Marie-Josée Fleury
Santé publique: organisation des services, épidémiologie et études d'impact
- Professeure associée
-
École de santé publique - Département de gestion, d’évaluation et de politique de santé
Profile
Research expertise
Public health (health service organization and epidemiology), and evaluation of services, particularly service integration and quality assessment, as well as change implementation, needs assessment, primary care services, service utilization, health systems analysis, performance indicators, and patient outcomes. Methods: quantitative (surveys, administrative databases, outcome studies), qualitative (case study designs, program evaluation), and mixed-method investigations, all involving close partnerships with clinicians and decision-makers. Main target groups: patients with both serious and common mental disorders, substance use disorders and co-occurring disorders; vulnerable populations such as the homeless; and health care practitioners (general practitioners, psychiatrists, multidisciplinary teams), managers and decision-makers.
Summary of my research program and its impact, especially in the last five years: The overall objective of my research program is to contribute to knowledge on strategies for optimizing organization of the mental health system (including services for addiction and homelessness) in order to improve health system performance, and respond more effectively to patient needs. My original scholarly contributions have focused on three streams within this overall research program: First, I have conducted studies on healthcare organization for the purpose of assessing mental health care reforms related to primary care, community-based and emergency services, and collaborative care, as well as integrated service networks, and multidisciplinary team work. Second, I have spearheaded research projects in the areas of needs assessment and adequacy of care, including patient satisfaction studies, with particular focus on patient clinical profiles and related outcomes (e.g. recovery, quality of life). Third, I have conducted epidemiological studies on mental disorders using surveys and administrative databases, especially on patterns of healthcare utilization among individuals with mental health, addiction and co-occurring disorders. Over the years, I have received multiple grants (including salary awards as recently as July 2014) to support my research program. Results of this work have been published in numerous high-quality journals in my fields of investigation. I have also endeavored to maximize the impact and value of my work by disseminating it through other media, including provincial and national reviews, reports and books. Overall, my scholarly output reflects a balance between the need to maintain high academic standards at the international level, but also to insure that my research has an especially strong empirical impact within the Quebec community, in order to enhance the social relevance of my work.
Key words of research: Public health, evaluation of services, best practices implementation, needs assessment, service utilization, healthcare system analysis, performance indicators, and patient outcomes
Biography
Marie-Josée Fleury est professeure titulaire au Département de psychiatrie de l’Université McGill, professeure associée à l’École de Santé publique de l’Université de Montréal, et chercheuse au Douglas Institut universitaire en santé mentale. Elle a été l’experte-conseil en santé mentale en soutien à l’élaboration du Rapport d’appréciation de la performance de 2012 du Commissaire à la santé et au bien-être (gouvernement du Québec), et directrice scientifique de l’Institut universitaire sur les dépendances de 2012 à 2016. Ses recherches visent à mieux comprendre les composantes clés de l’amélioration des services à répondre aux besoins des usagers ayant des troubles mentaux, des dépendances et des troubles concomitants ainsi que ceux en situation d’itinérance. Ses axes de recherche couvrent l'analyse des réformes, l’évaluation et l’utilisation des services, l’épidémiologie psychiatrique ainsi que les études de besoin et d’impact sur la clientèle. Elle dirige plusieurs projets de recherche, et compte plus de 300 publications et tout autant de présentations scientifiques.
Affiliations and responsabilities
Research affiliations
- Chercheuse, Douglas Institut universitaire en santé mentale
- Chercheuse, Institut universitaire sur les dépendances
- Chercheuse, RISQ (Recherche et intervention sur les substances psychoactives)
- FRQS (réseaux de recherche): 1) Réseau québécois sur les troubles de l’humeur, suicide et comorbidités (RQHSC); 2) Réseau-1 (Réseau de connaissances en services et soins de santé intégrés de première ligne); 3) Réseau de recherche en santé des populations (RRSPQ), Regroupement stratégique en santé mentale
Teaching and supervision
Recruitment in research
Oui.
Student supervision
Post-doctoral Supervision
Oui.
Theses and dissertation supervision (Papyrus Institutional Repository)
Facteurs facilitant ou entravant l’efficacité des urgences dans leurs réponses aux besoins des grands utilisateurs de ces services en santé mentale
Cycle : Master's
Grade : M. Sc.
L’utilisation des urgences en santé mentale : déterminants, profils et innovations associés
Cycle : Doctoral
Grade : Ph. D.
Theses and dissertation supervision
Oui.
Directed Studies
Oui.
Stages and Others
Oui.
Jury Member
Oui.
Projects
Research projects
Trajectoires de soins, profils et résultats de santé des clientèles avec des troubles mentaux
Grands utilisateurs des urgences pour raison de santé mentale
Impact de différents modèles de logements permanents avec soutien sur l’intégration sociale et la qualité de vie des personnes en situation d’itinérance
Déterminants des troubles liés aux substances (TLS) et troubles mentaux (TM), utilisation et qualité des services de santé
Soins partagés et qualité des soins en santé mentale de première ligne
Description
Exploitation de SIC-SRD et RAMQ – Quebec database on Addiction and co-morbidity (2008-2016)
Outreach
Publications and presentations
Publications
PUBLICATONS SÉLECTIONNÉES:
M.-J Fleury, Z. Cao, G. Grenier, C, Huỳnh (2022). Predictors of death by physical illnesses or accidental/intentional causes among patient with substance-related disorders, Canadian Journal of Psychiatry, 1-5.
Fleury, M.-J., G. Grenier (2022). Impact de divers types d’hébergement chez les personnes en situation d’itinérance au Québec, Revue Santé publique, 34(3): 1-11.
Gentil, L.*, G. Grenier, H.-M. Vasiliadis, M.-J. Fleury (2022). Predictors of length of hospitalization and impact on early readmissio in mental health, International Journal of Environmental Research and Public Health, 19(15127): 2-19.
Gabet, M*., M.-J. Fleury (2022). Innovations organisationnelles aux urgences pour améliorer la qualité des soins dispensés aux patients souffrant de troubles mentaux : perspectives internationales, Journal de Gestion et d’Économie de la Santé, 40(2): 10-25.
M.-J. Fleury, L. Gentil*, G. Grenier, E. Rahme (2022). The impact of 90-day physician follow-up care on the risk of readmission following a psychiatric hospitalization, APMH, 1-13.
Fleury, M.-J., G. Grenier, Z. Cao, C. Huỳnh, D. Chihade* (2022). Predictors of emergency department use for suicidal behaviors among patients with substance-related disorders. Archives of Suicide Research, 1-22.
M.-J Fleury, Z. Cao, B. Armoon*, G. Grenier, A. Lesage (2022). Profiles of patients using emergency departments and hospitalized for suicidal behaviors. Suicide and Life-Threatening Behavior (SLTB), 52: 943-962.
Gabet, M.*, Z. Cao, M.J. Fleury (2022). Profiles, correlates and outcomes among patients experiencing an onset of mental disorder based on outpatient care received following index emergency department visits. CJP: 1-15.
Gabet, M.*, L. Gentil, A. Lesage, M.-J. Fleury (2022). Thirty-day outpatient physician follow-up after emergency department visits among patients with mental disorders. BJPsych Open, 8, e95: 1-10.
Fleury, M.-J., G. Grenier, Z. Cao, C. Huỳnh (2022). Profiles of individuals with cannabis-related disorders: a latent class analysis. Substance Abuse, 43(1): 855-864.
Armoon B.*, Z. Cao, G. Grenier, X. Meng, M.-J. Fleury (2022). Profiles of high emergency department users with mental disorders. American Journal of Emergency Medicine, 54:131-141.
Kaltsidis, G.*, G. Grenier, Z. Cao, K. Bertrand, M.-J. Fleury (2022). Predictors of change in housing status over 12 months among individuals using emergency shelters, temporary housing or permanent housing in Quebec, Canada. Health and Social Care in the Community, 30(2): 631-643.
Fleury, M.-J., G. Grenier, Z. Cao, X. Meng (2021). Typology of Currently or Formerly Homeless Individuals Based on Their Use of Health and Social Services. Community Mental Health Journal, 57(5): 948-959.
Fleury, M.-J., G. Grenier, L. Gentil*, P. Roberge (2021). Deployment of the consultation-liaison model in adult and child-adolescent psychiatry and its impact on improving mental health treatment. BMC Family Practice, 22(1): 82.
Fleury, M.-J., G. Grenier, L. Gentil* (2021). Profiles of Quebec specialist respondent-psychiatrists (SRP) based on their perceptions related to the capacity of the SRP function to improve treatment of mental health disorders in primary care and youth centers. Mental Health in Family Medicine, 17: 1054-1062.
Fleury, M.-J., G. Grenier, J. Sabetti, K. Bertrand, M. Clément, S. Brochu (2021). Met and unmet needs of homeless individuals at different stages of housing reintegration: a mixed-method investigation, 1-18, Plos One.
Gentil, L.*, G. Grenier, M.-J. Fleury (2020). Factors related to 30-day readmission following hospitalization for medical reasons among patients with mental disorders, Canadian Journal of Psychiatry, 1-13.
Gentil, L.*, G. Grenier, M.-J. Fleury (2020). Determinants of suicidal ideation and suicide attempt among currently and recently homeless individuals, Social Psychiatry and Psychiatry and Epidemiology.
Gentil, L.*, C. Huynh, G. Grenier, M.-J. Fleury (2020). Predictors of emergency department visits for suicidal ideation and suicide attempt. Psychiatry Research, 285 (112805):2-8.
Gabet, M.*, G. Grenier, Z. Cao., M.-J. Fleury (2020). Implementation of three innovative interventions in a psychiatric emergency department aimed at improving services use: a mixed-method study, BMC Health Services Research, 20(1):854.
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2020). Relationships among structures, team processes, and outcomes for service users in Quebec mental health service networks. International Journal of Integrated Care, 20(2):12, 1-19,
Penzenstadler, L.* L. Gentil*, C. Huynh, G. Grenier, M.-J. Fleury (2020). Variables associated with low, moderate and high emergency department use among patients with substance related disorders. Drug and alcohol dependence, 207, 107817: 1-10.
Kaltsidis, G.*, G. Grenier, Z. Cao, M.-J. Fleury (2020). Change in housing status among homeless and formerly homeless individuals in Quebec, Canada: A profile study. International Journal of Environmental Research and Public Health (IJERPH), 17(17): 6254.
Fleury, M.-J., G. Grenier, Z. Cao, Meng, X. (2020). Typology of currently or formerly homeless individuals based on their use of health and social services. Community mental health journal.
Fleury, M.-J., G. Grenier, J.-M. Bamvita, F. Ferland (2020). Typology of patients who use emergency departments for mental and substance use disorders. BJPsych Open, 6(4).
Fleury, M.-J., L. Rochette, G. Grenier, C. Huynh, H.-M. Vasiliadis, E. Pelletier, A. Lesage, (2019). Factors associated with emergency department use for mental health reasons among low, moderate, and high users, General Hospital Psychiatry, 60: 111-119.
Fleury, M.-J., G. Grenier, L. Farand (2019). Satisfaction with emergency departments and other mental health services among patients with mental disorders, Healthcare Policy, 14(3): 43-54.
Loranger, C.*, J.-M. Bamvita, M.-J. Fleury (2019). Typology of patients with mental health disorders and perceived continuity of care. Journal of Mental Health.
Fleury, M.-J., M. Fortin*, L. Rochette, G. Grenier, C. Huynh, E. Pelletier, H.-M. Vasiliadis (2019). Assessing quality indicators related to mental health emergency room utilization. BMC Emergency Medicine, 19(8): 1-15.
Fleury, M.-J., J. Sabetti, J.-M. Bamvita, G. Grenier (2019). Modeling variables associated with personal recovery among service users with mental disorders using community-based services. International Journal of social psychiatry, 65(2): 123-135.
Fleury, M.-J., G. Grenier, F. Ferland, L. Farand (2019). Use of emergency rooms for mental health reasons in Quebec: Barriers and facilitators. Administration and Policy in Mental Health, 46: 18-33.
Fleury, M.-J., G. Grenier, J.-M. Bamvita, F. Chiocchio (2019). Variables associated with work role performance in multidisciplinary mental health teams overall and in primary care and specialized services teams, respectively. Evaluation & the Health Professions, 42(2): 169-195.
Fleury, M.-J., L. Rochette, M. Fortin, A. Lesage, H.-M. Vasiliadis, C. Huynh, E. Pelletier (2019). Surveillance de l’utilisation des urgences au Québec par les patients ayant des troubles mentaux (Report de recherche). INSPQ, 21 p.
Fleury, M.-J., M. Benigeri, A. Delorme, A. Vanasse (2018). Utilisation et enjeux des données clinico-administratives dans le domaine de la santé mentale et de la dépendance, Revue Santé mentale au Quebec, 43(2): 21-38.
Drapeau, A., M.-J. Fleury, L. Gentil* (2018). Sociodemographic variation in increasing needs for mental health services among Canadian adults from 2002 to 2012. Psychiatric Quarterly, 1-14.
Simo B.*, J.-M. Bamvita, J. Caron, M.-J. Fleury (2018). Predictors of service use among individuals with high psychological distress and mental disorders. Psychiatry Research, 269: 579-584.
Fleury, M.-J., G. Grenier, C. Vallée, L. Ferland, F. Chiocchio, J.-M. Bamvita (2018). Évaluation du Plan d’action en santé mentale (2005-2015): Intégration et performance des réseaux de services. Revue Santé Mentale au Quebec, XLIII(1): 15-38.
Fortin, M.*, C. Zhirong, M.-J. Fleury (2018). A typology of satisfaction with mental health services based on Andersen’s Behavioral Model (2018). Social Psychiatry and Psychiatric Epidemiology, 53(6): 587-595.
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2018). Associated and mediating variables related to quality of life among service users with mental disorders. Quality of Life Research, 27(2): 491-502.
Fleury, M.-J., J.-M. Bamvita, G. Grenier (2018). Comparing perceived adequacy of help received among different classes of individuals with severe mental disorders at five-year follow-up: A longitudinal cluster analysis. Community Mental Health Journal, 54(5): 540-554.
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2017). A comparative study of job satisfaction among nurses, psychologists/psychotherapists and social workers working in Quebec mental health teams. BMC Nursing, 16(62): 1-12.
Fleury, M.-J., G. Grenier, J.-M. Bamvita, F. Chiocchio (2017). Variables associated with work performance in multidisciplinary mental health teams. Sage Open Medicine, (5): 1-12.
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2016). Severity of needs among individuals with severe mental disorders: Changes after a five-year follow-up. Journal of Nervous and Mental Diseases, 204(2): 132-141.
Fleury, M.-J., G. Grenier, C. Vallée, D. Aubé, L. Farand, J.-M. Bamvita, G. Cyr (2016). Implementation of the Quebec mental health reform (2005-2015). BMC Health Services Research, 16(1): 586.
Fleury, M.-J., J.-M. Bamvita, G. Grenier, N. Schmitz, M. Piat, J. Tremblay (2016). Adequacy of help received by individuals with severe mental disorders after a major healthcare reform in Quebec: Predictors and changes at 5-year follow-up. Administration and Policy in Mental Health, 43(5): 799-812.
Roux, P., C. Passerieux, M.-J. Fleury (2016). Mediation analysis of needs, service performance and outcomes for patients with mental disorders, British Journal of Psychiatry, Oct 6. pii: bjp.bp.116.184010.
Fleury, M.-J., M. Perreault, G. Grenier, A. Imboua*, S. Brochu (2016). Implementing key strategies for successful network integration in the Quebec Substance-Use Disorders Program. International Journal of Integrated Care, 16(1): 7.
Fleury, M.-J., G. Grenier, J.-M. Bamvita, M. Perreault, J. Caron (2016). Variables associated with perceived unmet needs for mental health care in a Canadian epidemiological catchment area. Psychiatric Services, 67(1): 78-85.
Fleury, M.-J., A. Djouini, C. Huynh, J. Tremblay, F. Ferland, J.-M. Ménard, G. Belleville (2016). Remission from substance-use disorders: A systematic review and meta-analysis. Drug and alcohol dependence, Nov 1; 168: 293-306. .
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2015). Predictive typology of subjective quality of life among participants with severe mental disorders after a five-year follow-up: A longitudinal two-step cluster analysis. Health and Quality of Life Outcomes, 13(150).
Fleury, M.-J., G. Grenier, J.-M. Bamvita, M. Perreault, J. Caron (2015). Typology of individuals with substance dependence based on a Montreal longitudinal catchment area study. Administration and Policy in Mental Health, 42(4): 405-419.
Fleury, M.-J., G. Grenier, J.-M. Bamvita (2015). Predictors of frequent recourse to health professionals by people with severe mental disorders. Canadian Journal of Psychiatry, 60(2): 77-86.
Fleury, M.-J. & Brochu, S., Guest editors (2014). Special issue on addiction with co-occurring problems. Journal of Addiction Research Therapy, S10 (e001).
Fleury, M.-J., G. Grenier, J.-M. Bamvita, M. Perreault, J. Caron (2014). Predictors of alcohol and drug dependence. Canadian Journal of Psychiatry, 59(4): 203-212.
Fleury, M.-J., G. Grenier, C. Vallée (2014). Evaluation of the implementation of the Montreal At Home/Chez Soi project. BMC Health Services Research, 14:557.
Grenier, G.*, M.-J. Fleury (2014). Rôle du communautaire en santé mentale dans un système en évolution: État des connaissances et recommandations. Revue Santé Mentale au Quebec, 39(1): 119-136.
Fleury, M.J. in collaboration with A. Delorme (guest editors). (2014). Politiques de santé mentale. (special issue) Revue Santé Mentale au Quebec, 39(1).
Tremblay, J., J.-M. Bamvita, G. Grenier, M.-J. Fleury (2014). Utility of the Montreal assessment of need questionnaire for community mental health planning. Journal of Nervous and Mental Diseases, 202(9): 677-687.
Fleury, M.-J. (2014). La réforme des soins primaires de santé mentale au Québec et le rôle et les stratégies de coordination des omnipraticiens. Revue Santé Mentale au Québec, 39(1): 25-45.
Fleury, M.-J., L. Farand, D. Aubé, A. Imboua (2012). Management of mental health problems by general practitioners in Quebec/La prise en charge des troubles de santé mentale chez les omnipraticiens du Québec. Canadian Family Physician, 58 (12): e732-738, e725-731.
Fleury, M.-J., Bamvita, J.-M., Farand, L., Aubé, D., Fournier, L. & Lesage, A. (2012). GP group profiles and involvement in mental health care. Journal of Evaluation in Clinical Practice, 18(2): 396-403.
Fleury, M.-J., & Grenier, G. (2012). Primary mental healthcare and integrated services. In L. L’Abate (Ed.), Mental illnesses. Evaluation, treatments and implications (pp. 357-390). Rijeka, Croatia: InTech.
Fleury, M.-J., G. Grenier (2012). État de situation sur la santé mentale au Quebec et réponse du système de santé et des services sociaux. Vol. 2, Rapport d’appréciation de la performance du système de santé et des services sociaux 2012. Quebec, Gouvernement du Quebec, 232 pages.
Fleury, M.-J. (guest editor) (2009). Les soins primaires en santé mentale. Revue santé Mentale au Quebec, 34(1).
Fleury, M.-J., M. Tremblay, H. Nguyen, L. Bordeleau (2007). Le système sociosanitaire au Quebec. Régulation, gouvernance et participation. Montreal: Gaëtan Morin Publisher, 513 p.
Disciplines
- Preventive Medicine
- Public Health
Areas of expertise
- Alcohol abuse
- Health care accessibility
- Social action
- Psychosocial adaptation
- Health services administration
- Public Administration
- Health systems analysis
- Databases
- Organizational change
- Interprofessional collaboration
- Alcohol consomption
- Organizational culture
- Medical decision making
- Depression
- Health determinants
- Social determinants
- Social Determinants of Health
- Psychological disstress
- Surveys
- Epidemiology
- Social epidemiology
- Case studies
- Longitudinal studies
- Healthcare/Healthcare quality evaluation
- Program evaluation
- Health services evaluation
- Health care/Healthcare services management
- Qualitative methods
- Quantitative methods
- Mixed methods
- Organization of primary care services
- Health care/Healtcare services organization
- Healthcare/Health care organization
- Patient
- Performance of health care/Healthcare delivery services
- Performance of health care/Healthcare delivery system
- Organizational performance
- Public policies
- Social policies
- Clinical practice
- Social problems
- Psychiatry
- Quality of health care
- Health care/Healthcare reform
- Interprofessional relationships
- Integrated services networks
- Mental health
- Public health
- Health Services
- Primary health care/Healthcare
- Emergency services
- Sex and gender
- Healthcare/Health care systems
- Organizational theory
- Drug Abuse