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ABSTRACTThe new plan of care destined to adults at the Pavillon Albert-Prévost is described in this article and then compared to the one existing before September 1994. This reorganization aimed at finding solutions to problems existing in the old program. The different steps of the reorganization are exposed as well as certain results. After five years, the reform continues, taking into account data provided by a research group from the Université de Montéal (GRIS) (Farand et al., 1999).

SUMMARY"Children constitute the least organized population and the most exploited one, in the face of a society which is incapable of viewing the phenomenon of human sexuality in a realistic fashion" (Swift, 1983). If it was trying for a child to live through an incestuous situation, it is equally trying to speak of it. The focus of this article will be these children, now grown up. All have borne the weight of their secret for a long time. We have tried to find a method to permit them to unload it, or at least to share it.

SUMMARYPrevention in community mental health elaborates upon the necessary and sufficient causes of specific mental health centers in the community. The political-administration of research funds is an undesirable reality which becomes necessary if it is to obtain the resources in the community. The article clearly establishes the Catch. 22 logic of dollar-wise administrators who needs to forsee the cost-benefits that will accrue to the community from the work on prevention of mental illness. The fallacy of course, is that the prevention of mental illness or suicide has financial consequences and that there are of a nature to be assessed. Rather, the extent such benefits appear is dependent upon the choice of data one interprets and the instruments one uses to such ends. The experimental rigors seem inappropriate vis-à-vis the number of variables to be studied and manipulated. The ethical and moral considerations of experimentation, when someone's mental health is at stake, seems to outweigh the experimental paradigms.

Background: In Canada and several other countries, large cohorts of patients who used to be followed in psychiatric clinics are now steered toward primary care. To support this new reality, measures have been taken and investments made in service organization, collaborative work arrangements, and teaching geared toward primary care clinicians. However, these initiatives were implemented when little was known about GPs' needs.Methods: Using a qualitative approach, we analyzed the content of GPs' statements to explore when, why, and for what concerns GPs are inclined to collaborate with or seek advice from psychiatrists.Results: The results provide an innovative understanding of their practice and its boundaries and suggest that the management of patients with mental health problems in primary care is actually very different from what is done in psychiatry.Conclusion: Uncertainty about the broad spectrum of what is normal, the longitudinal aspect of the relationship, and the proximity of the soma are among the specificities we found that could be helpful in organizing care and educating primary care clinicians and medical students more coherently and efficiently.

Keywords: médecine familiale, omnipraticiens, santé mentale, psychiatrie, recherche qualitative, mental health, primary care, general practitionners, psychiatry, qualitative research

By using the encounter between the Little Prince and the fox (Saint-Exupéry), and after having defined caregiving, this article sets out to identify some aspects of caregiving and coporeal intimacy related to the work of caregiving. It highlights the importance of non-verbal observation of the one being cared for, the necessity of active listening and mutual respect as concerns the inherent practices in the fragile daily life of caregiving.

Keywords: accompagnement, respect, écoute active, caregiving, respect, active listening

By using a quotation from the work of Jacques Ferron as a starting point, the author attempts to locate the role and place of margin and marginality in complex dynamic reports with centrality. Affirming one's singularity and one's position with respect to everything, the self and to nothing, are three formidable human challenges that require a position of marginality, be it inner or outer. The author does not necessarily overlook the quite cruel and harmful aspects of an imposed social marginality maintained by a social, political and economic system generated by exclusion, if not rejection.

Keywords: marge intérieure, centralité, exclusion mortifère, marginalization, mortifying exclusion

Starting from our experience with breast cancer patients, we will tackle the problem of the consequences due to the notion of genetic predisposition of certain pathologies with a legal prognosis. During clinical interviews with women having undergone a mammectomy, genetic risk is discussed. How do they deal with this medical fact? Does the mother who has borne life see herself with cancer as the carrier of death? Is the diagnosis of this disease an obstacle to building up mother-daughter relationships? How can psychotherapy enable us to rethink a fairy of darkness as a good-enough mother? All these questions are expanded on in this article based on a case report.

Keywords: psycho-oncologie, mammectomie, génétique, transmission du féminin, psycho-oncology, mammectomy, genetics, passing on the feminine

This article, which introduces the second thematic issue of the journal Service social on family diversity, looks at support and assistance for families in situations of adversity. In a context where family solidarity has progressively given way to public solidarity, we are witnessing the State taking charge of vulnerable families, which is characterized by tensions between support and social control. Intervention with families, both social and judicial, is based on a neo-liberal reading of family problems, placing the responsibility for individual difficulties on the shoulders of parents or relatives, rather than on structural causes. The voice of the social actors directly concerned allows us to better understand their experience of the power dynamics that operate with the aid systems, as well as their needs in terms of support and services.

Keywords: famille, diversité familiale, soutien aux familles, contrôle social, multidisciplinarité, intervention sociale, intervention judiciaire, family, family diversity, family support, social control, multidisciplinarity, social intervention, judiciary intervention

The transmission of Freudian psychoanalysis has suffered from its institutionalisation and the totems and taboos which accompanied it. Like music, psychoanalysis is transmitted and interpreted by the same action, which feeds the guilt involved in betraying it. At the same time the interpretation opens a small saving apocalypse (Baricco) in face of the totemic traps. The institutional evolution has contributed to impoverishing the dialogue between psychoanalysis and today's culture, while this culture has moved away from any interest in the inner world through what we, following Winnicott, call a manic defence of everyday life. The psychoanalytical institution is giving signs of new vitality and the more economically affordable centres of consultation are evidence of this movement.

Keywords: institution, interprétation, défense maniaque, totem, tabou, institution, interpretation, manic defence, totem, taboo

Keywords: Fantômes