000			02028naa a2200169uu 4500
001			6042010081521
003			OSt
005			20190211161122.0
008			060420s2006 xx ||||gr |0|| 0 eng d
100	1		_aWIKTOROWICZ, Mary E. _911351
245	1	0	_aRestructuring mental health policy in Ontario : _bDeconstructing the evolving welfare state
260			_aToronto : _bIPAC, _cFall 2005
520	3		_aOntario’s mental health sector offers an insightful case study of the welfare state restructuring in which governments have been engaged, having recently undergone turbulent reform involving the divestment, closure or amalgamation of nine psychiatric hospitals and a fifty percent reduction in psychiatric beds. While premised on a shift to community-based care, investment in the community sector has been slow to occur, increasing the risk of ‘off-loading’ vulnerable members of society to the community without appropriate supports as occurred in previous movements of de-institutionalization. To understand why community sector reforms have not kept pace with institutional downsizing, we analyse the process of health system restructuring to clarify the obstacles contributing to delay. These include successive arm’s length governance processes with varying basis of authority; an absence of political will to allocate funds to the community and devolve the coordination of care to local networks; and insufficient engagement of the policy community in policy implementation. Finally, complexity - including the cross-jurisdictional nature and coordination of services on which community care relies - remains an important challenge. Not only have such obstacles diminished the pace of reform and led to regional disparities in Ontario, they reflect common barriers to effective reform across most provinces.
773	0	8	_tCanadian Publique Administration Publique du Canada _g48, 3, p. 386-412 _dToronto : IPAC, Fall 2005 _xISSN 008-4840 _w
942			_cS
998			_a20060420 _b1008^b _cNatália
999			_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c15730 _d15730
041			_aeng