[Fifteen years of commitment to improving mental health practices: 3 initiatives supported by participatory research]

Continuous improvement of practices is a constant challenge for healthcare organizations, managers, and decision-makers. Despite knowledge of evidence-based data and recommended health practices, integrating best practices into care and services remains difficult and requires tailored support approaches. Over the past 30 years, several initiatives have been implemented to support the continuous improvement of practices in the field of mental health in Quebec. Within these continuous improvement processes, close collaboration with stakeholders at all stages of the process, under collaborative leadership, has been an essential component. Objectives The aim of this article is to present 3 initiatives supporting the continuous improvement of practices in the field of mental health in Quebec, which involved a participatory research approach as well as a close partnership of more than 15 years between researchers and managers. Method The article draws on 3 different initiatives supporting continuous improvement of practices in the mental health field, as described by the researchers involved. It takes an auto-ethnographic approach and cross-reflection with the aim of identifying points of convergence and findings from experience. The 3 initiatives are as follows: (1) the À portée de main program, supporting the implementation of practices that foster personal recovery; (2) the cross-training program, supporting exchanges and transformation of practices in concurrent disorders; (3) the COMPAS+ program, supporting quality improvement in primary care services. These initiatives involved different stakeholders. Results Several points of convergence were identified regarding the challenges and facilitators of such approaches. They highlight the importance of spaces for exchange and co-creation to enable a redefinition of ways of doing things, as well as what is referred to as "transformative learning." They also illustrate the importance of participatory evaluative research in fostering reflective practice that leads to action and practice change. Conclusion This article provides an opportunity to engage in critical reflection on the complexity of continuous improvement initiatives in our healthcare systems. Despite structural reforms to Quebec's healthcare system, managers and other stakeholders must be able to rely on the expertise of researchers and their ability to inject agility into systems that, unfortunately, are not very flexible. Close collaboration between managers and researchers deserves to be protected and better valued.