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Sciences de la santé; Sciences médicales

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

marie-josee.fleury@umontreal.ca

Autre numéro : 514 761-6131 #4344 (Travail 1)
Autre courriel : flemar@douglas.mcgill.ca (Travail)

Portrait

Expertise de recherche

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

Biographie

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 260 publications et tout autant de présentations scientifiques.

Affiliations et responsabilités

Affiliations de recherche

Unités de recherche

Membre

  • 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

Enseignement et encadrement Ce professeur recrute

Recrutement en recherche Ce professeur recrute

Oui.

Encadrement

Postdoctorants

Oui.

Thèses et mémoires dirigés

Oui.

Travaux dirigés

Oui.

Stages et autres supervisions

Oui.

Participation à des jurys

Oui.

Projets

Projets de recherche

2019 - 2021

Déterminants des troubles mentaux (TM) et de l’utilisation des services, et profils (dont qualité des services) des jeunes usagers ayant des troubles liés à l’utilisation (TLU) du cannabis ou à risque de l’être, avec ou sans troubles concomitants

Chercheur principal : Marie-Josée Fleury
2019 - 2021

Impact de différents modèles de logements permanents avec soutien sur l’intégration sociale et la qualité de vie des personnes en situation d’itinérance

Chercheur principal : Marie-Josée Fleury
2019 - 2021

Exploitation de SIC-SRD et RAMQ – Quebec database on Addiction and co-morbidity (2008-2016)

Chercheur principal : Marie-Josée Fleury
2018 - 2020

Études d’innovations et des grands utilisateurs des services et patients en crise suicidaire à l’urgence visant à optimiser l’adéquation des services aux patients ayant des troubles mentaux

2017 - 2020

Les soins partagés: Rôle et impact des psychiatres-répondants sur l’amélioration des soins de santé mentale

Chercheur principal : Marie-Josée Fleury

Rayonnement

Publications et communications

Publications

PUBLICATONS SÉLECTIONNÉES:

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.

Durand, F., M.J. Fleury(2021). A multilevel study of patient-centered care perceptions in mental health teams, BMC Health Services Research, 21 (44): 1-8. 

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.

Gabet, M.*, G. Grenier, Perrottet D, M.-J. Fleury (2020). Le soutien postlogement transitoire auprès des femmes en situation d’itinérance : besoins, implantation et impact d’une étude pilote. Revue Santé mentale au Quebec, XLV(1): 79-103.

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.

Kaltsidis, G.*, G. Grenier, Z. Cao, K. Bertrand, M.-J. Fleury (2020). 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, 00, 1-13.

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.

Ndibu Muntu Keba Kebe N.*, J.-M. Bamvita, F. Chiocchio, M.-J. Fleury (2019). Profiling Mental Health Professionals in relation to perceived interprofessional collaboration. Sage Open Medicine, 7: 1-10.

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., G. Grenier, C. Vallée, L. Farand, F. Chiocchio, J.-M. Bamvita (2019). Impact des facteurs structurels et des processus de travail des équipes sur les personnes utilisatrices de tois réseaux locaux de service en santé mentale dans un contexte de réforme. Canadian Journal of CMH, 38(3): 115-133.

Gabet, M.,* G. Grenier, Z. Cao, M.-J. Fleury (2019). Predictors of emergency departments use among individuals with current or previous experience of homelessness. IJERPH, 16 (24):4965. 

Fleury, M.-J., L. Rochette, M. Fortin, A. Lesage, H.-M. Vasiliadis, C. Huynh, E. Pelletier (2019). Surveillance de l’utilisation des urgences au Quebec 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.

Markon, M.-P.*, J.-M. Bamvita, F. Chiocchio, M.-J. Fleury (2017). Profiles of mental health care professionals based on work role performance. Psychiatric Quarterly, 88: 827-838.

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, C. Vallée, D. Aubé, L. Ferland (2017). Implementation of integrated service networks under the Quebec Mental Health Reform: Facilitators and barriers associated with different territorial profiles. International Journal of Integrated Care, 17(1): 3, pp. 1-19.

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., G. Grenier, D. Robitaille (2016). Implementation of the consultation-liaison model in Quebec and its impact on primary care providers. Mental Health in Family Medicine, 12: 228-240. 

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, J. Caron (2015). Profiles associated respectively with substance dependence only, mental disorders only and co-occurring disorders. Psychiatric Quarterly, 86(3): 355-371.

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 Quebec et le rôle et les stratégies de coordination des omnipraticiens. Revue Santé Mentale au Quebec, 39(1): 25-45.

Fleury, M.-J., G. Grenier, C. Vallée, R. Hurtubise, P.-A. Levesque* (2014). The role of advocacy coalitions in a project implementation process: The example of the planning phase of the At Home/Chez Soi project dealing with homelessness in Montreal. Evaluation and Program Planning, 45: 42-49.

Ngamini Ngui, A.*, M.-J. Fleury, J. Moisan, J.-P. Grégoire, A. Lesage, A. Vanasse (2014). High users of emergency departments in Quebec among patients with both schizophrenia and a substance use disorder. Psychiatr Serv., Nov 1; 65(11): 1389-91.

Ngamini Ngui, A.*, P. Apparicio, M.-J. Fleury, A. Lesage, J.-P. Grégoire, J. Moisan, A. Vanasse (2014). Disentangling the influence of neighborhood and individual characteristics on early residential mobility among newly diagnosed patients with schizophrenia: A multilevel analysis. Social Psychiatry and Psychiatric Epidemiology, 49(10):1569-1578.

Fleury, M.-J., G. Grenier, J.-M. Bamvita, J. Tremblay, J. Caron, N. Schmitz (2013). Predictors of quality of life in a longitudinal study of users with severe mental disorders. Health and Quality of Life Outcomes, 11(1):92.

Grenier, G.*, M.-J. Fleury, A. Imboua*, A. Ngamini Ngui* (2013). Portrait et dynamique des organismes desservant les personnes en situation d’itinérance ou à risque d’itinérance dans la région de Montreal. Revue santé mentale au Quebec, 38(1): 119-141.

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.

Communications

Plus de 260 présentations au Québec, au Canada et à l'international

Disciplines

  • Médecine préventive
  • Santé publique

Champ d’expertise

  • Abus d'alcool
  • Accessibilité/Accès aux soins
  • Action sociale
  • Adaptation psychosociale
  • Administration des services de santé
  • Administration publique
  • Analyse des systèmes de santé
  • Banques de données
  • Changement organisationnel
  • Collaboration interprofessionnelle
  • Consommation d'alcool
  • Culture organisationnelle
  • Décision médicale
  • Dépression
  • Déterminants de santé
  • Déterminants sociaux
  • Déterminants sociaux de la santé
  • Détresse psychologique
  • Enquêtes
  • Épidémiologie
  • Épidémiologie sociale
  • Études de cas
  • Études longitudinales
  • Évaluation de la qualité des soins
  • Évaluation de programme
  • Évaluation des services de santé
  • Gestion des services de santé
  • Méthodes qualitatives
  • Méthodes quantitatives
  • Méthodologies mixtes
  • Organisation des services de première ligne
  • Organisation des services de santé
  • Organisation des soins
  • Patient
  • Performance des services de santé
  • Performance des systèmes de santé
  • Performance organisationnelle
  • Politiques publiques
  • Politiques sociales
  • Pratique clinique
  • Problèmes sociaux
  • Psychiatrie
  • Qualité des soins
  • Réforme des services de santé
  • Relations interprofessionnelles
  • Réseaux intégrés de services
  • Santé mentale
  • Santé publique
  • Services de santé
  • Services de santé primaires
  • Services d'urgence
  • Sexe et genre
  • Système de santé
  • Théorie des organisations
  • Toxicomanie