols. By advancing open science in Québec, the Alliance repository can catalyze scientific breakthroughs that rely on the analysis of large-scale datasets. This initiative could eventually be extended to other health institutions across Québec.

Accelerated, Neuronavigated Neuromodulation for Negative Symptoms in Schizophrenia: Protocol for a Randomized Controlled Pilot Trial

Ashley Choucroun, Olivier Roy, Stéphane Potvin, Lena Palaniyappan, Nadia Zeramdini, Aryamman Aiyaar, Katherine Picard, Samaneh Zanjani, Deven Parekh, Mariza Markessinis, Timothy Friesen, Tihare Zamorano, Andreea Diaconescu, Martin Lepage, Albert Powers, Jai Shah, Elissa Zavaglia and David Benrimoh
Background Negative symptoms (NS) of schizophrenia, including avolition, anergia, and social withdrawal cause major functional impairment and have limited treatment options. Repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (LDLPFC) shows promise in alleviating NS, though response remains modest, and multi-week protocols are often burdensome. A five-day, high-dose intermittent theta burst stimulation (iTBS) protocol using fMRI-guided neuronavigation has demonstrated rapid and sustained effects in major depression. Given the overlap between depressive lassitude and NS domains, accelerated neuronavigated iTBS may hold promise in schizophrenia with NS.Methods This multisite, randomized, patient- and rater-blinded trial evaluates the feasibility, safety, and preliminary efficacy of such a protocol in individuals with schizophrenia spectrum disorders. Seventy-five adults with clinically significant NS will receive either: (1) neuronavigated active iTBS targeting LDLPFC regions most anti-correlated with the subgenual anterior cingulate cortex (sgACC) (2) non-neuronavigated active iTBS using scalp-based coordinates; or (3) neuronavigated sham stimulation over 10 daily sessions spanning 5 consecutive days (90,000 pulses total), with follow-ups at 1 week, 1 month, and 3 months. Résultats Outcomes include a reduction in NS; Efficacy comparisons between neuronavigation and non-neuronavigation; Feasibility and safety; Change in social and affective information processing; Change in depressive symptoms.Conclusion Results will inform future trials, while comparison of targeting strategies will clarify the utility of neuronavigation. If successful, this trial will offer a time-efficient, personalized intervention for NS.

Patients partenaires et neuromodulation en santé mentale : un champ à cultiver

Jillian Mills, Kamilia Soltani, Olivier Roy and Lionel Cailhol
Background/Originality Collaboration between patient partners (PPs), clinicians, and researchers is rapidly expanding in mental health care and research. This participatory approach, integrating patient experiential knowledge with scientific expertise is progressively transforming research paradigms with significant positive impacts. Patient engagement promotes adhesion to research projects, facilitates knowledge transfer, and contributes to reducing the stigma associated with mental illness. In addition, it helps advance therapeutic targets and interventions that better address patients’ real-world needs.Neuromodulation is an emerging field with the potential to overcome many limitations of our current mental health systems. Its therapeutic efficacy has been demonstrated for various psychiatric conditions, yet it remains largely unknown to the public and inaccessible to many patients who could benefit from these otherwise promising interventions. The involvement of PPs in neuromodulation research and its impacts, currently undocumented in the scientific literature, would offer new and necessary perspectives on these challenges and warrants further investigation.Objective This article explores the roles and impacts of PP engagement in mental health research involving neuromodulation, with a focus on the specific issues that affect its implementation. We also examine the perspectives of both the PP and the researchers currently collaborating on TENTADIS, a project investigating home-based transcranial direct current stimulation (tDCS) for individuals suffering from borderline personality disorder. Through an examination of the literature and experiential reflections, this paper identifies various roles that the patient partner can fill in the co-construction of neuromodulation research and the important effects of such partnerships.Method/Expected Results This perspective article is based on a reflective analysis of co-construction experiences within the TENTADIS project, integrated with current literature on neuromodulation research and participatory approaches in mental health.Expected Impacts (Discussion) Within the TENTADIS research project, the PP actively participates in protocol development, contributing experiential knowledge that highlights practical constraints, participant expectations, and patient needs, thus enriching project design. Expected outcomes include advances in understanding both clinical and patient-related issues associated with neuromodulation, and identification of the specific contributions PPs can make in this field. This collaboration illustrates how co-construction can reduce barriers to access, improve intervention acceptability, and accelerate the implementation of neuromodulation in mental health services.

Réinventer les soins : l’innovation collaborative au coeur de la santé mentale – Entre pratiques interdisciplinaires et voix des personnes patient(e)s partenaires

Novembre Mercier and Jillian Mills
Collaboration with patient partners (PP) in mental health has become an essential practice, spurred by public policy and participatory research methods. Alliance en Santé Mentale du Québec, inspired by the principles of open science, actively promotes this involvement within the Centre de recherche de l’Institut universitaire en santé mentale de Montréal (CR-IUSMM). To mark the occasion of the CR-IUSMM’s 30th anniversary, a committee of PPs conducted a series of interviews with key stakeholders involved with the Centre to explore their experiences, challenges, and perspectives regarding the patient-research partnership. In this article, we highlight the transformations and lessons learned from these collaborations.

L’approche en santé mentale : une évolution permanente

Nadine Larivière

Vers un continuum de soins en troubles de la personnalité au Québec : entre avancées cliniques et inertie organisationnelle

Simon Poirier, Nadine Larivière, Pierre David, Suzane Renaud, Julie Jomphe and Lynn Courey

Le PRISM : un modèle de soins québécois en pleine expansion

Vincent Laliberté

Le pair-accompagnant professionnel : un levier émergent pour la santé mentale au travail

Imaine Sahed and Siham Sahed
Mental health in the workplace represents a growing challenge at the intersection of performance imperatives and well-being. Facing the limitations of traditional psychosocial risk prevention frameworks, the figure of the professional peer-supporter is emerging, grounded in the valuation of experiential knowledge as an intervention resource. By mobilizing their lived experience of distress or recovery, these hybrid actors support their colleagues, foster the recognition of lived experiences, and contribute to the cultural transformation of organizations. Drawing on French and Canadian contexts, this study highlights the potentialities and tensions inherent in this role: professionalization, institutional recognition, ethical issues, and the risks of instrumentalization. Thus, the professional peer-supporter appears as a strategic lever for social innovation, promoting a participatory and inclusive approach to mental health at work, yet requiring further empirical and ethical consolidation to be sustainably embedded in professional practices.

Du cône orange au phénomène clinique : émergence publique du « syndrome de Montréal »

Emmanuel Stip

« J’essayais tellement fort d’être normale… J’ai fini par m’épuiser. » : les formes d’exclusion sociale vécues par de jeunes adultes autistes

Isabelle Courcy, Maxime Bélanger, Catherine Des Rivières-Pigeon, Lucila Guerrero and Isabelle Soulières
Introduction Autistic people are particularly at risk of experiencing forms of violence, ostracism or discrimination, which lead to social exclusion in the course of their lives. However, very little research has addressed social exclusion from its subjective dimensions (e.g. attitudes, opinions, social representations and self-perception) and the relational contexts in which these experiences take shape and affect well-being and mental health. This article presents the results of qualitative research conducted with young autistic adults in Quebec who took part in asynchronous online discussion groups. It aims to identify the forms of social exclusion shared by the participants to better understand the relational contexts in which these experiences take place.Method Four asynchronous online focus groups were conducted with 23 autistic adults living in Quebec and aged 19 to 31 (average: 24). They all have received a professional diagnosis of autism. For nearly 3 weeks, open-ended questions were asked on a specific topic. A qualitative analysis using open coding was conducted. Results: The results show 4 main sources of exclusion mentioned by the participants: microaggressions, discrimination, victimization and constraints on self-determination. Social exclusion takes place in a variety of relational contexts, in which the entourage and formal services are sometimes seen as supports, sometimes as sources of vulnerability. Strategies of concealment, self-exclusion and camouflage appear to be ways of preventing exclusion, to the detriment of well-being.Discussion Five avenues for improvement in clinical and reception practices in general services are identified:Develop service delivery practices in general and specialized services that are sensitive to the characteristics and needs of autistic people;Adopt a trauma-informed approach and promote environments that support recovery;Improve the flexibility of services and intervention methods in response to the needs expressed by autistic people;Continue awareness-raising efforts to promote greater social acceptance of autism and neurodiversity in schools and the workplace;Establish cross-sectoral collaborations between the education, employment, health, and social services sectors, involving user groups and advocacy organizations, to contribute to the development of truly inclusive practices.

Le groupe, un soin : dynamiques et fonctions groupales de la thérapie par l’aventure auprès de jeunes adultes psychotiques

Catherine Séguin-Green, J. Éric Dubé and Clairélaine Ouellet-Plamondon
Ojectives The repercussions of a first episode psychosis (FEP) can be very trying for people suffering from it and those around them. The recovery process remains laborious and some people have difficulty engaging in it. Understanding better the effects of group intervention on people suffering from so-called negative symptoms or on those more resistant to usual treatments appears necessary. Adventure therapy stands out among group interventions for its outdoor activities, in a natural setting, aimed at behavioral changes. This study aims to better understand emerging group phenomena, as well as the functions of a group of young psychotic adults who participated in an adventure therapy program. The program included four weeks of preparatory meetings, followed by a four-day expedition in nature and a postexpedition debriefing session.Method This qualitative study is based on participant observation conducted throughout the program, as well as semi-structured interviews with 8 participants who experienced a FEP, carried out up to 6 months after the expedition. The research material was analysed using a thematic analysis, followed by an interpretative phenomenological analysis, in order to deepen the understanding of participants’ lived experience.Results The analyses highlighted 8 key themes, 4 focused on group phenomena that emerged during the expedition (mutual support and initiative in interpersonal context, motivational effect, destigmatizing effect, solidarity) and 4 on the functions of group dynamics (containment, regulation, mediation, contemplation).Discussion Adventure therapy appears to promote setting in motion and the recovery of self-confidence among participants in addition to helping them overcome significant relational difficulties related to their mental health diagnosis. The structure of the program, the continuous presence of mental health professionals, as well as the presence of peers with a similar life path, seem reassuring and to allow for breaking isolation, socializing, developing emotional regulation skills, initiating reflections on lifestyle habits and, for some, changing these habits following the expedition.Conclusion This study highlights the therapeutic potential of adventure therapy, which can be beneficial and complementary to usual treatment in a global approach to the treatment of a FEP.