IntroductionEven in countries with universal healthcare systems, excess mortality rates due to physical chronic diseases in patients also suffering from serious mental illness like schizophrenia is such that their life expectancy could be lessened by up to 20 years. The possible explanations for this disparity include: unhealthy habits (i.e. smoking; lack of exercise); side-effects of psychotropic medication; delays in the detection or initial presentation leading to a more advanced disease at diagnosis; and inequity of access to services. The main objective of this paper is to explore the feasibility and acceptability of patient partnership for developing an interactive guide to improve access to primary care providers for chronic diseases management and health promotion among patients with severe mental illnesses.MethodsA participatory action research design was used to engage patients with mental illness as full research partners for a strategy for patient-oriented research in primary care for persons with schizophrenia who also have chronic physical illnesses. This strategy was also developed in partnership with a health and social services centre responsible for the health of the population of a territory with about 100,000 inhabitants in East-end Montreal, Canada. A new interactive guide was developed by patient research partners and used by 146 participating patients with serious mental illness who live on this territory, for them to be better prepared for their medical appointment with a General Practitioner by becoming more aware of their own physical condition.ResultsPatient research partners produced a series of 33 short videos depicting signs and symptoms of common chronic diseases and risk factors for the leading causes of mortality and study participants were able to complete the corresponding 33-item questionnaire on an electronic touch screen tablet. What proved to be most relevant in terms of interactivity was the dynamic that has developed among the study participants during the small group learning sessions, a training technique designed for healthcare professionals that was adapted for this project for, and with patient partners.ConclusionThis research has shown the feasibility and acceptability of patient partnership and patient-oriented research approaches to the R&D process of a new medical tool and intervention for patients with serious mental illness, and its acceptability for addressing inequity of this disadvantaged population in terms of access to primary care providers.

La neuro-imagerie permet d’observer et de comparer des groupes d’individus réagissant différemment lorsqu’exposés, en laboratoire, à des images provocatrices ou à des situations particulières. Pour certains, cette réaction impliquera des zones cérébrales davantage associées à l’émotivité, ce qui peut expliquer des déficits dits cognitifs ou d’attention faisant obstacle à leurs capacités d’apprentissage, d’abstraction et d’adaptation. On peut ainsi comparer des schémas de réactions qui ont été assez souvent répétés et observés pour que l’on puisse tirer certaines conclusions statistiques : en présence d’un même stimulus ou en situation de stress, le cerveau des personnes présentant par exemple un trouble obsessif-compulsif réagit différemment de celui de la population en général. Pour certains d’entre nous il est rassurant de constater, images à l’appui, que c’est telle partie du cerveau plutôt qu’une autre qui est surtout sollicitée dans une situation donnée. Cela « prouverait » que ce n’est pas intentionnellement que la réaction est plus émotive que rationnelle, le cas échéant. Par contre, pour d’autres, il est important d’être informés au moins autant des possibilités du rétablissement que d’identifier les dysfonctions et les causes apparemment anatomiques d’un problème de santé mentale. Dans un cas comme dans l’autre, cet accès à de l’information médicale et la possibilité pour les étudiants en rétablissement de dialoguer avec un scientifique sont à la base de tout un programme dit d’éducation thérapeutique et cette « Université du rétablissement » est ici introduite pour la première fois.Objectives Located at the heart of a mental health university institute in Montreal, Canada, the University of Recovery (UR) is a peer-run agency of service users who came together as a private non-profit organization to promote their experiential knowledge in science and public health, and to transform the academic milieu as an inclusive work environment conducive to recovery and full citizenship. UR students can thus have access to scientific conferences and classes on various topics and invite scientists or other professionals to further discuss new discoveries and techniques, and possible ways of improving healthcare from a patients’ and service users’ perspective. Our conversation with a scientist specialized in obsessive-compulsive disorders triggered this collective reflection on neuroimaging in terms of psychiatric diagnoses, prognoses, recovery opportunities and meta-cognition.Method At the core of the UR as a therapeutic education program is the Projet Citoyen, an adaptation and a transposition in Montreal of the Yale Citizens Project, which has been developed in New Haven, USA, over the past fifteen years. The Projet Citoyen is comprised of four main components: bi-weekly group discussions, individualized peer support, involvement and practicum in the community, and participation in public events and debates. UR students therefore evolve in the academic and scientific milieu, here regarded as a translational commun...