臺灣地區的精神醫療發展，始於日據時期。1917年，崛內次雄聘請日教授中村讓授課，開啟了臺灣醫界對精神疾病的知識領域。初期日人對精神病患採取監護措施， 直到1922年才對精神病患施以治療。1934年6月總督府發布精神病院官制，將精神病院定名為《養神院》，是年10月養神院竣工啟用，為公立精神病院的濫觴。 在此時期，臺灣的精神醫療尚處於起步階段。到了二次戰後日人陸續被遣返，精神科學的發展，才開始以臺灣本土醫師為主幹。一九八○年代以後，臺灣經濟起飛、社會急遽轉變，精神疾病的預防，逐漸被列為國家醫療政策中的重點工作，直到今日。十多年來，精神病院擴增、設備改善、推行專科醫師制度、精神衛生法的實施、精神病患給付納入保險等，對精神醫療的進步漸有正面積極性的影響。全民健保開辦後，精神病患的醫療照護明顯的改善。然而，近年來精神病患住院人數雖然遞減，住院日數反而上升，凸顯出慢性病患佔用急性病床的問題很嚴重。未來精神醫療政策應朝向廣設社區式復建、庇護場等機構，制定職能治療師法、心理治療師法、社會工作師法（發稿時社工師法己於立院通過三讀，職能治療師法草案尚在院會待審）等法規賦予專業資格認定，建立良好的轉送系統，設置厚生部結合精神醫療與社會福利，方能將有限的醫療經費發揮最大的效益。究竟在我國長期以來的整個醫療政策裡，精神醫療佔有什麼樣的角色？身為精神醫療專業工作人員，應該瞭解自己在政府規畫施政藍圖中的地位？我們怎麼要求自己？本文主要目的在於回顧臺灣精神醫療的歷史發展，檢視國家的角色為何？如何運作？我們身為精神醫療專業人員，在國家機器體制下如何自處？

　　　　　The use of mordern psychiatric techniques in Taiwan began about 80 years ago. Since 1917 a Japanese professor taught psychiatry at the Medical School of Taiwan University. Until 1945, the Japanese government retreated from Taiwan, there were only nine mental hospitals (including one publie) offering less than four hundred beds to care for psychiatric patients. After World War II, the Chinese government took over Taiwan, but mental health care remained underdeveloped for the next forty years. Before 1985, psychiatric care made up less than 1% of the national health care budget and most psychiatric patients stayed in chronic hospitals. During the last 10 years, medical care of psychiatric patients has gradually received more attention from the government. After the 'Mental Health Act' was enacted in 1990, and the national health insurance program was began in 1995, medical expenditure for psychiatric patients increased considerably. Now, about 7 to 8 billion dollars per year is spent for psychiatric care in Taiwan, about 2.5% of the total medical budget for all patients. There are about 500 psychiatrists and thirteen thousand beds for psychiatric patients. Nevertheless, manpower and money are still not sufficient, and governmental support is still very limited, It may be very difficult to improve the situation. In my opinion, the solution must come from psychiatric professionals. We need to try to transfer chronic inpatients from mental hospitals into community care facilities such as dya-care centers, sheltered workshops, and half-way houses. Instead of building more mental hospitals and caring for chronic inpatients, we could use that money to care for acute inpatients and outpatients. In addition, we need more psychologists, social workers, occupational therapists, and nurses to help psychiatric patients in the community. These psychiatric professionals should have legal certification in the near future. Real comprehensive care for psychiatric patients by the joint effort of the psychiatric team, may be the best choice for the future development of psychiatry in Taiwan.