Marie‐josée Fleury
Dados Biográficos
| ID | 3602848 |
|---|---|
| NOME | Marie‐josée Fleury |
| PRENOMES | Marie‐josée |
| SOBRENOME | Fleury |
| ASSINATURA | FLEURY M J |
| AFILIAÇÕES | Douglas Mental Health University Institute |
| ORCID | 0000-0002-4743-8611 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 75 |
| TOTAL DE CITAÇÕES | 46 |
| TOTAL COMO AUTOR | 75 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2000 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Profiles of service use among patients with gambling disorders
Exploring oral health perception, dental care use, and barriers among permanent supportive housing residents in Quebec
Permanent Supportive Housing (PSH) programs can improve access to health services, yet their impact on dental care remains underexplored. To explore the perception of oral health, dental care use, barriers to care, and expectations among residents of single-site and scattered-site PSH. Convergent mixed-methods were used. Quantitative data from a prior study (2023, n = 308) and a survey of 19 PSH residents were analyzed descriptively. Semi-structu…
Residents’ perception of the quality and impact of different models of permanent supportive housing
Exploring family physicians’ mental health referrals via centralized referral systems in Quebec, Canada
Background Centralized referral mechanisms anchored in primary care have been implemented to facilitate timely and appropriate access to health care in Quebec, Canada, like via Centre de répartition des demandes de services (CRDS), a regionally centralized referral system used by family physicians (FPs) for new requests to specialty care, including psychiatric services. CRDS for psychiatry was implemented in 2019, where local centralized referral…
Variables associated with higher community integration among permanent supportive housing residents
Few studies have used a framework for exploring a broad range of resident characteristics, housing, and service use features that might increase community integration among permanent supportive housing (PSH) residents who have lived in scattered-site or single-site PSH for 6 months to 5+ years. This study is original in identifying predisposing, enabling, and need factors associated with higher community integration among PSH residents. PSH resid…
Predictors of readmission to substance-related disorder treatment over a five-year period
Profiles of quality of life among residents in permanent supportive housing during the Covid-19 pandemic
This study identified profiles of quality of life (QoL) deterioration among permanent supportive housing (PSH) residents during the COVID-19 pandemic, which hasn’t been reported on yet. Between November 2020 and April 2022, 231 PSH residents from Quebec (Canada) were interviewed. Patient profiles were identified with Cluster Analysis based on the participants’ sociodemographic and clinical characteristics, and service use were compared (p < 0.05)…
Factors associated with mental health service use during the pandemic
Background: Scarce are the studies focusing on initiation of new mental health service use (MHSU) and distinguishing individuals who have sought services but have been unsuccessful in accessing these. Aims: Assessing the factors associated with initiating new MHSU as compared to no MHSU due to self-reported no need, no MHSU due to health system and personal barriers and MHSU using resources already in place. Methods: The sample included participa…
Profiles of Emergency Department Users with Psychiatric Disorders Related to Barriers to Outpatient Care
Emergency department (ED) overcrowding is a growing problem worldwide. High ED users have been historically targeted to reduce ED overcrowding and associated high costs. Patients with psychiatric disorders, including substance-related disorders (SRDs), are among the largest contributors to high ED use. Since EDs are meant for urgent cases, they are not an appropriate setting for treating recurrent patients or replacing outpatient care. Identifyin…
Emergency Department Use among Patients with Mental Health Problems
Patients with mental health (MH) problems are known to use emergency departments (EDs) frequently. This study identified profiles of ED users and associated these profiles with patient characteristics and outpatient service use, and with subsequent adverse outcomes. A 5-year cohort of 11,682 ED users was investigated (2012-2017), using Quebec (Canada) administrative databases. ED user profiles were identified through latent class analysis, and mu…
Profiles of Permanent Supportive Housing Residents Related to Their Quality of Life and Community Integration
Permanent supportive housing (PSH) is the main approach advocated in Western countries for eradicating homelessness. Considering that PSH residents are not a homogeneous group and that their quality of life (QoL) and community integration (CI) might differ in this setting, improving our understanding of these residents’ profiles may help stakeholders formulate informed recommendations to improve PSH. This study identified PSH resident profiles ba…
Barriers and Facilitators to High Emergency Department Use Among Patients with Mental Disorders
Emergency Department Use, Hospitalization, and Their Sociodemographic Determinants among Patients with Substance-Related Disorders
Notions et brève évaluation de la qualité des services en santé mentale au Québec
Notions et brève évaluation de la qualité des services en santé mentale au Québec. Un article de la revue Santé mentale au Québec (La qualité des services en santé mentale au Québec) diffusée par la plateforme Érudit
Facteurs encourageant ou limitant l’utilisation des services d’urgence pour des raisons de santé mentale par les patients grands utilisateurs de ces services
Facteurs encourageant ou limitant l’utilisation des services d’urgence pour des raisons de santé mentale par les patients grands utilisateurs de ces services. Un article de la revue Santé mentale au Québec (La qualité des services en santé mentale au Québec) diffusée par la plateforme Érudit
The Global Prevalence of Problem and Pathological Gambling and Its Associated Factors Among Individuals with Substance Use Disorders
Variables Associated with Quality of Life Among Individuals Living in Permanent Supportive Housing
Factors associated with change in moderate or severe symptoms of anxiety and depression in community-living adults and older adults during the Covid-19 pandemic
Health and socio-economic factors were associated with changes in symptoms of anxiety and depression during the pandemic, further increasing inequities in mental health needs. Public health campaigns on the importance of healthy behaviours should continue and health policies should reduce economic and social barriers to integrated substance use and mental health care
Predictors of no, low and frequent emergency department use for any medical reason among patients with cannabis‐related disorders attending Quebec (Canada) addiction treatment centres
Predictors of Frequent Emergency Department Use and Hospitalization among Patients with Substance-Related Disorders Recruited in Addiction Treatment Centers
Few studies have assessed the overall impact of outpatient service use on acute care use, comparing patients with different types of substance-related disorders (SRD) and multimorbidity. This study aimed to identify sociodemographic and clinical characteristics and outpatient service use that predicted both frequent ED use (3+ visits/year) and hospitalization among patients with SRD. Data emanated from 14 Quebec (Canada) addiction treatment cente…
Predictors of Length of Hospitalization and Impact on Early Readmission for Mental Disorders
Length of hospitalization, if inappropriate to patient needs, may be associated with early readmission, reflecting sub-optimal hospital treatment, and translating difficulties to access outpatient care after discharge. This study identified predictors of brief-stay (1-6 days), mid-stay (7-30 days) or long-stay (≥31 days) hospitalization, and evaluated how lengths of hospital stay impacted on early readmission (within 30 days) among 3729 patients …
Inconsistent Condom Use and Risk Taking Among People Who Inject Drugs in Saveh
Using administrative health data to estimate prevalence and mortality rates of alcohol and other substance‐related disorders for surveillance purposes
Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons
Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only. Methods: Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a …
Predictors of Recurrent High Emergency Department Use among Patients with Mental Disorders
Few studies have examined predictors of recurrent high ED use. This study assessed predictors of recurrent high ED use over two and three consecutive years, compared with high one-year ED use. This five-year longitudinal study is based on a cohort of 3121 patients who visited one of six Quebec (Canada) ED at least three times in 2014-2015. Multinomial logistic regression was performed. Clinical, sociodemographic and service use variables were ide…
Implementing Housing First Across Sites and Over Time
This article examines later fidelity and implementation of a five‐site pan‐Canadian Housing First research demonstration project. The average fidelity score across five Housing First domains and 10 programs was high in the first year of operation (3.47/4) and higher in the third year of operation (3.62/4). Qualitative interviews (36 key informant interviews and 17 focus groups) revealed that staff expertise, partnerships with other services, and …
Quebec mental health services networks
To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of int…
Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada
User satisfaction is a crucial quality indicator in health service provision. Few studies have measured user satisfaction among homeless and formerly homeless individuals, despite the high prevalence of mental health disorders (MHD) in this population. The purpose of this study was to assess overall satisfaction among 455 homeless and formerly homeless individuals who were receiving health and community services, and to identify factors associate…
Collaboration and involvement of persons with lived experience in planning Canada's At Home/Chez Soi project
Planning the implementation of evidence-based mental health services entails commitment to both rigour and community relevance, which entails navigating the challenges of collaboration between professionals and community members in a planning environment which is neither 'top-down' nor 'bottom-up'. This research focused on collaboration among different stakeholders (e.g. researchers, service-providers, persons with lived experience [PWLE]) at fiv…
Divergent modes of integration
Integration strategies in Quebec and Ontario yield clinical autonomy and power to physicians while simultaneously making them key partners in change. Contextual factors combined with increased and varied forms of physician remunerations and incentives mitigated some of the challenges from policy legacies, interests and cultures. Virtual partnerships and accountability agreements between providers promise positive but gradual movement toward integ…
Mental health network governance and coordination
In metropolitan and rural networks with such shared forms of network governance as an alliance or voluntary mutual adjustment, external mediation by a regional or provincial authority was an important lever to foster inter-organizational collaboration
Profiles of Permanent Supportive Housing Residents Related to Their Quality of Life and Community Integration
Permanent supportive housing (PSH) is the main approach advocated in Western countries for eradicating homelessness. Considering that PSH residents are not a homogeneous group and that their quality of life (QoL) and community integration (CI) might differ in this setting, improving our understanding of these residents’ profiles may help stakeholders formulate informed recommendations to improve PSH. This study identified PSH resident profiles ba…
Network collaboration of organizations for homeless individuals in the Montreal region
The Montreal homeless network seems adequate to address non-complex homelessness problems. Considering, however, that most homeless individuals present chronic and complex profiles, it appears necessary to have a more formal and better integrated network of homeless organisations, particularly in the health and social service sectors, in order to improve services
Patients’ Report of Help Provided by Relatives and Services to Meet Their Needs
Conditions d'implantation d'une réforme. Institutionnalisation des champs impliqués dans le traitement du sida
L'évolution des structures et des connaissances pousse les systèmes sociosanitaires à modifier leurs régulations; aussi, mieux comprendre les processus favorisant ou contrant les changements planifiés est-il important. Cet article vise à intégrer la notion de champ à l'analyse institutionnelle du changement. Cette notion définie par Pierre Bourdeau est particulièrement utile pour cerner la dynamique de l'implantation d'une réforme, comme l'illust…
Variables Associated with Quality of Life Among Individuals Living in Permanent Supportive Housing
Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks
The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes
Predictors of change in housing status over 12 months among individuals using emergency shelters, temporary housing or permanent housing in Quebec, Canada
Homelessness is an ongoing societal and public health problem in Canada and other countries. Housing services help homeless individuals along the transition towards stable housing, yet few studies have assessed factors that predict change in individual housing trajectories. This study identified predictors of change in housing status over 12 months for a sample of 270 currently or formerly homeless individuals using emergency shelters, temporary …
Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services
Implementation of Integrated Service Networks under the Quebec Mental Health Reform
Strategies for the implementation of healthcare reform and integrated service networks should include sustained support and training in best-practices, adequate performance indicators and resources, formalized integration strategies to improve network coordination and suitable initiatives to promote staff retention
Proposition d'un modèle d'évaluation de la mise en oeuvre et des effets de la planification des programmes régionaux d'organisation des services de santé mentale au Québec
To effect changes in the health care system, the Quebec government advocates an integrated program management approach within each region. In particular, regional service organization plans (PROS) are a strategy for developing this approach. PROS are complex and dynamic tools for planning services that aim to meet the diverse needs of regional populations and to coordinate delivery of services. To assess the potential of this intervention, this a…
Émergence des réseaux intégrés de services comme modèle d’organisation et de transformation du système sociosanitaire
Émergence des réseaux intégrés de services comme modèle d’organisation et de transformation du système sociosanitaire. Un article de la revue Santé mentale au Québec (Les réseaux intégrés de services) diffusée par la plateforme Érudit
La transformation des services de santé mentale et le rôle des pros
Le système québécois de santé mentale est actuellement confronté à une réorganisation importante de sa gestion et de l'offre de ses services. Cette restructuration peut être interprétée comme la deuxième phase d'une réforme, amorcée avec la Politique de santé mentale (1989) qui s'est traduite dans les régions sociosanitaires par les plans régionaux d'organisation de services (PROS) (1989-1997). À partir d'une étude de cas, cet article vise à décr…
Quebec mental health services networks
To apply the models successfully, the necessity of rallying all the actors of a system, from the strategic, tactical and operational levels, according to the type of integration involved: functional/administrative, clinical and physician-system is highlighted. The importance of formalizing activities among organizations and actors in a network and reinforcing the governing mechanisms at the local level is also underlined. Finally, a number of int…
Conditions d'implantation d'une réforme. Institutionnalisation des champs impliqués dans le traitement du sida
L'évolution des structures et des connaissances pousse les systèmes sociosanitaires à modifier leurs régulations; aussi, mieux comprendre les processus favorisant ou contrant les changements planifiés est-il important. Cet article vise à intégrer la notion de champ à l'analyse institutionnelle du changement. Cette notion définie par Pierre Bourdeau est particulièrement utile pour cerner la dynamique de l'implantation d'une réforme, comme l'illust…
Bilan de la mise en oeuvre et des effets des plans régionaux d’organisation des services (PROS) comme stratégies d’implantation de la réforme des services de santé mentale au Québec
Comme principale stratégie d'implantation de la Politique de santé mentale (PSM, MSSS, 1989), des plans régionaux d'organisation de services (PROS) sont mis en oeuvre dans l'ensemble des régions sociosanitaires du Québec. Cet exercice de planification des activités et des soins de santé mentale vise à démocratiser, décentraliser et reconfigurer le système de santé mentale en fonction d'une gamme plus diversifiée de services. Les PROS entendent au…
Stratégies d’intégration des services en réseau, régulation et moteurs d’implantation de changement
Les réseaux intégrés de services sont présentés comme l'une des principales voies de solutions pour accroître l'efficience, la pertinence et la cohérence du système de santé dans le contexte actuel d'augmentation de la demande et de contraintes budgétaires. Dans le domaine de la santé mentale, l'intégration s'inscrit aussi dans une tentative de répondre aux besoins multiples de la population cible, plus spécifiquement les personnes souffrant de t…
La création d’une nouvelle génération d’études épidémiologiques en santé mentale
Grâce à une subvention des Instituts de recherche en santé du Canada (IRSC), il se développe actuellement une nouvelle génération d’études en épidémiologie sociale et psychiatrique dans une zone circonscrite se situant dans le sud-ouest de Montréal où vivent 258 000 personnes. Ce programme de recherche repose sur une étude prospective longitudinale visant à identifier les déterminants de la santé mentale de la population, et sur quatre études spé…
Integration Strategies in Mental Health Care
This study evaluates the implementation and impact of a pilot project aimed at establishing an integrated service network for adults with severe mental disorders in an urban area in the province of Quebec. Post-implementation evaluation shows that the project helped improve the perceived integration and quality of services. However, the implementation of a true integrated service network in mental health necessitates involvement of all providers …
Patients’ Report of Help Provided by Relatives and Services to Meet Their Needs
Les organismes communautaires en santé mentale au Québec
Cette étude présente un portrait global des 371 organismes communautaires en santé mentale (OCSM) subventionnés par l’État québécois durant l’année 2003-2004, et fait état de leur dynamique partenariale avec les réseaux communautaire, institutionnel et intersectoriel. Les auteurs abordent la diversité des OCSM à partir des dimensions suivantes : période de fondation de l’organisme, type et étendue du territoire couvert, type et nombre de services…
Santé mentale en première ligne
enqute sur la sant dans les collectivits canadiennes, Initiative canadienne de collaboration en sant mentale
Les problèmes de santé mentale sont-ils détectés par les omnipraticiens ? Regard sur la perspective des omnipraticiens selon les banques de données administratives
Les problèmes de santé mentale sont-ils détectés par les omnipraticiens ? Regard sur la perspective des omnipraticiens selon les banques de données administratives. Un article de la revue Santé mentale au Québec (Santé mentale en première ligne) diffusée par la plateforme Érudit
Médecins omnipraticiens
Cet article examine le profil sociodémographique des médecins omnipraticiens (MO), leur rôle dans la prise en charge des troubles mentaux (transitoires/modérés, graves/persistants) dans les différents territoires (urbain, semi-urbain ou rural) du Québec, et si la pratique clinique et de collaboration de ces derniers est orientée vers une intégration des services de santé mentale. Cette étude transversale est basée sur 398 MO représentatifs de l’e…
La médecine et la santé au Canada français
En 1987, l’historien Jacques Bernier signalait que l’histoire de la médecine et de la santé au Canada français, malgré la publication entre 1976 et 1986 de certains écrits importants, était encore au stade de l’enfance. Depuis, ce champ d’étude a connu un essor considérable. Cet article présente une recension des écrits publiés, regroupés selon les thèmes qui ont été privilégiés, au cours des années 1987 à 2002 sur l’histoire de la médecine et de…
Across the pond–lessons from the US on integrated healthcare
The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 5.120 (2020 JCR, received in June 2021)The IJIC 20th Anniversary Issue was published in 2021
Mental health network governance and coordination
In metropolitan and rural networks with such shared forms of network governance as an alliance or voluntary mutual adjustment, external mediation by a regional or provincial authority was an important lever to foster inter-organizational collaboration
Mental Health Service Utilization Among Patients with Severe Mental Disorders
Divergent modes of integration
Integration strategies in Quebec and Ontario yield clinical autonomy and power to physicians while simultaneously making them key partners in change. Contextual factors combined with increased and varied forms of physician remunerations and incentives mitigated some of the challenges from policy legacies, interests and cultures. Virtual partnerships and accountability agreements between providers promise positive but gradual movement toward integ…
Comprehensive determinants of health service utilisation for mental health reasons in a canadian catchment area
Our study broke new ground by uncovering the impact of longstanding violence victimisation, and the proportion of homeownership on mental health service utilisation among this population. It also confirmed the prominence of some variables (gender, age, emotional problems and self-perceived mental health) as key enabling variables of health-seeking. There should be better promotion of strategies designed to change the attitudes of males and youths…
Facteurs associés à l’exposition élevée aux médicaments psychotropes identifiés lors d’une étude épidémiologique montréalaise
L’article examine les associations entre l’exposition élevée aux médicaments psychotropes, la présence d’un diagnostic de trouble mental et les caractéristiques sociodémographiques chez la population adulte. Un questionnaire a été passé par entrevue auprès de 2433 personnes de 15 ans et plus dans le cadre de l’enquête ZEPSOM (zone épidémiologique du sud-ouest de Montréal). Les déterminants de leur consommation de psychotropes ont fait l’objet d’a…
Réformes du système de santé mentale. Tendances internationales et perspectives Québec-France
Cet article fait un survol des tendances internationales des réformes en cours en santé mentale. Il décrit les modèles et les stratégies déployés afin d’améliorer les dispositifs de soins. Pour illustrer les réformes en santé mentale par les exemples du Québec et de la France, l’article se base sur une recension des écrits et sur des recherches en cours sur l’organisation de ces services. Dans la dernière décennie, la consolidation des soins prim…
Portrait et dynamique des organismes desservant les personnes itinérantes ou à risque d’itinérance dans la région de Montréal
Cet article dresse un portrait des organismes desservant les personnes itinérantes ou à risque d’itinérance (PIRI) à Montréal ainsi que des déterminants de leurs relations interorganisationnelles. L’étude montre que la collaboration interorganisationnelle, particulièrement avec le réseau de la santé et des services sociaux (RSSS), gagnerait à être accrue afin de répondre aux problèmes concomitants auxquels sont confrontées les PIRI. Le nombre de …
Does elapsed time between first diagnosis of schizophrenia and migration between health territories vary by place of residence? A survival analysis approach
La réforme des soins primaires de santé mentale au Québec et le rôle et les stratégies de coordination des omnipraticiens
Les systèmes sociosanitaire et de santé mentale au Québec ont été substantiellement transformés dans les dernières années. Au coeur des restructurations, les réformes ont visé la consolidation des soins primaires et une meilleure intégration du dispositif de soins, tendances centrales des réformes sur le plan international. Cet article résume les principaux axes de transformation des réformes du système sociosanitaire et de la santé mentale au Qu…
Medicine (48 obras) · Psychiatry (37 obras) · Mental health (35 obras) · Psychology (31 obras) · Political science (26 obras) · Homelessness and Social Issues (25 obras) · Nursing (21 obras) · Humanities (19 obras) · Mental Health Treatment and Access (18 obras) · Gerontology (17 obras)