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Youth homelessness is a complex psychosocial problem. It refers to the experience of young people who live without their parents or legal guardians and who do not have the means or the capacity to reside in a stable, secure, and permanent place. This exploratory study sought to examine the mental health and suicidal behaviour of 76 homeless Québec adolescents as part of a reflection on the mission of primary healthcare. Note that these adolescents are mostly in the first segment of the homelessness continuum and have voluntarily left their homes because of personal and family difficulties. These 43 girls and 33 boys aged 12 to 19 living temporarily in shelters completed a semi-structured interview and self-administered questionnaires regarding stressful events, psychosocial stress, and mental health. Of these, 38 reported suicidal behaviour, including attempted suicide in 19 cases. The results show that these young people exemplify a high degree of suffering and multiple problems. Evidence indicates that lost relationships and academic problems rooted in attention deficit/hyperactivity disorder are linked to suicidal behaviour. Finally, non-productive coping strategies centred on somatization and little reassurance of worth provided by the social support network are associated with suicidal behaviour. Caregivers in temporary shelters should look out for these factors and refer vulnerable youth to primarycare mental health professionals.

Life satisfaction among homeless youth is particularly low, yet remains a poorly investigated phenomenon. This study aims to explore three positive psychological factors related to homeless youth’s...

Abstract. Background: Homeless youth are a population at risk for suicidal behavior. Despite growing knowledge about risk factors, protective factors against suicidal behavior among this population are still poorly understood. Aims: To explore differences in coping and social support between homeless adolescents who attempted suicide and those who did not. Method: In total, 76 homeless adolescents from eight different shelters provided information about their suicidal behaviors over the previous year and filled out coping and social support questionnaires. Results: Homeless adolescents who had not attempted suicide perceived more social support (tangible assistance and guidance). Conversely, youth who had attempted suicide reported using more nonproductive strategies of coping (tension reduction, keep to self, and self-blame). Tangible assistance and tension reduction were found to be the strongest predictors. Limitations: As most of these youth were not homeless for a long time, care should be taken in generalizing these results to adolescents with longer histories of homelessness. Conclusion: Productive coping does not seem to constitute a sufficient personal resource to protect homeless adolescents from suicide attempts. Nonproductive coping could, however, be considered a serious risk factor. Consequently, promoting homeless youths' ability to find environmental resources, especially tangible assistance, could be the most valuable approach.

Research since the 1960s has consistently found that lay volunteers are better at helping suicidal callers than professionals. Yet, professional degrees are increasingly becoming requirements for helpline workers. In our first study, we conducted post hoc comparisons of U.S. helplines with all professional paid staff, all lay volunteers, and a mix of both, using silent monitoring and standardized assessments of 1,431 calls. The volunteer centers more often conducted risk assessments, had more empathy, were more respectful of callers, and had significantly better call outcome ratings. A second study of five Quebec suicide prevention centers used silent monitoring to compare telephone help in 1,206 calls answered by 90 volunteers and 39 paid staff. Results indicate no significant differences between the volunteers and paid employees on outcome variables. However, volunteers and paid staff with over 140 hours of call experience had significantly better outcomes. Unlike the United States, Quebec paid employees were not required to have advanced professional degrees. We conclude from these results and previous research that there is no justification for requiring that suicide prevention helpline workers be mental health professionals. In fact, the evidence to date indicates that professionals may be less effective in providing telephone help to suicidal individuals when compared to trained lay volunteers.

Objectives Mental, personality and substance use disorders are over represented among prisoners and aggressive individuals. The psychopathological and biological markers linked to mental functioning remain still unclear. In particular, the role of trace elements in mental illness is still matter of debate. Here, we investigated whether trace elements are correlated to specific psychopathological phenotype groups. Methods Axis I and II disorders, aggression, impulsivity, adult attention deficit/hyperactivity disorders (ADHD) indices and serum levels of zinc, copper and cadmium were evaluated in 160 male prisoners. Results Using latent class analysis we could subdivide prisoners into three distinct psychopathological classes: Class 1 characterized by low prevalence of aggression, personality disorders and substance abuse/dependence (alcohol, cannabis, cocaine); Class 2 represented by low prevalence of aggression and high prevalence of personality disorders and substance abuse/dependence; Class 3 defined by high prevalence of aggression, personality disorders and substance abuse/dependence. Serum levels of zinc were higher in Class 2 and 3 compared to Class 1. Moreover, Class 3 was associated with higher scores of impulsivity and ADHD indices. Conclusion Our results suggest that impulsivity but also adult ADHD indices are related to aggressive behaviour, and higher zinc levels are linked to personality disorders and addictions, but not to aggression.

En milieu carcéral, la prévalence des troubles mentaux et des décès par suicide atteint des proportions largement supérieures à celles de la population générale, le risque de mourir par suicide étant de 11 à 14 fois plus élevé. À partir d’un échantillon de 565 individus nouvellement incarcérés, le lien entre les tentatives de suicide et les troubles mentaux a été étudié, en mettant l’accent sur le trouble du déficit de l’attention avec hyperactivité (TDAH). Les résultats démontrent que la présence possible d’un TDAH chez un détenu augmente la probabilité d’avoir déjà fait une tentative de suicide, au même titre que la présence d’un trouble de l’Axe I ou II., In prisons, the prevalence of mental disorders and death by suicide reach proportions far above that of the general population : the risk of suicide being 11 to 14 times higher. Based on a sample of 565 newly incarcerated individuals, the relationship between suicide attempts and mental disorders was studied, with an emphasis on the attention deficit hyperactivity disorder (ADHD). Results show that a possible presence of ADHD in a prisoner increases the likelihood of having already attempted suicide, as well as the presence of an Axis I and II disorders., En el medio carcelario, la prevalencia de trastornos mentales y de decesos por suicidio alcanza proporciones altamente superiores a aquélla de la población general ; el riesgo de morir por suicidio es de 11 a 14 veces más elevado. A partir de una muestra de 565 individuos recientemente encarcelados, ha sido estudiada la relación entre los intentos de suicidio y los trastornos mentales, poniendo énfasis sobre el trastorno de déficit de atención e hiperactividad (TDAH). Los resultados demuestran que la presencia posible de un TDAH en un detenido aumenta la probabilidad de haber realizado ya una tentativa de suicidio, al igual que la presencia de un trastorno del Eje I o II.

Objective To measure the predictive power of the Suicide Probability Scale (SPS) in a male inmate population (federal penitentiary) with the added contribution of actuarial data. Method SPS scores and data from the files of 518 inmates were analyzed in relation to their suicidal behaviors over the following 10 years. Results During this period, 12 inmates committed suicide (2.32%), 43 engaged in non-lethal self-harm (8.3%) and 15 expressed serious suicidal intention (2.9%), for a total of 70 (13.51%) who manifested at least one form of suicidal behavior. The records of the 518 inmates allowed identifying seven actuarial variables (out of 24 documented) that distinguished the group that acted out. These variables were tested in combination with the SPS score to determine the best predictive models of suicidal behavior. Depending on type of suicidal behavior and on observation period, the following seven variables could prove useful in improving the predictive capacity of the SPS: age, prior suicidal behavior, borderline personality disorder, length of sentence, number of sentences, prior incarceration in a provincial prison, and juvenile priors. However, analyses did not allow developing a better predictive model for the specific subgroup of suicide completers. Conclusions SPS is improved when adding actuarial data.

Purpose: To determine the death rate among offenders, especially by suicide, inside and outside prison. Methods: A follow-up of 1,025 inmates over the period from 1995 to 2006 was conducted by searching the computerized records of correctional services and coroner files for data on suicidal behaviour and death. Results: There were 47 deaths (4.59%) from all causes among the 1,025 offenders during the observation period, of which 82.98% occurred outside prison. Of the 1,025, 26 died by suicide (2.54%). Of these suicides, 76.92% occurred outside prison. Conclusions: Offenders seem to be at risk for suicide throughout their life and even more so outside prison. This does not mean correctional services bear no responsibility for the suicide of inmates. On the contrary, vulnerable offenders should be treated while in prison.

'How I Think Questionnaire' (HIT) is used to measure self-serving cognitive distortions among delinquents. Previously validated on Americans, this instrument was translated, adapted and validated for French-speaking teens. To assess convergent and discriminant validity, 336 adolescents with externalizing behaviors in Quebec (Canada) completed the HIT, the Self-Reported Delinquency Scale (SRD), and the Auto-aggression Questionnaire. There were 165 boys and 171 girls with M(age) = 16.4 years (SD = 0.5) who received services under the Youth Criminal Justice Act (n = 145) or the Youth Protection Act (n = 191). HIT and SRD total scores were correlated (0.51, p Language: en

Resume Le present article expose d’abord l’etat de la situation des enfants endeuilles par suicide et de l’aide a apporter a ce groupe particulier, notamment sous la forme d’une recension des ecrits scientifiques et cliniques. Suit une description plus detaillee de deux experiences novatrices dans le domaine : le Programme de therapie de groupe pour enfants endeuilles par suicide de Laval (Canada) et de celle de l’organisme Vivre son deuil (Europe francophone). La specificite du deuil par suicide est d’abord etablie, surtout celle du deuil vecu par des enfants. Devant le besoin d’intervenir aupres de ces enfants, diverses approches de groupe ont ete experimentees, puis evaluees. La-dessus, la litterature conclut a une certaine efficacite, mais force est de constater une grande diversite des approches.

This paper describes the predictive power of the Suicide Probability Scale (SPS) within a male inmate population. The SPS scores of 1,047 inmates from 1995 to 1996 were compared against their suicidal behaviors in the following 10 years. The SPS probability score and the scores on its four subscales were found to be significantly higher in the group that engaged in at least one of three types of suicidal behavior: suicide, non-lethal self-harm and serious suicidal intentions. However, the SPS did not discriminate the inmates who went on to commit suicide. The SPS’s capacity to predict suicidal behavior proved limited in terms of sensitivity. In this regard, the SPS’s low and high risk levels correctly identified 36% of inmates who later engaged in suicidal behavior. The specificity was 0.85. These results confirm the SPS’s predictive power with male prisoners. These findings are the first to demonstrate the predictive validity of the SPS.

Dans un contexte où la problématique suicidaire chez les enfants est de plus en plus préoccupante et où il existe peu de documentation sur le sujet, le programme Intervention-suicide en milieu scolaire primaire a été élaboré et implanté dans une région du Québec. Le présent article explicite d’abord quelle est la problématique réelle du suicide chez les enfants, puis les différentes façons d’y faire face. Une dernière partie décrit sommairement le programme Intervention-suicide selon trois volets : repérage, soutien et référence des élèves à risque suicidaire ; intervention et prise en charge des élèves à risque suicidaire ; intervention à la suite d’un suicide dans l’entourage des élèves du primaire. Pour chacun des volets, des stratégies et des moyens sont ciblés. L’expérience est relativement novatrice ; elle a été évaluée et elle semble répondre aux attentes du milieu. Cependant, des recherches plus poussées sur le suicide chez les enfants permettraient encore de bonifier de telles interventions dans la communauté., Although child suicide is a growing concern, very little documentation exists on the subject. Against this backdrop, a suicide intervention program was implemented in primary schools in a remote region of Quebec. This article presents the current knowledge of suicide among young children and the different ways of addressing the problem. It then describes the three components of the intervention program in question : identifying, supporting and referring students at suicide risk ; intervening and taking charge of at-risk students ; intervening with primary-school students following exposure to suicide. For each component, strategies and means are targeted. The experiment is largely innovative. It was evaluated and seems to meet the expectations of primary-school circles. However, more in-depth research into child suicide would allow further improving such interventions in the community.

Suicide rates can vary quite considerably and attitudes regarding suicide may explain part of the variation. The present study investigated, across the 17 regions of Quebec (Canada), men’s attitudes towards suicide, expressing pain and help seeking, as they are related to suicide rates and sociodemographic variables (unemployment, divorce/separation, income and education). Most correlations were non-significant. However, in regions with an above-average educational level and with higher divorce/separation rates, men had better attitudes towards expressing pain. Furthermore, in regions where men were more inclined to express pain, suicide rates were lower. Also, significant positive correlations were found between suicide rates and low educational level, but also between an increase in suicide rates and an increase in income level. Where the aetiology of suicide is concerned, researchers must examine both sociodemographic factors and the psychological factors associated with them.

Aggressive behavior is one of the most challenging symptoms in psychiatry, and biological markers for aggression lack of large sample validations. Serotonin (5-HT) and other neuroactive compounds deriving from Tryptophan (Trp), including kynurenine (Kyn), have not yet been investigated in large cohorts of aggressive individuals to validate their potential as biomarkers of aggression.In 361 male inmates we measured serum levels of Trp, 5-hydroxytryptophan, 5-HT, Kyn, the ratios 5-HT/Trp * 1000 and Kyn/Trp * 1000, and performed Structured Clinical Interview for DSM-IV Axis-I and -II Disorders (SCID-I and -II), global assessment of functioning (GAF), and scales for aggressive behavior, impulsivity, adult attention-deficit/hyperactivity disorder (ADHD), and intelligent quotient (IQ).Aggressive compared to non-aggressive inmates exhibited lower Trp and Kyn serum levels but higher levels of 5-HT and 5-HT/Trp * 1000, higher levels of impulsivity and ADHD indices, lower IQ and GAF, higher prevalence of mood disorders, drug abuse/dependence, and borderline, conduct and antisocial behaviors. Interestingly, Kyn/Trp * 1000 was positively correlated to the number of severe aggressive acts (r = 0.593, P < 0.001). After adjusting for confounding factors, logistic regression analysis indicated that 5-HT/Trp * 1000, antisocial behavior, and GAF were predictors of aggressive behavior. The model combining these three predictors had an area under the ROC curve of 0.851 (95% CI 0.806-0.895).This study indicates that while circulating Trp is reduced in aggressive individuals, the combination of biological (5-HT/Trp ratio) and psychopathological (antisocial behavior and GAF) markers discriminates between aggressive and non-aggressive behavior suggesting the potential of a multi-marker approach in psychiatry given the heterogenic nature of mental diseases.

Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problem-solving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.

There is a dissonance between the purposes and services of the justice system compared to the needs of suicidal people or those with mental health problems. Correctional authorities are faced with sometimes difficult responsibilities when they have to incarcerate those who fall through the gaps in the social safety net. Correctional Service Canada’s (CSC) mandate is to carry out the sentences of two or more years imposed by the Court; consequently that federal authority may have more time and means than its provincial counterparts receive for inmates on remand or serving shorter sentences. CSC developed strategies for inmates with mental health problems and, specifically, an exhaustive suicide prevention program. The implementation of all the components of the mental health strategy is not completed but it is based on good planning. With respect to suicide prevention activities, these are mainly based on screening the most vulnerable inmates at the time of intake, but they cover a larger spectrum.

The Suicide Risk Assessment Scale (SRAS; nine items) is useful in correctional settings but needed further validation. First, 44 inmates originally screened as suicidal with the SRAS were evaluated by institutional psychologists according to five criteria: suicidal urgency, risk, appropriateness of referral, need for short- or long-term watch. On the whole, the SRAS was judged to be as effective as a more elaborate test. Second, 242 suicidal and non-suicidal inmates were tested with the SRAS. Their results correlated better with suicidal risk (.71) than with urgency (.50). Receiver operating characteristic (ROC) analysis even showed that the SRAS performed better than a more elaborate test in predicting risk.

Abstract. Five variables were investigated in the evaluation of Suicide Prevention Weeks (SPW) held in 1999, 2000, and 2001 in Québec, Canada: exposure to the campaign, previous suicide ideation, knowledge, attitudes, and intentions. After the year 2000 campaign, a telephone survey conducted on a representative sample of 1020 men revealed that only those actually exposed to the SPW had gained more knowledge of suicide facts and resources. However, the SPW did not influence attitudes or intentions to seek help. Results are not surprising, considering the low intensity of the campaign, especially in the media. Campaigns aimed at changing suicidal behaviors must be intensive.

The effectiveness of restricting access to certain means of committing suicide has been demonstrated, at least as regards toxic domestic gas, firearms, drugs and bridges. At the individual level, studies tend to indicate that many persons have a preference for a given means, which would limit the possibility of substitution or displacement towards another method. Similarly, the fact that suicidal crisis are very often short-lived (and, what is more, influenced by ambivalence or impulsiveness) suggests that an individual with restricted access to a given means would not put off his plans to later or turn to alternative methods. This has been more difficult to demonstrate scientifically in population studies. Nevertheless, it appears that, should such a shift occur towards other means, it would be put into effect only in part and over a longer term.

Les programmes novateurs ne doivent pas leur succes qu'a leur originalite ou leur pertinence. Ils doivent aussi s'elaborer a partir d'un consensus dans la communaute, de l'expertise et de la credibilite du personnel et d'une approche evaluative. Le programme Virgule repond a ces conditions et s'adresse a la clientele des jeunes de 10 et 11 ans qui commettent un premier delit. Cette erreur de parcours n'est pas consideree comme un echec definitif dans la vie de l'enfant mais plutot comme une occasion de changement, d'ou la philosophie de Virgule: «Transformer un point en virgule, c'est faire d'une difficulte une raison d'avancer».

To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of "Rogerian" nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.

Objective: To present an overview of promising strategies to prevent repetition of suicidal behaviours. Method: This literature review on tertiary preventive interventions of suicide attempts was produced using the computerized databases PubMed and PsycINFO from January 1966 to September 2010, using French- and English-language limits and the key words: suicid* or deliberate self-harm and treatment* or therapy or intervention* or management. Results: Thirteen of the 35 included studies showed statistically significant effects of fewer repeated attempts or suicides in the experimental condition. Overall, 22 studies focused on more traditional approaches, that is, pharmacological or psychological approaches. Only 2 of the 6 pharmacological treatments proved significantly superior to a placebo—a study of lithium with depression and flupenthixol with personality disorders. Eight out of 16 psychological treatments proved superior to treatment as usual or another approach: cognitive-behavioural therapy (CBT) ( n = 4), (including dialectical behaviour therapy [ n = 2]); psychodynamic therapy ( n = 2); mixed (CBT plus psychodynamic therapy [ n = 1]); and motivational approach and change in therapist ( n = 1). Among the 8 studies using visit, postal, or telephone contact or green-token emergency card provision, 2 were significant: one involving telephone follow-up and the other telephone follow-up or visits. Hospitalization was not related to fewer attempts, and 1 of the 4 outreach approaches had significant results: a program involving individualized biweekly treatment. The rationale behind these single or multiple approaches still needs to be clarified. There were methodological flaws in many studies and some had very specific limited samples. Conclusions: There is a need for more research addressing the problem in definitions of outcomes and measurement of the dependent variables, gender-specific effects, and inclusion of high-risk groups. There is a need for the development and evaluation of new approaches that support collaboration with community resources and more careful assessment and comparisons of existing treatments with different populations.

'How I Think Questionnaire' (HIT) is used to measure self-serving cognitive distortions among delinquents. Previously validated on Americans, this instrument was translated, adapted and validated for French-speaking teens. To assess convergent and discriminant validity, 336 adolescents with externalizing behaviors in Québec (Canada) completed the HIT, the Self-Reported Delinquency Scale (SRD), and the Auto-aggression Questionnaire. There were 165 boys and 171 girls with M(age) = 16.4 years (SD = 0.5) who received services under the Youth Criminal Justice Act (n = 145) or the Youth Protection Act (n = 191). HIT and SRD total scores were correlated (0.51, p0.01). On the HIT, past suicidal attempting delinquents were not significantly different than non-suicide attempting delinquents; also delinquents living in closed detention facilities had more self-serving cognitive distortions than delinquents living in open facilities or under probation in the community. This French-language version of the HIT is a reliable and valid measure.

Suicide-related behavior (SRB) is significantly more prevalent among female (40.8%) than among male (28%) inmates, although suicide risk is higher among the latter. When instrumental behavior (IB) is excluded and only suicidal acts (SA) considered, rates for the two groups are more comparable (11.9% and 16%, respectively). Compared with other female inmates, the SRB group is more suicidal, hostile, and impulsive and more likely to have been previously victimized and to be diagnosed with Axis I and II disorders. Women with IB are not significantly different from those with SA, except that their behavior provides significantly greater tension release.

The International Association for Suicide Prevention created a Task Force on Suicide in Prisons to better disseminate the information in this domain. One of its objectives was to summarize suicide-prevention activities in the prison systems. This study of the Task Force uncovered many differences between countries, although mental health professionals remain central in all suicide prevention activities. Inmate peer-support and correctional officers also play critical rotes in suicide prevention but there is great variation in the involvement of outside community workers. These differences could be explained by the availability of resources, by the structure of the correctional and community services, but mainly by the different paradigms about suicide prevention. While mere is a common and traditional paradigm mat suicide prevention services are mainly offered to individuals by mental health services, correctional systems differ in the way they include (or not) other partners of suicide prevention: correctional officers, other employees, peer inmates, chaplains/priests, and community workers. Circumstances, history, and national cultures may explain such diversity but they might also depend on the basic way we think about suicide prevention at bom individual and environmental levels. © 2007 Hogrefe & Huber Publishers.

In 2000 the Department of Mental Health of the World Health Organization (WHO) published a guide named Preventing Suicide. A Resource for Prison Officers as part of the WHO worldwide initiative for the prevention of suicide. In 2007 there are new epidemiological data on prison suicide, a more detailed discussion of risk factors accounting for the generally higher rate of suicide in correctional settings in comparison to the general population, and several strategies for developing screening instruments. As a first step, this paper presents an update of the WHO guide by the Task Force on Suicide in Prisons, created by the International Association for Suicide Prevention. A second paper, by the same Task Force, will present some international comparisons of suicide prevention services in correctional facilities. © 2007 Hogrefe & Huber Publishers.

Suicidality has been related to inwardly directed aggression. We compared convenience samples of 89 Canadian students of Chinese origin (CC) and 81 Canadian students from other backgrounds on measures of suicidality, hostility and aggression. The Chinese Canadian group reported higher levels of suicidality and hostility than the group of other Canadians. However, aggressive behaviors directed toward self or others were less frequent among Chinese Canadians. No differences were found between men and women. The results are interpreted by invoking the influence of Chinese culture on emotional restraint, particularly as regards aggressiveness.

The effectiveness of restricting access to certain means of committing suicide has been demonstrated, at least as regards toxic domestic gas, firearms, drugs and bridges. At the individual level, studies tend to indicate that many persons have a preference for a given means, which would limit the possibility of substitution or displacement towards another method. Similarly, the fact that suicidal crisis are very often short-lived (and, what is more, influenced by ambivalence or impulsiveness) suggests that an individual with restricted access to a given means would not put off his plans to later or turn to alternative methods. This has been more difficult to demonstrate scientifically in population studies. Nevertheless, it appears that, should such a shift occur towards other means, it would be put into effect only in part and over a longer term.

Results from the Minnesota Multiphasic Personality Inventory (MMPI) were compared for three groups of male inmates in federal penitentiaries: 47 suicide completers, 43 suicide attempters and, 123 non-suicidal controls. Analyses show that the groups differed on all 10 clinical scales and on at least 8 after Bonferroni correction. Attempters obtained the highest scores on 4 of 8 scales; they also posted the highest scores on 3 others, but differences were significant only against non-suicidal controls. Completers posted the highest score on only one scale (Mf), but the difference was significant only against non-suicidal controls. All told, completers proved more similar to non-suicidal controls than to attempters. Regarding profiles, completers are more strongly correlated with non-suicidal controls (r=0.95) than with attempters (r=0.86); non-suicidal controls are less strongly correlated with attempters (r=0.88). The fact that attempters seem more pathological than the others can mislead clinicians screening for suicide risk.

L'article porte sur un échantillon de 243 hommes incarcérés dans deux villes différentes, échantillon au sein duquel on retrouve des taux élevés d'antécédents suicidaires et de troubles mentaux. Les niveaux de gravité, d'urgence et de risque suicidaires caractérisant ce groupe d'hommes étaient également élevés. Des 243 détenus à l'étude, 43 (17,7 %) présentaient une urgence suicidaire élevée et/ou un trouble mental grave. L'analyse des dossiers institutionnels de ces individus en difficulté a révélé que seulement 35 % d'entre eux avaient été dépistés formellement, mais que 75 % avaient au moins été identifiés informellement. Les dossiers étaient peu annotés et ne rendaient peut-être pas justice au travail clinique qui n'est pas toujours consigné. Ce manque d'informations pouvait néanmoins laisser entrevoir un problème au niveau du suivi des individus. Par ailleurs, de grandes différences étaient observées entre les détenus des deux villes. Les services psychiatriques et de déjudiciarisation offerts dans les communautés respectives pourraient expliquer ces différences en ce qui concerne les prisons. Cela tendrait à démontrer que la prise en charge communautaire des délinquants suicidaires ou souffrant de troubles mentaux peut avoir une influence sur la qualité de vie de ces derniers mais aussi, indirectement, sur celle des personnes vivant ou travaillant en milieu carcéral., High levels of suicide attempts, lethality of these attempts, suicidal urgency and risk, and mental disorders were found in a sample of 243 inmates incarcerated in two different cities. From the total sample, 43 inmates (17,7 %) were found to have a high suicidal urgency and/or a serious mental disorder. The problems of these high risk people were identified formally in only 35 % of the institutional files inves- tigated but informally in at least 75 %. The amount of information found in the files was low, which was probably not fair to the clinical job being done otherwise. Nevertheless, the fact that so little information was registered in the files could point to problems with the follow-up of high-risk individuals. Beyond these observations, great differences were found between the inmates of the two cities. The psychiatric and diversion services offered in the respective communities could explain the differences observed at the prison level. That would tend to confirm that community caring of the suicidal or mentally ill delinquents can have an effect on their quality of life but also, indirectly, on the quality of life of inmates and employees of prisons.

Lorsque survient un suicide en milieu carcéral, le débat sur le partage des responsabilités se situe à au moins quatre niveaux qui ne sont pas toujours très explicites : celui de la société, en général, celui des institutions, celui des intervenants actifs dans ces institutions et, finalement, celui des personnes incarcérées elles-mêmes (qu’elles soient suicidaires ou pairs de suicidaires). Nous sommes tous interpellés à ces différents niveaux et, par-delà la culpabilisation qui pourrait en résulter, notre prise de conscience devrait plutôt nous amener à agir, de façon cohérente et proactive, dans les différentes sphères où nous pouvons avoir une emprise., When a suicide occurs in a prison environment, the debate on the sharing of responsibilities lies on four levels that are not always explicit: the societal level, in general, the institutional level, the level of caregivers working in these institutions and, lastly, the level of the incarcerated individuals themselves, either being suicidal or being the peer of a suicidal person. We are all called upon at these different levels and, beyond the placing guilt that may result, our awareness of the situation should rather bring us to take action, consistently and proactively, in the various spheres in which we may have some influence.

Cet article a pour objectif de décrire une expérience pilote fondée sur les principes d’action des communautés de pratique (CoP), afin de rapprocher chercheurs et milieux de pratique en prévention du suicide et favoriser une meilleure utilisation des connaissances scientifiques. Des professionnels (n = 15) de différents organismes concernés par la prévention du suicide au Québec et disséminés sur tout le territoire (Centres de prévention du suicide, centres jeunesse, direction de santé publique, milieux hospitaliers), ainsi que des chercheurs (n = 4) et un animateur de la communauté ont participé à cette expérience innovante. La CoP a permis d’obtenir des effets sur la réceptivité envers les connaissances, l’accès aux ressources et aux connaissances et le développement de collaboration entre les membres. Des conditions préalables semblent cependant nécessaires à des collaborations accrues entre recherche et pratique, notamment un rapprochement sur le plan des valeurs et une relation fondée sur la confiance et le respect de l’autre et la capacité d’investir du temps dans le développement de relations de travail., The objective of this article is to describe a pilot experiment based on community of practice (CoP) action principles and aimed at bridging the gap between suicide prevention researchers and practitioners and encouraging better utilization of research knowledge. Participants in this innovative experiment included professionals (n = 15) from a variety of Quebec organizations concerned with suicide prevention located throughout the province (suicide prevention centers, youth centers, public health department, hospital settings), researchers (n = 4) and one community animator. The CoP made it possible to obtain effects on receptivity to knowledge, access to resources and knowledge, and the development of collaboration between members. However, it would appear that certain preconditions are necessary for increased collaboration between researchers and practitioners, notably the development of greater common ground in terms of values and a relationship based on trust and mutual respect and the ability to invest time in the development of work relations.

Cet article présente les résultats de l’évaluation de l’implantation du programme Intervention-suicide en milieu scolaire primaire. Les principales forces de ce programme résident dans sa spécificité, l’articulation du travail du personnel scolaire et des intervenants professionnels, la motivation, l’engagement et la diligence de ses partenaires, le professionnalisme des intervenants, l’expertise et la motivation particulière du responsable du programme, la qualité de la documentation disponible, la qualité des formations et sensibilisations dispensées, l’utilisation des forces d’intervention de la santé et de l’éducation, la diversité des expertises et expériences chez les intervenants, l’ouverture à la critique et la modération dans l’interprétation du phénomène suicidaire dans les actions à prendre. Des faiblesses relatives sont cependant notées au regard des aspects suivants : le partage des responsabilités, le manque d’information explicite dans les guides sur les objectifs, la structure et les fondements théoriques du programme, les formations trop courtes offertes aux intervenants, la dilution de l’expertise des intervenants, l’isolement de certains de ceux-ci, l’absence fréquente de leadership dans les équipes de secteur, et le décalage dans la durée de la formation clinique des intervenants., The article documents the results of the evaluation of the implementation of a suicide intervention program in primary schools in a remote region of Quebec. The main strengths of the program include : its specificity ; task coordination between school staff and professional practitioners ; highly motivated, engaged and diligent partners ; professionalism of practitioners ; expertise and personal motivation of program head ; quality of documentation available ; quality of training and awareness-raising activities provided ; use of power of intervention of healthcare and education systems ; diversity of practitioner expertise and experience ; openness to criticism and moderate interpretation of suicide phenomenon in actions to take. Certain relative weaknesses are observed in terms of sharing of responsibilities, lack of explicit information on objectives in program guides, program’s structure and theoretical foundation, overly short duration of training offered to practitioners, dilution of practitioner expertise, isolation of some practitioners, frequent absence of leadership in sector teams, and differences in duration of clinical training of practitioners.