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Our topic today is the history of the medical-social sector in mental health and its institutional realities, not from the point of view of a historian, but from that of the managing director of Œuvre Falret, an association created in 1841, at the time when psychiatry was being institutionalized (1838). The history that the medical-social sector, working for those with mental disorders, shares with psychiatry—two disciplines that are sometimes connected and sometimes separate—encourages us to describe the past and present issues from our own point of view.To trace this shared history, we begin by recalling the development of the medical-social sector and psychiatry, including the recognition of mental disorders as disabilities in 2005. We then focus on the last fifteen years, during which medical-social mental health provision has increased substantially.