In a developed country as ours, 30 % of the nursing care has to do with a psychological approach. The problem therefore concerns the whole of the medical system and is a problem linked to a global approach, overstepping the psyche/soma dichotomy. An important part of the health expenses in France (13 %) is assigned to the three components of medical discipline split into public activities, liberal and associative, with no real interconnections. Psychiatry appears balanced and strong as to its capacities of response (stabilisation of psychoses, curative capacities for many clinical cases) but suffers a number of "handicaps", particularly, but not solely in what concerns its public component. If, indeed, priority and orientations have been constantly defined, they appear insufficiently relayed and attended to. It is important in duration and in order to remain loyal to it, to give further thought to sector politics, in preserving the conceptual assets (permanence of care, open care network) developing its limits (rigidness of equipments, lack of respect of the logics of the flow) and to promote trans or intersectorial steps in the field of organization (emergency and liaison) or the approach to certain claims or pathologies. Such re-definition must concern the field competence and complementarities of general medicine, of private specialists, sectorised, intersectorised or non sectorised publics; the indications of full time hospitalisation and other means of taking charge ; the sanitary articulation : social and medicosocial (separating what is relevant to care, assistance and sheltering). Expected, better and better understood levers relate to managing as well as initial and continuous training of professionals, with the aim of attending the change of structures, including evaluation, communication and research. In our country, no technical reason does valuably oppose to the rapid implementation of a global process of development, able to meet the needs of patients but also of professionals whatever their means of practice may be.