Your search

This article examines the judicial treatment of complaints of discrimination from workers with mental health issues. Equality protections promise full inclusion in social, work and community life. The principle of inclusion is understood in three inter-related parts: inclusion in the workforce, inclusion in decision-making and, in the most broad and prospective sense, inclusion in Canadian society. The current framework of equality protections has not effectively addressed these core values of inclusion for workers with mental health issues. The workplace continues to be a site of discrimination and harassment. Barriers prevent workers with mental health issues from getting or keeping employment, discourage their participation in decision-making, and entrench the devaluation, isolation and exclusion of persons with mental health issues. Accommodative measures must be alive.

This volume is a collection of papers presenting theories & strategies for public interest litigation, a specialized area of litigation aimed to bring about social impact, & the various avenues & methodologies that have been used in Canadian history.

The novel coronavirus SARS-CoV-2, which causes the disease known as COVID-19, has infected people in 212 countries so far and on every continent except Antarctica.   Vast changes to our home lives, social interactions, government functioning and relations between countries have swept the world in a few months and are difficult to hold in one’s mind at one time. That is why a collaborative effort such as this edited, multidisciplinary collection is needed. This book confronts the vulnerabilities and interconnectedness made visible by the pandemic and its consequences, along with the legal, ethical and policy responses. These include vulnerabilities for people who have been harmed or will be harmed by the virus directly and those harmed by measures taken to slow its relentless march; vulnerabilities exposed in our institutions, governance and legal structures; and vulnerabilities in other countries and at the global level where persistent injustices harm us all.   Hopefully, COVID-19 will forces us to deeply reflect on how we govern and our policy priorities; to focus preparedness, precaution, and recovery to include all, not just some.  Published in English and French.

OBJECTIVE: Mental health care reform has brought an increasing emphasis on community care, with concomitant reductions in inpatient psychiatric resources. Hospitalization remains a necessary and integral component of the mental health care system, but it is taking on a more specialized role. Examining the circumstances in which hospitalization is indicated can help clarify emergency psychiatric practices and determine whether patients' needs are being met within this changing environment. This pilot study examined the impact of selected patient and contextual characteristics on the decision to admit patients to inpatient psychiatric units and assessed the utility of the Severity of Psychiatric Illness (SPI) scale for monitoring clinical practice in emergency psychiatric services. METHODS: Crisis workers in two emergency psychiatric services crisis teams in Toronto, Canada, used the SPI in the assessment of 205 visitors to the services during the winter of 1998-1999. Contextual characteristics, including bed availability, service site, and the admitting physician's level of training, were recorded. Multivariate logistic regression was used to assess the relative contribution of patient and contextual variables in the admission decision. RESULTS: The severity of axis I symptoms and difficulties with self-care were significantly associated with the decision to admit. Site, bed availability, and the admitting physician's level of training did not appear to be associated with clinical decisions. CONCLUSIONS: Patients with the most need are being admitted to inpatient units despite significant systemic pressures on inpatient services. The SPI is a useful and discriminating tool for evaluating clinical practice in emergency services.

It has been well established that early adversity is a major risk factor for depression and for anxiety disorders in various populations and age groups. Few studies have considered the relative strength of these associations and the possible role of co-morbid depression/anxiety in understanding them. Using data from a large community sample of Ontario, Canada, we examined the relative strength of the associations between early physical abuse, sexual abuse, and/or parental strain with depression alone, anxiety alone, and co-morbid depression/anxiety. The current sample consisted of 6,597 individuals 15–64 years of age who were interviewed using the World Health Organization Composite International Diagnostic Interview (CIDI). Using a multivariate design, we compared early adversity scores across four diagnostic study groups including normal controls, individuals with major depression but no anxiety disorders, individuals with one or more anxiety disorders without major depression, and individuals with co-morbid major depression and anxiety. Individuals with past disorders were considered separately from those with current disorders. For both past and current disorders, highly significant differences in early adversity scores were found across the four study groups. A novel and robust finding, consistent across all analyses, was a marked association between early sexual abuse and co-morbid depression and anxiety but not the “pure” disorders. A strong association between early parental strain and major depression (independent of anxiety) was also found. The overall pattern of results suggest that there may be unique relationships linking particular adversities to particular manifestations of depression and anxiety disorders later in life. A particularly strong association between early sexual abuse and co-morbid depression/anxiety was found. Depression and Anxiety 17:34–42, 2003. © 2003 Wiley-Liss, Inc.

The Pathways Into Homelessness project in Toronto interviewed 300 unaccompanied adult users of homeless shelters to identify characteristics of individuals who are homeless for the first time. The sample reflected the total population of homeless shelter users in terms of age, sex, level of use, and type of shelter. Two fifths of the sample were homeless for the first time. There were more similarities than differences between those who were homeless for the first time and those who had been homeless previously. The prevalence of psychiatric and substance use disorders and the rate of previous hospitalization did not differ between first-time homeless persons and those who had been homeless before. The two groups were distinguished by some childhood experiences related to housing. Both groups had multiple indicators of serious problems, suggesting that the need for intervention is as pressing for persons who are homeless for the first time as it is for the larger population of homeless persons.

Background: Separate lines of research have demonstrated strong associations linking alcohol misuse with major depression on the one hand, and anxiety disorders on the other. In the current study we examined the possible confounding and/or additive effects of co-morbid depression/anxiety in understanding these relationships. Methods: A total of 7195 individuals in Ontario, aged 15–64, were interviewed using the CIDI. Based on lifetime diagnoses, we compared rates of alcohol abuse/dependence in four groups consisting of normal controls, individuals with unipolar major depression but no anxiety disorders, individuals with one or more anxiety disorders without depression, and individuals with co-morbid major depression and anxiety. Age of onset of alcoholism in the four study groups was also compared. Results: In both genders, there were significantly higher rates of alcoholism in all three psychiatric groups relative to controls. In females only, there was also a significantly higher rate of alcoholism in the depressed/anxious group than in the pure anxious group. The age of onset of alcoholism was the same across all four study groups. Limitations: Due to limitations related to sample size, we combined subjects with various anxiety disorders into a single anxiety group and concurrent and sequential co-morbidity were not distinguished. Conclusions: Both gender effects and depression/anxiety co-morbidity may be important considerations in the design and interpretation of studies on alcohol misuse. This may be particularly relevant when considering the strength of the association between alcoholism and anxiety disorders in women. Depression and anxiety do not appear to influence the age of onset of alcoholism. Furthermore, no single temporal pattern of onset was identified in individuals with all three disorders, suggesting no obvious cause-effect relationship among them.