title: [What's a framework without its frame?].
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ministère de la Santé et des Services sociaux.
authors.forename: André
authors.initials: A
authors.lastname: Delorme
authors.affiliation: Centre national d'excellence en santé mentale, ministère de la Santé et des Services sociaux.
authors.forename: Michel
authors.initials: M
authors.lastname: Gilbert
mesh_terms: D002568:Certification; D006077:Government Agencies; D018166:Health Care Reform / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D011792:Quebec