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The chronic mental patient: the position of th Canadian Psychiatric Association.

The Canadian Psychiatric Association recommends: 1. In this International Year of Disabled Persons, that the needs of the chronic neural patient be publicized with emphasis on the potential for improvement if these needs are adequately met. A working definition of the chronic mental patient refers to those members of society who suffer from a chronic mental illness and who demonstrate significant impairment of task performance and/or social performance. 2. A comprehensive network of services should be developed including provision for basic need with a range of housing options, inpatient and outpatient psychiatric evaluations and treatment, personal clinical support, living-skills training and vocational assessment and training. Aside from patient needs, the professional status of the caregivers involved is to be enhanced. Laudable efforts by self-help groups should be further encouraged. 3. Community resources should be enlisted following principles and practices identified as basic to successful programs already existing, for example: -- provision of economic stability -- presence of administrative leadership -- striving for continuity of care -- allowance for adequate manpower -- establishment of vocational supports -- respect for patients' rights -- provision of community education -- design of ongoing evaluation and research 4. A greater emphasis should be placed in undergraduate and postgraduate medical and psychiatric training programs on the treatment of the chronically ill. 5. The Canadian Council on Hospital Accreditation should continue to elaborate and publish criteria by which services to the chronically mentally ill would be evaluated both at the inpatient and outpatient levels. These criteria when available should be promoted in all relevant institutions.

Adolescent

The interaction with allied non-medical professions: the Canadian Psychiatric Association's guidelines. The position of the Canadian Psychiatric Association.

While psychiatrists employ skills common to other professionals in areas that are not the sole prerogative of psychiatry (1,2), the challenges of this position paper are to define the unique qualifications psychiatrists possess in comparison to other mental health professionals, to reflect awareness of social, governmental priorities in health care, to avoid vested professional interest.

Allied Health Personnel

Research productivity among PhD faculty members and affiliates responding to the Canadian Association of Professors of Psychiatry and Canadian Psychiatric Association survey.

OBJECTIVE: This survey endeavours to assess the research productivity of PhD degree holders affiliated with Canadian academic departments of psychiatry. METHOD: A questionnaire was adapted to suit the Canadian milieu and was distributed to a target population of 2484, of whom 345 were nonmedical PhDs. RESULTS: Out of 861 respondents, 148 indicated that they held a PhD degree only--a response rate of 42.9% for that subgroup. PhD respondents engaged in significantly more research activities than MDs. Their fields of research activity differed according to amount of time spent in research activities. Few gender differences were observed. CONCLUSIONS: The recruitment of sole PhD holders is an indicator of the current research needs of departments and of the dearth of candidates for these positions among MDs.

Authorship

Research training and productivity among faculty: the Canadian Association of Professors of Psychiatry and the Canadian Psychiatric Association Survey.

OBJECTIVE: This survey assesses the research training and productivity of academic faculty in Canadian departments of psychiatry and compares the findings with those of colleagues in the United States. METHOD: A questionnaire was adapted to suit the Canadian milieu and was distributed to a target population of 2484, including a core 522 full-time faculty. RESULTS: The response rate among full-time faculty was 65%, but only 26.5% for clinical and adjunct faculty. A small proportion (16%) of our MD and a greater proportion (57%) of our PhD respondents were included in a fairly lenient definition of researcher. Departments seek to recruit PhDs with an active involvement in research. Overall there appear to be more similarities than differences in research interests with our colleagues in the United States. The pharmaceutical industry was the most frequently mentioned source of research funding for MDs, while the availability of a mentor was perceived as the most influential factor determining the choice of a research career. CONCLUSIONS: Recommendations include adequate exposure to research during medical school and residency as well as appropriate inducements for the recruitment and retention of practising researchers.

Canada

Physician resource variables and their impact on the future pool of research expertise among psychiatrists: the Canadian Association of Professors of Psychiatry and Canadian Psychiatric Association Survey.

OBJECTIVE: To assess the impact of the increased proportion of female psychiatrists and trainees, the rapid reduction of international medical graduates allowed in the country, and the expanding number of practitioners with subspecialization on the future pool of psychiatrist researchers in Canadian academic departments of psychiatry. METHOD: A questionnaire was adapted to suit the Canadian milieu and distributed to a target population of 2484, including a core of 522 full-time faculty. RESULTS: Female psychiatrists responding to the questionnaire reported less research involvement overall than their male counterparts. International medical graduates with both undergraduate and residency training abroad reported more research interests than other graduate categories. Respondents training in a subspecialty showed no difference in research commitment. CONCLUSIONS: Concerted efforts must be made to recruit, support, and retain female researchers. Particular attention must be paid to developing research expertise among Canadian medical graduates. The trend towards subspecialization influences only the selection of research topic.

Canada

Patient care review: results of the Canadian Psychiatric Association Hospital Survey.

This paper is a report of the Education and Professional Liaison Council of the Canadian Psychiatric Association on the results of its questionnaire to 104 psychiatric hospital facilities in Canada on the extent, type and usefulness of patient care review procedures. The results indicate that the majority of hospitals appear to have initiated one or more patient care review activities within the last decade and have been carrying these out on a regular basis. These procedures have been considered useful for patient care and for continuing medical education. Both the frequency of patient care review activity and the type of procedure used, however, are directly related to the number of psychiatrists present in the center, with those hospitals having the least resources indicating little or no activity.

Canada

Geriatric psychiatry: training guidelines and their application. Section on Geriatric Psychiatry of the Canadian Psychiatric Association.

Geriatric psychiatry is now a mandatory part of psychiatric residency education in Canada. Educational requirements in geriatric psychiatry were updated by the Royal College of Physicians and Surgeons of Canada in 1988, and guidelines were developed in more detail in 1989 by the Section on Geriatric Psychiatry of the Canadian Psychiatric Association (CPA). These guidelines are presented here together with a survey, conducted in the fall of 1991, of all 16 Canadian psychiatry residency programs. Thirteen of the training centres now require residents to have a formal rotation in geriatric psychiatry, generally three months in length. Residents are exposed to elderly patients in other services, such as consultation/liaison, but these services may not include formal teaching in geriatric psychiatry. Most programs have a seminar series in geriatric psychiatry and have training guidelines similar to those of the CPA. However, it is not clear how closely these are being followed, since it was felt in almost one-third of all programs that there was an insufficient number of teachers to fulfill the training requirements. In addition, a number of training directors felt that the objectives were too comprehensive to be met in the three month period. Earlier studies in the field are reviewed, implications of the current findings are discussed, and suggestions are made for further research.

Canada

Continuing education for psychiatrists: report on Canadian Psychiatric Association questionnaire.

This report on the CPA Questionnaire on Continuing Education represents the answers of a sample of 485 of the 1,360 certified psychiatrists belonging to the Association. A total of 72.6% of the sample lived in urban centres with populations greater than 200,000; 28.9% worked in solo practice, but only 7.4% worked in settings where no other psychiatrists were present. The amount of time spent in continuing education activities was found to vary inversely with the distance that had to be travelled to major educational centres. Nevertheless, there were no psychiatrists that did not partake in some continuing education activities. Ninety-three percent read journals, 99% went to meetings, and 96% used consultation with other psychiatrists; 99% stated that these activities were useful. The favourite methods were reading and consultation. Eighty percent of the sample spent more than 41 hours per month in continuing education activities. Sixty-five percent stated that they would like a voluntary credit award system instituted. It is concluded that Canadian psychiatrists do spend a great deal of time in continuing education activities and believe that this is of value to their professional work.

Adult