La transformation des services de santé mentale et le rôle des pros
Bibliographic record
Abstract
Le système québécois de santé mentale est actuellement confronté à une réorganisation importante de sa gestion et de l’offre de ses services. Cette restructuration peut être interprétée comme la deuxième phase d’une réforme, amorcée avec la Politique de santé mentale (1989) qui s’est traduite dans les régions sociosanitaires par les plans régionaux d’organisation de services (PROS) (1989-1997). À partir d’une étude de cas, cet article vise à décrire le processus de mise en oeuvre et les effets de cette première restructuration du système. Les conditions favorisant ou entravant l’implantation des PROS, les outils de gestion ainsi que différents facteurs contextuels, structurels et temporels sont étudiés. Enfin, les leçons à tirer de cette expérience pour la poursuite de la réforme des services de santé mentale sont discutées.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.006 | 0.009 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.001 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".