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Axes of Intervention

Public Mental Health

Qualaxia is acting to improve public mental health
When taking the following points into consideration, our concern with mental health problems as an issue of public health is certainly justified:
  • 15 to 20 percent of adults currently suffer from a mental disorder and at least 30 percent will be afflicted by a mental disorder during their lifetime.
  • Mental disorders are second after cardiovascular diseases and ahead of all cancers combined regarding their burden on the health system.
  • Anxiety and depression are the most common mental disorders. They are the cause of an enormous amount of distress and functional, social and physical incapacities.
  • If these disorders are left untreated, they present a high risk of cooccurrence with other disorders, reoccurrence and chronicity.
  • The risk of death by suicide is approximately 10 times greater in individuals suffering from anxiety disorders and 20 times greater in individuals suffering from depression than in the general population.
Above and beyond disease, mental health is an important resource for our society. It must therefore be maintained and strengthened.

During the course of its actions, Qualaxia is striving to provide a continuum of interventions encompassing the promotion of mental health, prevention of mental disorders and primary care mental health treatments. Qualaxia’s vision is to be a bridge between these different types of interventions instead of conforming to traditional silo administration practices.

Although a number of proven effective interventions already exist in each field described above, their application is significantly delayed. Qualaxia wishes to remedy this situation by making these interventions known, developing expertise, supporting their implementation, evaluating conditions favourable to their application and their effectiveness in a live context. Our network is also the venue to develop new knowledge on effective interventions.

Axis 1. Promote and Prevent

Qualaxia is effective actions that promote public mental health
A population's mental health is not only essential to its overall health, but to its social, economic and human development. Mental health is more than the absence of a mental disorder. The World Health Organization (WHO) provides the following definition:

It's a state of well-being in which the individuals can realize their potential, can face the normal stresses of life, can work productively and fruitfully, and are able to make a contribution to their community.

To promote mental health and prevent mental disorders, we believe it is possible to act on a number of elements, namely positive factors such as basic personal resources, self-esteem and social support. Also, the effect of negative factors such as stress, negative work environments and social inequality must be diminished.

The Qualaxia Network believes it is important to act on various planes: within individuals, their living environments (family, school, workplace) and global environments (public policies, social inequality).

Lastly, we take into account various life cycles. We cannot stress enough the importance of early intervention (0-5 years, 6-17 years), and continuing these efforts in adulthood, even in seniors. Although principles outlined above remain constant, interventions would differ for each life cycle.

Axis 2. Treat and Support

Qualaxia is a sustained effort towards a better quality of primary care treatments and services
Treatments and services are considered determining factors in the mental state of a population, and as such, they concern public health and the Qualaxia Network.

Only half of people afflicted with common mental disorders (depression or anxiety) seek treatment. Qualaxia wants to understand why this occurs and find a way to change this reality.

Over 80 percent of individuals who consult refer to primary care services, especially general practitioners. In addition, in Quebec, with the Plan d'action en santé mentale (2005), and in the rest of the world (WHO), these services constitute the key element in the treatment system for people with mental disorders. For that reason, Qualaxia focuses its efforts on this type of service.

In our opinion, making use of these services for mental health issues is insufficient, services must also be effective. Studies show that only half of people suffering from depression or anxiety, who seek help for mental health reasons, receive a minimally adequate treatment according to practice guidelines.

Qualaxia is working to publicize, develop and sustain effective strategies to improve the quality of mental health care.

Axis 3. Observe and Evaluate

Qualaxia is the continuous evaluation of results
Our approach is populational. Qualaxia focuses on actions that have the potential to improve the state of public mental health.

Qualaxia aims to evaluate if such actions have met expectations. However, there is currently a significant lack of indicators necessary to follow-up on the state of public mental health and inform planners on the effectiveness of existing interventions.

We have noticed that available indicators have several deficiencies, for example:
  • indicators coming from administrative databases only provide information on individuals consulting in the public sector. They do not include people with mental disorders who do not consult or people seeking treatment in the private sector (psychologists, etc.), two very common occurrences in mental health.
  • although they compensate for gaps in administrative databases, populational studies are also flawed. Due to their considerable expense, they are rarely repeated. They are also carried out on a national scale and are therefore sparingly used in local service planning.
As Qualaxia's goal is to improve this situation, these factors are a priority. We are also looking to contribute to the development of epidemiological knowledge linked to public mental health, while taking into account the various stages of life. For example:
  • protective factors for mental health
  • risk factors associated with most common mental disorders
  • factors influencing use of services
  • factors influencing adequacy of treatments

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