[Clinical and ethical stakes of external supervision of mental health teams]. / Enjeux cliniques et éthiques de la supervision externe des équipes en santé mentale.

External supervision of teams is increasingly part of mechanisms put in place both in public networks and community organizations to contribute in supporting professional mental health workers in developing their abilities and improving their clinical practices. It also plays a role in the analysis of ethical questions and in the prevention of deontological errors. The supervision of teams also includes its share of challenges, notably with regards to group dynamics and mechanisms to favour in order for supervision to rightly adjust to the needs and levels of participating professionals. Finally, the supervisor must also consider his own ethical responsibilities towards those supervised and towards their clients.

[The Swedenborg mystery: sanity or insanity?]. / Le mystère Swedenborg: raison ou déraison ?

In this article, the author proceeds to a clinical analysis of the Swedenborg phenomenon by examining the extraordinary life of this thinker who had a great influence on the intellectual world and the then rising psychology. The author examines more closely the progression and the colossal contribution of Emmanuel Swedenborg to several scientific fields. Finally, the author raises the issue of a possible psychiatric illness suffered by this individual considered during his time as the Leonardo de Vinci of the North, the Aristotle of Sweden.

[Is merging organizations the solution to service integration?]. / L'intégration des services passe-t-elle par des fusions d'établissements?

Organizational models inherited from the time when institutionalizing patients was common practice are now obsolete. Service coordination, undergone earlier within a same institution, is now governed by professionnals linked to various organizations and different settings. One of the difficulties of integration of these services is that contributing organizations often continue to operate individually, consequently going against the pursued goal. The solution most often proposed to counter this compartimentalization consists in reinforcing integration of organizations, which will in time favor integration of various services. One of the ways to realize this organizational integration is to reduce the number of existing organizations, by merging for example, a certain number of them. It is this path of hierarchical organization that the Québec health care system has taken during the 1990. Other paths that of networking have also been experienced during the same period. To judge of the relevance of these options, the authors propose a reversal of the dominating perspective according to which service integration necessarily pass through installing mecanisms of organizational integration. Withought minimizing the importance of such mecanisms, the authors put forth that integration of services commands first and foremost collaboration between professional health workers. Through this angle, the relevance of an organizational integration model depends on the impact it will have on the capacity and willingness of health workers to work in a concerted way. The authors submit that the fact of giving to a sole authority the govern of existing organizations is not the panacea some would like to believe.