[Assessment of psychiatric and mental health services in Québec.]

One of the ways of finding out where we are going consists of asking ourselves where do we come from. Here the author uses a historical approach to give an overview of the problem of insanity in Québec. The author discusses how people view insanity, its causes and treatments and the characteristics of the organizations (actors, values, knowledge, human and financial resources) that have met its challenge. The author describes two periods: the period of bureaucratic rationalization (the Bédard and Castonguay-Nepveu reports) and the period of community responsibility. Rather than presenting anecdotes, the author concentrates on raising a number of questions that can help unravel the debate on forming a policy on mental health.