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40,000 psychiatric patients starved to death in France during the Nazi Occupation. Were they deliberately starved by the Vichy government because they were considered "useless mouths"? Did they die because hospital directors paid no attention to the equitable distribution of what were already substandard rations? To whom or to what can these deaths be attributed? Although the Vichy government enacted no deliberate plan to eliminate the mentally ill, lack of interest in the country's weakest members during a time of crisis led to tragic consequences.

The change of centuries, and especially the start of a new millennium, naturally encourages us to make assessments, to appraise the movement of ideas and the concrete achievements of the period that is ending, and to take a preliminary view of the evolutions that have marked its course. For example, in the area of assistance to mental patients, there is an extraordinary contrast between the approach taken in the first and the second half of the past century. Indeed, the contrast between the two periods is so remarkable that it provides us with an introduction.