michael mccubbin, Ph.d., est coauteur à titre posthume. il a dirigé la conception et les premières phases de réalisation de la recherche dont les résultats sont présentés ici. cette étude est la dernière d'une longue liste de travaux qui ont jalonné une carrière scientifique brillante, nationalement et internationalement saluée. le présent article est dédié à sa mémoire.les auteurs tiennent à remercier les jeunes, les parents et les intervenantes et intervenants ayant participé au projet, ainsi que les organisations qui ont soutenu leur participation. ils remercient également le conseil de la recherche en sciences humaines du canada pour son appui financier à cette étude, dont le présent article constitue l'une des retombées. la correspondance concernant cet article devrait être acheminée à Bernadette dallaire,

The Association St. Camille de Lellis, a Catholic charitable association, serves people with mental health problems in Côte d'Ivoire. The remarkable work of the association, whose innovative character was recognized by the World Health Organization in a recent report, is situated in a particular socio-political and cultural context that combines solidarity and rejection. We describe this context, then we show how the association's activities open the way to new solutions for both developing and industrialized countries. We then present some information and analysis regarding “African madness,” and go on to consider the nature of mental health policies and services in a continent where chronic shortages of financial and material resources have a major impact on African populations. We found 3 of the Association St. Camille de Lellis's practices especially promising: people taking control of their futures, the protection of people's rights, and the establishment of social enterprises. At the same time, we also retain a critical point of view regarding the Association's experience, and we examine the obstacles to replication of this experience in other sites, the therapeutic and psycho-social consequences of some of its practices, and issues regarding financing.

association caritative catholique, intervient auprès des personnes ayant des problèmes de santé mentale en Côte d'Ivoire. Le travail remarquable de cette association, dont le caractère novateur a été reconnu par l'Organisation mondiale de la santé dans un récent rapport, se situe dans un contexte sociopolitique et culturel bien spécifique où la solidarité voisine le rejet. Nous présentons ce contexte, puis nous montrons en quoi la démarche de l'association ouvre la voie à des solutions nouvelles tant pour les pays en développement que pour les pays industrialisés. Nous présentons ainsi quelques éléments d'informations et d'analyse quant à la « folie africaine », puis il est question des politiques et services sanitaires en Afrique, continent où la pénurie chronique de ressources financières et matérielles a un impact majeur sur les populations. Pour les fins de la description de l'action de l'association St. Camille, nous avons retenu 3 pratiques que nous considérons particulièrement « porteuses »: la prise en charge par les personnes elles-mêmes de leur devenir, la protection des droits de ces personnes et la mise sur pied d'entreprises sociales. Adoptant aussi un point de vue critique sur l'expérience de l'association, nous discutons les obstacles à la reproduction de l'expérience, les conséquences thérapeutiques et psychosociales de certaines pratiques, ainsi que la question du financements.

The vast majority of older Canadians live without serious mental health conditions. And, in large part, this speaks to the stability of mental well-being across the lifespan (Chappell, Gee, McDonald, & Stones, 2003). However, circumstances sometimes create conditions that give rise to particular mental health needs. Are those needs properly recognized, or recognized at all? Above all, are they adequately met? In a seminal article about psychiatry and the elderly, Butler (1975) evoked a "therapeutic nihilism"-a pessimistic attitude that was seen as pervasive in professsional mental health services provided to the elderly. More recently, the World Health Organization's European regional office, through its Task Force on Destigmatization, has denounced the stigma, discrimination, and exclusion that seniors with mental health conditions are still subjected to today (Mendonça Lima, Levav, Jacobsson, & Rutz, 2003). In this regard, some analysts point out that these phenomena are rooted in the double labelling process by which older citizens are stigmatized both because of old age and because of mental illness (Bartels, 2003; Dallaire, McCubbin, Carpentier, & Clément, in press).The papers in this special section consider variations on normal aging among people who are experiencing mental health conditions, sharply changed social circumstances, or chronic disease. In each case, attention is paid to the interactions among older patients/clients and providers, and sometimes their caregivers. Their focus is to identify and document some aspects of the social and professional responses to the specific mental health needs of the elderly.The paper by Garcia and Finlayson speaks of the service needs of persons growing older with multiple sclerosis. Taylor, Taylor-Henley, and Doan discuss the challenges faced by older immigrants to Canada and the ways in which English as a Second Language classes can be designed to facilitate addressing these challenges in addition to teaching English. The discussion of these ESL classes as a "best practice" model also points to their health promotion attributes in helping older persons develop the tools to address the issues they face. The Seniors Mental Health Policy Lens that is the focus of MacCourt and Tuokko's paper is an analytical tool designed to be used by older persons, service providers, and policymakers as they construct programs and policy. The objective of the lens is to enhance the prevention of mental health problems and promote mental health well-being in the course of program and policy design. On another level, Pérodeau, Paradis, Ducharme, Cohen, and Collin introduce the family dimension in the provision of services: They show the important role of family support in perceived psychological well-being or distress among el-5

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