Developing a national plan for schizophrenia research

Characteristics of clients with schizophrenia who express certainty or uncertainty about continuing treatment with depot neuroleptic medication

In this exploratory study, the factors corresponding to clients' certainty or uncertainty in continuing with depot neuroleptic medication for schizophrenia were examined. Ninety-four participants from a tertiary care schizophrenia clinic received an educational intervention aid containing information about treatment risks and benefits and were interviewed to elicit their levels of decisional conflict, self-efficacy, and emotional support, as well as expectations of risks and benefits of treatment. Eighty-seven percent of participants decided to continue treatment. Clients who expressed uncertainty (10%) about continuing with treatment had higher levels of decisional conflict (p = .000), lower levels of decision self-efficacy (p = .037) and decision emotional control (p = .003), lower expectations of hospitalization if treatment was stopped (p = .04) as well as lower expectations of benefits and higher expectations of side effects (p = .04), if treatment continued. In addition, reasons identified by participants for certainty or uncertainty were reported. The research may be useful in increasing the awareness of clinicians about the factors contributing to treatment decision making by clients diagnosed with schizophrenia and ultimately improve collaborative decision making.

Research funding of psychiatric disorders in Canada: a snapshot, 1990-1991

Although mental illness accounts for up to 14% of total direct health care costs and an estimated cost of over five billion dollars annually, research funding of psychiatric disorders is regarded as underfunded relative to other biomedical research. This study was conducted to determine the amount of funds allotted to the research of specific psychiatric disorders in Canada. Data was obtained from a national database of peer-reviewed health research funding. Based on the title of the research grant, all projects that pertained to psychiatric disorders were identified and classified according to diagnosis. Research funding for psychiatric disorders totalled $16,391,000 from 1990 to 1991, or 3.7% of all biomedical research funding for that period. The relative contributions of federal, provincial and private (nonprofit) agencies to the funding total were 54%, 39% and 8%, respectively. Research funding for mental illness remains disproportionately low relative to other medical illnesses. The role of private nonprofit agencies, in particular, is much more limited for psychiatric disorders than for other identified medical illnesses. These data suggest that increased attention to research advocacy is required to increase psychiatric research support. Advocacy strategies should include: 1. publicizing the value and scope of psychiatric research in Canada; 2. working to de-stigmatize mental illness; 3. strengthening personal and professional affiliations with patient advocacy groups; 4. increasing the number and the qualifications of psychiatric researchers; 5. improving the scientific quality of research programs; and 6. organizing national research collaborations.

Planning mental health services: II. Current Canadian initiatives

A brief overview of recent policy developments across Canada and a discussion of the common themes and challenges they address demonstrates the scope of activity in this field. The federal level of mental health planning and a summary of recent of policy developments in each province are described. Significant progress has been made in Canada in the development of mental health services since deinstitutionalization. Major challenges remain, however, which are being addressed to varying degrees across the country. The challenges related to the key issues of major mental illness, integration and consumerism are illustrated.