Que serait une oeuvre sans son cadre ? What’s a framework without its frame?

Résumé

Une réforme ne peut voir le jour et atteindre ses objectifs sans être soutenue de diverses façons. Au Québec, le Plan d’action en santé mentale 2005-2010 – La force des liens a introduit de nombreuses réformes de fond et de forme dans le réseau de services en santé mentale. Cet article voudra explorer quelles formes d’encadrement peuvent soutenir cette réforme et à quel point ces formes ont été exploitées ou devraient l’être. Il pourra ainsi soutenir la réflexion sur les moyens d’encadrement qu’il faudra utiliser pour soutenir le prochain plan d’action actuellement en rédaction au ministère de la Santé et des Services sociaux.

Mots-clés :

• réforme,
• plan d’action,
• santé mentale,
• encadrement,
• soutien,
• participation de l’usager

Abstract

OBJECTIVE: In 2005, the Québec Ministry of Health launched a major reform of its Mental Health services. This reform aimed both the type of services (collaborative care; community care) and the structure (shift to primary care venues) in which these services where offered. Any major reform must be supported by different means. This article will review which means are best suited to do this and up to what point these where used to support the implementation of the reform. It will also help in preparing for the upcoming launch of the next Mental Health Plan of Action by the Québec Ministry of Health.

METHOD: The authors exchanged on several occasions on their observations and thoughts on the subject.

RESULTS: Any major health reform must be supported by different means. Some are related to legislation or government policies, but these alone are insufficient. Others means include academic and continuing development actions, service accreditation or certification and user participation in policy and implementation stages of service delivery.

CONCLUSION: If some means of support are easily invested, some are neglected. An effort should be made to use all available means to support the upcoming Plan of Action. User involvement seems particularly promising.

Keywords:

• Plan of action,
• mental health,
• health reform,
• support,
• user participation