[Death of an illusion?]

What is the future of community psychiatry in Quebec, more precisely in the Montreal area? Initially aimed at globally reorganizing psychiatric services, community psychiatry intended to take care of psychotic patients outside psychiatric hospitals, and in a different way. After an initial period of positive influence on psychiatric services in Quebec, the early objectives seem to be deteriorating. At the beginning, the geographical division of the territory in catchment areas was but one of the many characteristics of community psychiatry : with years the part has become more important than the whole and is consuming an increasing amount of energy among clinicians as well as administrators in the fiels of psychiatry. Professionalism (professions claiming more autonomy) has become a threat to team work, another characteristic of community psychiatry. As one could have expected, theses changes have brought, it seems, some modifications in the quality of care, as witnessed by the many psychiatric patients waiting for many days on streatchers in emergency wards and by the lenghtening of waiting lists in out-patient clinics.