Indiana University-Purdue University Indianapolis (IUPUI) / There is a lack of existing research that investigates the feasibility of using consumers to evaluate the fidelity of evidence-based practices, including supported employment which is an intervention that helps people with severe mental illnesses to obtain competitive employment. Fidelity refers to the extent that the SE program adheres to the Individual Placement and Support (IPS) model of supported employment. The present study was a concordance study that investigated whether or not consumers’ self reports of IPS fidelity information agreed with administrative charts and employment specialists. Additionally, it was hypothesized that consumers’ program satisfaction ratings would be positively correlated with their self reported IPS fidelity scores. An additional purpose of this study was to examine what types of supported employment fidelity items consumers were able to report on. Participants included a volunteer sample of 30 consumers and 5 employment specialists from one IPS program in Indiana. Consumers in the IPS program were interviewed by telephone using a survey that included questions related to their program’s fidelity as well as their satisfaction with the program. Questions were based off of items from the IPS Fidelity Scale and were categorized into the following subscales: work incentives counseling, job search, engagement, organization, staffing, and job support. Similar questions were asked in an employment specialist survey and a chart review. All three sources (consumers, charts, and employment specialists) indicated high IPS fidelity responses on the researcher developed surveys. However, there was a low level of agreement between the sources at both the subscale level and item level. Although there was an overall low level of agreement between sources, there were several items that had a moderate or higher degree of agreement. Additionally, the present study did find a positive correlation between the consumer fidelity score percentage and consumer IPS program satisfaction ratings, supporting the researcher’s hypothesis. Among the items that consumers had difficulty answering were several tapping program level policies such as zero exclusion. Reasons for the discrepancy in agreement between sources as well as clinical implications of the findings are discussed.

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La violence est responsable de 2,5 % des décès à travers le monde, en plus d’avoir un impact important sur la santé physique et mentale des victimes. Par conséquent, il s’agit d’un problème de santé publique prioritaire. Des études récentes réalisées auprès d’individus atteints de troubles mentaux graves (TMG) ont démontré qu’il existe une association entre l’usage du cannabis et les comportements violents. Considérant que ces individus sont plus à risque de consommer des drogues et de commettre des crimes que la population générale, cette découverte est particulièrement importante dans le contexte actuel de la légalisation. L’objectif de mon projet de recherche était donc de valider et de préciser la relation entre le cannabis et la violence chez les individus TMG. Pour se faire, trois études ont été réalisées. La première visait à faire état de la littérature au moyen d’une méta-analyse. En regroupant les études ayant calculé une telle association chez les TMG, nous avons mis en lumière l’existence d’une association modérée entre l’usage du cannabis et la violence. Pour ce qui est de la deuxième étude, nous avons identifié les principaux facteurs de risque dynamiques et statiques de la violence et de la criminalité chez les TMG ; dans les deux cas, l’usage du cannabis était un facteur d’une importance majeure. La dernière étude a permis de confirmer la relation unidirectionnelle entre l’usage persistant du cannabis et la violence dans une population atteinte de schizophrénie. Finalement, ces résultats seront particulièrement importants afin de formuler des recommandations cliniques pertinentes. De futures études devront toutefois être réalisées afin d’élucider les mécanismes sous-jacents de cette association. / Worldwide, violence is responsible for 2.5% of deaths, besides having an important impact on victims’ physical and mental health. Therefore, it is a priority public health problem. Recent studies of individuals with severe mental illnesses (SMI) have shown that an association exists between cannabis use and violent behaviours. Considering that these individuals are at higher risk of drug consumption and crime than the general population, this discovery is particularly important in the current context of the legalization. My research project therefore aimed to validate and to specify the relationship between cannabis use and violence in SMI individuals. To do so, three studies were conducted. The first one was to report current literature through a meta-analysis. By grouping the studies that calculated such an association among SMI, a moderate association was found between cannabis use and violence. As for the second study, we identified the main dynamic and static risk factors for violence and criminality in SMI; in both cases, cannabis use was one of these factors. The last study confirmed the unidirectional relationship between persistent cannabis use and violence in a population with schizophrenia. Finally, these results will be particularly important in order to formulate relevant clinical recommendations. However, future studies will need to be conducted to elucidate the underlying mechanisms of this association.