[Bernadette through the ages: An evolving perspective on psychiatric care from institutionalization to alternatives to hospitalization].

Abstract

In 1909, 21-year-old Bernadette was hospitalized after the parish priest deemed her to be suffering from "puerperal insanity." She was committed to Saint-Jean-de-Dieu, separated from her newborn and husband, who would send dozens of letters inquiring about her health and longing for the day she could return home. Sadly, that return never happened. This article explores the evolution of psychiatric and mental health practices from the past to the present - and the progress still to be made - by focusing on alternatives to hospitalization. How might Bernadette's care have been managed today? And what could her care pathway look like 50 years from now? Today, the expertise of the Institut universitaire en santé mentale de Montréal (IUSMM) extends beyond its walls, reaching people in their own environments. Bernadette could have received treatment at home, supported by a care team with her husband playing an active role. This article documents current alternatives to hospitalization and links them to the lived experience of a woman who underwent involuntary hospitalization over a century after Bernadette. By examining three distinct eras, we can see not only how far we've come but also the challenges that remain.