[Hope and deficiency: community mental health and severe mental disorders]

Over the second half of the twentieth century, the way in which Canadian society treats people with mental challenges has changed radically, from exclusion and containment in asylums to reintegration and maintenance in the community. Now that deinstitutionalization is practically complete, the objective has increasingly shifted from reintegrating people with severe mental challenges in their communities to upholding their rights and ensuring that they have access to resources allowing them to assume their responsibilities and roles as citizens. This change of vision results in a completely different set of issues for community mental health. Given the prejudices surrounding mental illness, the capacity of community mental health professionals to play a mediating and facilitating role becomes a determining factor in successfully reestablishing and re-empowering people with severe mental challenges. The advances that have clearly been made give cause for hope, but in the context of the unwanted effects of deinstitutionalization and unfavourable socioeconomic conditions, significant obstacles still need to be overcome before people with severe mental challenges can participate fully in the life of the collectivity.