Basé sur deux entrevues semi-dirigées effectuées auprès de personnes qui vivent des problèmes de santé mentale et qui ont vécu des périodes d’incarcération, cet article explore leurs points de vue sur les systèmes de la santé et de la justice. Leurs témoignages illustrent le clivage qui semble exister entre les besoins des personnes atteintes de trouble mental et les soins qui leur sont prodigués. Les auteurs concluent qu’il existe une difficile jonction entre besoins et services qui semble provenir de sources diverses (préjugés, manque de formation du personnel, processus administratif complexe) et les éléments qui la facilitent apparaissent peu nombreux (entraide entre les détenus, organismes d’aide aux personnes ayant un trouble mental).Based on two open-ended interviews with people suffering from a mental illness and who have been incarcerated, this article explores their perspectives on both health and justice systems. In their view, there is a divide between the needs of people with mental health problems and the care that is offered. The difficult juncture between needs and services seems to have numerous explanations (prejudice, lack of training of personnel, difficult administrative process, lack of communication between “inside” and “outside”); and the elements that could facilitate this juncture appear to be scarce (mutual help among inmates, community based mental help organizations).Basándose en dos entrevistas semidirigidas efectuadas con personas que viven con problemas de salud mental y que han vivido períodos de encarcelamiento, este artículo explora sus puntos de vista acerca de los sistemas de salud y justicia. Sus testimonios ilustran la diferencia que existe entre las necesidades de las personas que sufren de trastornos mentales y los cuidados que les son prodigados. Los autores concluyen que existe una conexión difícil entre las necesidades y los servicios, que parece provenir de diversas fuentes (prejuicios, falta de formación del personal, procesos administrativos complejos) y los elementos que la facilitan parecen poco numerosos (ayuda mutua entre los detenidos, organismos de ayuda a personas con trastornos mentales).Este artigo, baseado em duas entrevistas semi-estruturadas realizadas com pessoas que sofrem problemas de saúde mental e que vivenciaram períodos de encarceramento, explora os pontos de vista destas pessoas sobre os sistemas de saúde e de justiça. Seus testemunhos ilustram a brecha que existe entre as necessidades das pessoas que apresentam transtornos mentais e os cuidados que lhes são prestados. Os autores concluem que existe uma difícil relação entre necessidades e serviços por diversos motivos (preconceitos, falta de formação dos funcionários, processo administrativo complexo) e os elementos que a facilitam parecem pouco numerosos (entreajuda entre os detentos, organismos de ajuda às pessoas que apresentam transtornos mentais)

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ObjectivesAssess the feasibility and impact of a continuous professional development (CPD) course on type 2 diabetes and depression on health professionals’ intention to include sex and gender considerations in patient care.Design and settingIn collaboration with CPD organisations and patient-partners, we conducted a mixed-methods feasibility controlled trial with postintervention measures in three Canadian provinces.ParticipantsOf 178 eligible health professionals, 127 completed questionnaires and 67 participated in semistructured group discussions.Intervention and comparatorAn interactive 1 hour CPD course, codesigned with patient-partners, on diabetes and depression that included sex and gender considerations (innovation) was compared with a similar course that did not include them (comparator).OutcomesFeasibility of recruitment and retention of CPD organisations and patient-partners throughout the study; adherence to planned activities; health professionals’ intention to include sex and gender considerations in patient care as measured by the CPD-Reaction questionnaire; and barriers and facilitators using the Theoretical Domains Framework.ResultsAll recruited CPD organisations and patient-partners remained engaged throughout the study. All planned CPD courses occurred. Overall, 71% of eligible health professionals participated (63% under 44 years old; 79.5% women; 67.7% practising in French; 66.9% practising in Quebec; 78.8% in urban practice). After training, mean intention scores for the innovation (n=49) and control groups (n=78) were 5.65±0.19 and 5.19±0.15, respectively. Mean difference was −0.47 (CI −0.95 to 0.01; p=0.06). Adjusted for age, gender and practice settings, mean difference was −0.57 (CI −1.09 to −0.05; p=0.03). We identified eight theoretical domains related to barriers and six related to facilitators for providing sex-adapted and gender-adapted diabetes and depression care.ConclusionsCPD training on diabetes and depression that includes sex and gender considerations is feasible and, compared with CPD training that does not, may prompt health professionals to modify their care. Addressing identified barriers and facilitators could increase intention.Trial registration numberNCT03928132 with ClinicalTrials.gov; Post-results.

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