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Implementation of the Quebec mental health reform (2005–2015)

Overview of attention for article published in BMC Health Services Research, October 2016
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Title
Implementation of the Quebec mental health reform (2005–2015)
Published in
BMC Health Services Research, October 2016
DOI 10.1186/s12913-016-1832-5
Pubmed ID
Authors

Marie-Josée Fleury, Guy Grenier, Catherine Vallée, Denise Aubé, Lambert Farand, Jean-Marie Bamvita, Geneviève Cyr

Abstract

This study evaluates implementation of the Quebec Mental Health (MH) Reform (2005-2015) which aimed to improve accessibility, quality and continuity of care by developing primary care and optimizing integrated service networks. Implementation of MH primary care teams, clinical strategies for consolidating primary care, integration strategies to improve collaboration between primary care and specialized services, and facilitators and barriers related to these measures were examined. Eleven Quebec MH service networks provided the study setting. Networks were identified in consultation with 20 key MH decision makers and selected based on variation in services offered, integration strategies, best practices, and geographic criteria. Data collection included: primary documents, structured questionnaires completed by 25 managers from MH primary care teams and 16 respondent-psychiatrists working in shared-care, and semi-structured interviews with 102 network stakeholders involved in the reform. The study employed a mixed method approach, triangulating the three data sources across networks. While implementation was not fully achieved in most networks, the Quebec reform succeeded in improving primary care services with the creation of adult primary care teams, and one-stop services which increased access to care, mainly for clients with common MH disorders. In terms of clinical strategies implemented, the functions provided by respondent-psychiatrists had a greater impact on the MH primary care teams than on general practitioners (GPs) in medical clinics; whereas the implementation of best practices were indirect outcomes of another reform developed simultaneously by the Quebec substance use disorders program. The main integration strategies used for increasing continuity of care and collaboration between primary care and specialized services were those involving fewer formal procedures such as referrals between teams and organizations. The lack of operational mechanisms and protocols governing new services and structures were important barriers to primary care consolidation and service integration, as was the lack of interest and involvement of most GPs in MH. Successful and sustained healthcare reform requires attention to process and outcomes as well as structural change or service reorganization. Six recommendations for more successful implementation of the Quebec MH Reform are provided, with implications for healthcare reform internationally.

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Mendeley readers

The data shown below were compiled from readership statistics for 37 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 37 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 27%
Unspecified 8 22%
Researcher 6 16%
Student > Doctoral Student 4 11%
Student > Ph. D. Student 3 8%
Other 6 16%
Readers by discipline Count As %
Unspecified 11 30%
Nursing and Health Professions 10 27%
Medicine and Dentistry 6 16%
Psychology 3 8%
Social Sciences 3 8%
Other 4 11%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 December 2016.
All research outputs
#6,636,825
of 8,713,305 outputs
Outputs from BMC Health Services Research
#2,657
of 3,216 outputs
Outputs of similar age
#206,373
of 298,886 outputs
Outputs of similar age from BMC Health Services Research
#71
of 92 outputs
Altmetric has tracked 8,713,305 research outputs across all sources so far. This one is in the 13th percentile – i.e., 13% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,216 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.6. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 298,886 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 92 others from the same source and published within six weeks on either side of this one. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.