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

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.

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PUBLICATONS SÉLECTIONNÉES: https://douglas.research.mcgill.ca/marie-josee-fleury

Fleury, M.-J., Z. Cao, G. Grenier (2024). Emergency department use among patients with mental health problems: Profiles, correlates and outcomes, International Journal of Environmental Research and Public Health, 21(864): 1-18.

Fleury, M.-J., Z. Cao, G. Grenier, E. Rahme (2024). Profiles of quality of outpatient care among individuals with mental disorders based on survey and administrative data, Journal of Evaluation in Clinical Practice, 30: 1373-1385.

Armoon, B.*, G. Grenier, M.-J. Fleury (2024). Perceived higher unmet needs for care among residents in permanent supportive housing, Administration and Policy in Mental Health and Mental Health Services Research, May 31, 1-14, https://doi.org/10.1007/s10488-024-01390-2.

Fleury, M.-J., A. Imboua, G. Grenier (2024). Barriers and facilitators to high emergency department use among patients with mental disorders. A qualitative investigation, Community Mental Health Journal, 60(5), 869-884.

Fleury, M.-J., L. Rochette, L. Gentil*, G. Grenier, A. Lesage (2024). Predictors of physician follow-up care among patients affected by an incident mental disorder episode in Quebec, Canadian Journal of Psychiatry, 69(2):100-115.

Fleury, M.-J, Z. Cao, G. Grenier (2024). Characteristics for low, high and very high emergency department use for mental health diagnoses from health records and structured interviews, Western Journal of Emergency Medicine, 25(2):144-154.

Fleury, M.-J., F. Ferland, L. Farand, G. Grenier, A. Imboua, F. Gaida* (2024). Reasons Explaining High Emergency Department use in Patients with Mental Illnesses: Different Staff Perspectives, International Journal of Mental Health Nursing, 0: 1-13.

Armoon, B.,* N. L’Espérance, M.-J. Fleury (2024). Variables associated with quality of life among individuals living in permanent supportive housing, Community Mental Health Journal, 60(2): 259-271.

Armoon, B.*, M.-J. Fleury (2024). Variables associated with higher community integration among residents of permanent supportive housing, Journal of Social Distress and Homelessness, 1-12.

Fleury, M.-J. (2023). Notions et brève évaluation de la qualité des services en santé mentale au Québec (Éditorial), Santé mentale au Québec. Numéro spécial sur la Qualité des services en santé mentale, XLVIII(2), 13-27.

Fleury, M.-J., Z. Cao, G. Grenier, C, Huỳnh (2023). Profiles of quality of outpatient care received, associated sociodemographic and clinical characteristics, and adverse outcomes among patients with substance-related disorders, Substance Abuse Treatment, Prevention, and Policy, 18(5): 1-13.

Gabet, M*., B. Armoon,* X., Meng, M.-J. Fleury (2023). Effectiveness of interventions to reduce service use for frequent emergency department users with mental health issues: A systematic review, American Journal of Emergency Medicine, 74: 1-8.

Fleury, M.-J., 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, Administration and Policy in Mental Health, 49:(6):1047-1059.

Fleury, M.-J., Z. Cao, B. Armoon*, G. Grenier, A. Lesage (2022). Profiles of patients using emergency departments and hospitalized for suicidalbehaviors. Suicide and Life-Threatening Behavior, 52(5): 943-962.

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.

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). Determinants of suicidal ideation and suicide attempt among currently and recently homeless individuals, Social Psychiatry and Psychiatry and Epidemiology.

Gentil, L.*, G. Grenier, M.-J. Fleury (2021). Factors Related to 30-day Readmission following Hospitalization for any medical reason among Patients with Mental Disorders. Canadian Journal of Psychiatry, 66(1): 43-55.

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, 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., 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.

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., 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.

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.

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., 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. 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., 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.