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This article presents an analysis of the lived experiences of youth mental health practitioners taking part in Transcultural Interinstitutional and Interdisciplinary Case Discussion Seminars (TIICDS), an intercultural training initiative developed in Montréal (Québec, Canada), while considering the current context of increasing social polarizations. Using insights from the community of practice (CoP) framework and drawing on the analysis of 21 seminar sessions and 26 semi-structured individual interviews, this article examines the relation between the local sociopolitical context, the participants' verbalization about their identities, and the affect and cognition evoked by the training. Results indicate that TIICDSs present several features of a CoP and that intercultural training needs to build on both theoretical and experiential knowledge, while considering local contextual elements. These include historical and contemporary social representations and power differentials between groups, the cultural identities of trainees, and the institutions and sociopolitical structures in which clinical practices take place. These elements, we argue, are sensitive and potentially conflictual but can be addressed through supportive and reflexive group-based initiatives such as CoPs that bring together practitioners on a regular basis and provide them with a 'culturally safe enough' space in which they can learn to complexify their understanding of clinical situations., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective This article aims at filling some gaps in the literature regarding conditions conducive to high-quality collaborative care in youth mental health (YMH) for migrant families. It focuses on the factors that are susceptible to foster the engagement of migrant families in the services, by examining the clinical encounter, as well as sociopolitical and institutional dimensions. Methods Using a multiphase mixed methods design, it sequentially follows qualitative and quantitative results regarding migrant families within the different projects of a research program on collaborative care in YMH in culturally and socioeconomically diverse neighborhoods, done in Montreal during the last decade. These results come from data collected through questionnaires, semi-structured interviews, focus groups, participatory observation and documentation, with research participants being children, adolescents and parents from migrant families, clinicians and managers. Results The results suggest that the sociopolitical and macro institutional system finds its way into the clinical space by influencing the process of care. In particular, successive reforms of the health system challenge institutions and YMH teams in their capacity to create a favourable environment for continuity of care and interinstitutional partnership and interprofessional collaboration, factors associated with families' engagement into care. This engagement is also dependent on the representations of mental health and services that migrant families hold. These representations are shaped by their experience of the services, but also by what their sociocultural environment and the public discourses allow them to imagine of these services. This calls for the integration of cultural and sociopolitical dimensions within the concept of engagement. Finally, results also suggest that schools are playing an important role to foster engagement in mental health care. Conclusion The quality of mental health care for migrant children and adolescent relies on the engagement of families, as well as on the mutual engagement of clinicians and of their institutions. Political contexts where tensions between majority and minority groups are present can also act as barriers to the care. Given that migrant families are engaging less in the services compared to non-migrant families, these considerations call for an important review of avenues to facilitate engagement of migrant families into collaborative care YMH services. This article suggests certain avenues to promote this engagement.

The importance of children and youth mental health is increasingly recognized. This rapidly developing field cannot be conceptualized as an extension of adult services to a younger age group and its developmental and organizational specificities are the object of debate. Reviewing recent literature in this domain and some preliminary information about the Quebec Mental Health Plan implementation, this paper addresses some of the questions which structure this debate in Quebec.Quebec mental health plan has put at the forefront collaboration among disciplines and partnership among institutions. In spite of having produced significant improvement in the field, discontinuities in services, which interfere with an ecosystemic model of care, persist. Recent studies suggest that the organisational climate which surrounds youth mental health services has a direct impact on the quality of services and on youth health outcomes. A flexible management structure, which engages clinicians and health workers, favors empowerment, minimizes work stress and facilitates partnership, is needed to foster successful interdisciplinary and intersectorial collaboration. This collaboration is the cornerstone of youth mental health services.

This article describes a collaborative mental health care project for youths, implemented in Montreal in a multiethnic setting. The authors examine the adjustments needed in the shared-care model to address the complexity of cultural and cooperation issues raised in the provision of services to a multiethnic population. A preliminary qualitative evaluation of the project shows how first-line workers face many uncertainties, stemming from both the institutional context and the multicultural reality of the population served. Results from this study advance the hypothesis that although uncertainties may generate discomfort and confusion, they may also open a space for innovation and acceptance of otherness.

Migration flux is being transformed by globalization, and the number of people with either undocumented or with a precarious status is growing in Canada. There are no epidemiological data on the health and social consequences of this situation, but clinicians working in primary care with migrants and refugees are increasingly worried about the associated morbidity. This commentary summarizes findings from a pilot study with health professionals in the Montreal area and suggests that the uninsured population predicament is a national problem. Although ethical and legal issues associated with data collection by clinicians, institutions and governments need to be examined, estimating the public health consequences and long-term cost associated with problems in access to health care due to migratory status should be a priority. Current regulations and administrative policies appear to be at odds with the principles of equal rights set out by the Canadian Charter of Rights and Freedoms and the UN Convention on the Rights of the Child. Beyond the commitment of individual clinicians, Canadian medical associations should take an advocacy role and scrutinize the ethical and medical implications of the present system.