This study has for object to observe the " process of change " in the psychiatric hospital of Sainte-Gemmes-sur-Loire (49) between 1910 and 1977, from the coming of Dr. Baruk to the beginning of the sectorisation. This conceptual, therapeutic and institutional gradually changes the asylum towards another model. The transformation started in the 1920-1930 by the improvement of the nurses living conditions. After the Second World War, the patients' life was harmonized with the social life of the city. The outpatient's department, and then the neuroleptics and the voluntary ward opened breaks in the asylum framework by allowing a different way of caring. At the same time, the institutional psychotherapy in some psychiatric wards aimed at releasing speech and initiatives. At the conclusion of the strike of May-June 1968, certain number of local and national psychiatric claims was ratified. By sectorisation, a speeding up of change occurred in the hospital by breaking up into pieces a partition between pathologies and gender of the nurses and the patients. At the end of the seventies, the opening of the psychiatric hospital of Cholet, the therapeutic apartments and a psychiatric aftercare hostel, amplified the care in the patients living place and contributed to decentralizing the hospital.
