Research Team on the Organisation and Adequacy of Services

The research team on service organization and adequacy, directed by Marie-Josée Fleury, PhD, aims to develop optimum service models in order to improve the quality of the health and social services system while more efficiently meeting the diverse needs of people who suffer from mental health disorders and substance abuse.

The team integrates two main research themes:

  • Organizational theme: As part of ongoing reforms, this theme is mainly concerned with the organization of services in local networks along with the structure, dynamics and practices of these networks. It aims to better understand the most efficient practices and modes of integration with the goal of improving the quality of the health and social services system, particularly in the area of mental health and substance abuse.
     
  • Client theme: This theme concerns people who suffer from mental health disorders and substance abuse. It focuses on the interaction between the sociodemographic and clinical characteristics of users as well as on an evaluation of their needs, the assistance they receive, the services they use, as well as their satisfaction level. It also aims to better understand service trajectories and their impact on users' community integration and recovery.

The team uses diverse research methods and considers the perspectives of managers, clinicians and users. Comprised of researchers from varied disciplines, the team also solicits the active participation of decision-makers, clinicians and users.

Team

Director

Marie-Josée Fleury, PhD

Associate investigators from the Douglas

Jacques Tremblay, MD
Jean Caron, PhD
Michel Perreault, PhD
Myra Piat, PhD
Eric Latimer, PhD
Norbert Schmitz, PhD

Associate investigators outside the Douglas

  • Alain Lesage, Centre de Recherche Fernand-Séguin, Hôpital Louis-H. Lafontaine, Université de Montréal
  • Lambert Farand, Université de Montréal
  • Denise Aubé, Institut national de santé publique du Québec (INSPQ), Université Laval
  • Catherine Vallée, CSSS de la Vieille-Capitale, Université Laval
  • Roch Hurtubise, CSSS Jeanne-Mance, Université de Sherbrooke
  • François Chiochio, Université de Montréal
  • Michel Landry, Centre Dollard-Cormier Institut universitaire sur les dépendances, Université de Montréal
  • Serge Brochu, Centre Dollard-Cormier Institut universitaire sur les dépendances, Université de Montréal

Research staff

Guy Grenier, PhD
Jean-Marie Bamvita MD, PhD
Nadège Maisy
Armelle Imboua MD, MSc
André Ngui, Ph.D.
Ervane Kamgang, M.Sc.
Geneviève Cyr, M.Sc.


Research themes and studies

1- Determinants of adequacy of help with regard to the needs of users with severe mental health problems

Longitudinal study on the relationship between needs and help needed for recovery

This research theme aims to bring about a better understanding of the relationship between users’ needs and the help they receive as part of an effort to enhance their chances for recovery and integration within the community. Several factors that affect this relationship between needs and help are examined, including socio-demographic, economic, clinical, psychological, and environmental factors. The study is primarily focused on the perspectives of users, whose point of view has too often been neglected in assessments of the help and services they need. In this study, their participation in the needs-evaluation process is viewed as a key enabling factor in their recovery.

Studies are being carried out in collaboration with the CSSS de Dorval-Lachine-LaSalle and the CSSS du Sud-Ouest–Verdun. The goal is to answer the following questions in particular:

  • What are the conditions that allow users to attain, maintain or restore an acceptable level of social independence and quality of life?
  • What are the key factors at play in users' recovery?

The first two rounds of data collection are complete (350 and 300 participants respectively). A third round has started and will go on from June to September 2013.

For information on this research theme

Geneviève Cyr
Research theme coordinator
Tel. : 514-761-6131 ext. 3471
genevieve.cyr@douglas.mcgill.ca

 

2- Roles of general practitioners (GPs) in mental health and coordination in the context of shared care

The current transformation of mental health services aims to consolidate primary care, to better integrate the provision of care, and to allow patients with mental health disorders to regain a place in the community. In order to better support the decision-making process, this research theme aims to improve our understanding of the clinical and interprofessional practices of general practitioners (GPs) in the sector of mental health in Quebec as well as GPs perception of the quality of services and the strategies that should be implemented to improve the organization of the health and social services system.

Studies are being conducted in close partnership with a group of decision-makers involved in organizing health care services: Ministère de la Santé et des Services sociaux (MSSS), Fédération des médecins omnipraticiens du Québec (FMOQ), Association des médecins psychiatres du Québec (AMPQ - 1er volet de la recherche), Association québécoise d'établissements de la santé et de services sociaux (AQESSS), Institut national de santé publique du Québec (INSPQ), Centres intégrés de santé et de services sociaux (CSSS) (auparavant les Agences de la santé et des services sociaux - ASSS) de Chaudière-Appalaches, Montérégie, Montréal, Outaouais et Québec, Institut universitaire en santé mentale Douglas et Institut universitaire en santé mentale de Québec.

For information on this research theme

Armelle Imboua
Research theme coordinator
Tel. : 514-761-6131 ext. 2374
armelle.imboua@douglas.mcgill.ca

Knowledge transfer

Some research reports and other publications from the team

  • Fleury, M.-J. et al., (2009), Les soins primaires en santé mentale. Santé Mentale au Québec, (M.-J. Fleury: Guest Editor), XXXIV(1).
  • Fleury, M.-J., J. Tremblay, L. Farand, A. Lesage, M.-T. Lusier, D. Aubé, P. Lamarche, L.-R. Poirier et L. Fournier (2008), Rôle des médecins omnipraticiens en santé mentale au Québec (IRSC). Research Report, Quebec, Douglas Institut Universitaire en santé mentale.
  • Imboua., A. (2008), Profil de pratique des médecins omnipraticiens en santé mentale au Québec. Mémoire de maîtrise. Département d’administration des services de santé. Université de Montréal, 127 pages.

 

3- Integration and performance of mental health service networks

As part of the implementation of the Mental Health Action Plan (MHAP), this research theme aims at assessing the transformations of the mental health care service framework. The MHAP aims to reinforce the first-line care provided in the community, promote the recovery of individuals, and improve integration of the care framework through the creation of local service networks (LSN). The research theme will help identify the elements that promote or hinder these transformations, the degree to which the reform is implemented as well as the impacts on the system and users in different LSN in Quebec.

This project is being carried out in close collaboration with the following organisations:

  • Ministère de la Santé et des Services sociaux (MSSS)
  • Centre national d’excellence en santé mentale (CNESM)
  • Association québécoise d'établissements de santé et de services sociaux (AQESSS)
  • Fédération des médecins omnipraticiens du Québec (FMOQ)
  • Association des médecins psychiatres du Québec
  • One psychiatrist psychiatre répondant
  • Regroupement des ressources alternatives en santé mentale du Québec.
  • Agences (CISSS) du Bas-Saint-Laurent, de la Capitale-Nationale, de Chaudière-Appalaches, de l’Estrie, de Laval, de la Mauricie/Centre-du-Québec, de la Montérégie, de Montréal et du Saguenay

and the following CSSSs:

  • CSSS de Rimouski-Neigette
  • CSSS de la Vieille-Capitale
  • CSSS Alphonse-Desjardins
  • CSSS Memphrémagog
  • CSSS de Laval
  • CSSS de l’Énergie
  • CSSS Richelieu-Yamaska
  • CSSS Jardins-Roussillon
  • CSSS du Pontiac
  • CSSS de Dorval-Lachine-LaSalle
  • CSSS du Sud-Ouest - Verdun
  • CSSS de Chicoutimi

For information on this research theme

Geneviève Cyr
Research theme coordinator
Tel. : 514-761-6131 ext. 3471
genevieve.cyr@douglas.mcgill.ca

Knowledge transfer

Some research reports and other publications from the team

  • Fleury, M.-J., A. Landry, G. Cyr, D. Aubé, C. Vallée et M. Desranleau, (avril 2013), Portraits synthèses des réseaux locaux de services (RLS) du Québec - Document de travail, Montréal, 107 p.
  • Wiktorowicz, M.E., M.-J. Fleury, C.E. Adair, A. Lesage, E. Goldner, P. Goering, S. Peters (2009), Mental health network governance and coordination: Comparative analysis across ten Canadian regions (Phase 2). Canadian Health Services Research Foundation Co-sponsors: Ontario Ministry of Health and Long Term Care, Alberta Heritage Foundation for Medical Research, Canadian Mental Health Association.
  • Wiktorowicz, M.E., M.-J. Fleury, C.E. Adair, A. Lesage, E. Goldner, P. Goering, S. Peters (2006), Mental Health Restructuring Among Canadian Provinces: Lessons in Policy Reform and Regional Coordination. Phase I: Themes in Provincial Mental Health Policy. Canadian Health Services Research Foundation Co-sponsors: Ontario Ministry of Health and Long Term Care, Alberta Heritage Foundation for Medical Research, Canadian Mental Health Association.
  • Fleury, M.-J., C. Mercier, A. Lesage, Y. Ouadahi, G. Grenier, D. Aubé, M. Perreault and L.-R. Poirier (November 2004), Réseaux intégrés de services et réponse aux besoins, Raport, CHSRF.
  • Fleury, M.-J., Y. Ouadahi, G. Grenier, L. Cazale and M. Perreault (2003), Évaluation du projet de démonstration de mise en réseau des services en santé mentale sur le territoire du CLSC Longueuil-Ouest, Final Report, Direction of Public Health, Montérégie Regional Board.
  • MSSS (2002), Lignes directrices pour l’implantation de réseaux locaux de services intégrés en santé mentale, Québec, Direction générale des services à la population, April (with the collaboration of M.-J. Fleury).

 

4- Organisation of the health care system

This research theme integrates several ongoing or finalized projects that include:

  • The Quebec health and social services system
  • Community organizations (COs)
  • Use of mental health services
  • Homelessness (At Home Project)
  • Substance abuse and concomitant disorders

For information on this research theme

Guy Grenier, PhD
Research theme coordinator
Tel. : 514-761-6131 ext. 3460
guy.grenier@douglas.mcgill.ca

Knowledge transfer

Quelques rapports et autres publications de l’équipe

  • M.-J. Fleury et Magali Marc (2012), Entrée dans la Vie Adulte et Parcours en Milieu Ordinaire, Réseau Handicap Domicile 77, avec le soutien financier de la Caisse nationale de solidarité pour l’autonomie.
  • Fleury, M.-J., C. Vallée, R. Hurtubise, A. Landry and G. Grenier (2011 – French and English versions), The Homeless Demonstration Project, Implantation Report – Phase 1 (2009-2010), CMHC.
  • Fleury, M.-J., C. Vallée, R. Hurtubise and G. Grenier (2010 – French and English versions), The Homeless Demonstration Project, Planning and Development Report, CMHC.
  • Mercier, C., J.-F. Pelletier, M.-J. Fleury and J. Rousseau (2005), Évaluation d’un modèle alternatif d’intégration au travail pour des personnes handicapéesConsentra, Montréal, Centre de réadaptation Lisette-Dupras.
  • Caron, J., M.-J. Fleury, D. Godbout and M. Desranleau (2005), Traumatisés cranio-cérébraux présentant des troubles graves du comportement: définition, mesure et détermination des besoins pour l’organisation des services, Douglas Hospital Research Centre.
  • Pelletier, J.-F., C. Mercier, M.-J. Fleury and J.-R. Rousseau (2004), Ensemble de neuf monographies sur Consentra et ses organisations, Centre de réadaptation Lisette-Dupras, Montréal.

Contact

Marie-Josée Fleury. Ph.D.
Institut Douglas
Perry Pavilion, Room 3C E-3106
6875 LaSalle boulevard
Montreal (Quebec), H4H 1R3
Tel.: 514-761-6131 ext. 4344
Fax.: 514-762-3049
marie-josee.fleury@douglas.mcgill.ca


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