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an inconsistent implementation of PSR model due to issues such as: training, facility design, understanding and interpretation of PSR and a focus on activities of daily living. Community-based supports for people with mental illness are still under-resourced and little has been done to augment services that provide important supports to assist people to gain access to the aspects of citizenship which we are all entitled such as income and education. In addition, in BC deinstitutionalization is taking place in the context of housing shortages that have created barriers for individuals ready to move into the community and live more independently.

4. Reflections on Gender and Social Determinants of Health

Findings from our collaborative program of research on deinstitutionalization as it has occurred in BC’s interior region suggest that the deinstitutionalization process has significant gendered implications and is also providing new opportunities for care and training that would take gender into account in the development of rehabilitation models. For example, moves of patients to new facilities have significantly shifted their relationships with families, creating new tensions and responsibilities for the mostly female family members who provide support. Staff, in turn, perceived male and female patients differently and their care was shaped by these perceptions.

It remains to be seen if a recovery model of care can fully embrace elements of citizenship such as the gendered dimensions of care, and other social determinants of health. Implicit in this is a willingness to incorporate an analysis of the social construction of oppression. Until social constructs of mental illness address stigma and discrimination, policy decisions can be made that put cost containment and social control ahead of funding responsive programs of recovery for the seriously and persistently mentally ill among us.


“GAM” – A Global Approach to Psychiatric Medication for Individual and Collective Transformation*

Lourdes Rodriguez del Barrio et Céline Cyr. Social Work, Université de Montréal

[* Title inspired by an activist who described the GAM approach as such, as it related to her own experience of GAM.]

We opted to present the “GAM” initiative as we thought it was one of the most innovative, empowering, unique and useful approach to share with the wider mental health community. “GAM” stands for “Gestion Autonome de la Médication en santé mentale” or in English «Gaining Autonomy with my Medication”. GAM is a novel idea developed by people who live with or have lived with mental health problems, by rights groups and by alternative mental health groups in Québec.

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