Several CSSS in Quebec are reflecting on the organization of mental health care and services for older clients in order to better serve this clientele. There has been an interest in implementing the organizational model of mental health services similar to the one at the CSSS Cavendish-CAU. In existence for over a decade, this model was developed with the expertise and clinical best practices in the field. Before introducing this model of innovative services elsewhere, it seemed important to analyze its evolution over time. A detailed analysis of data from several sources (e.g. working papers, individual interviews, focus groups, etc.) found that the services, as planned in 1999, have changed somewhat. This analysis highlights several positive changes such as the improvement of the continuum of care, an increase and diversification of the range of services, but likewise other philosophical changes are questionable. The Plan d’action (2005) of the MSSS has disposed of two fundamental concepts of the specialized mental health services for adults 60 years and more (SSSM60+), that of psychosocial autonomy and risk behaviours, that are the basis for an intervention which is more social than medical. Particular attention should be paid to these concepts in order to return them to the forefront in the provision of services.