This paper discusses the evolution of PSR development for people with severe mental illness since the early 20th century in Malaysia. The various aspects of PSR include the activities, service target, the treatment settings, factors contributed to the development and the challenges that have been faced are also described along with the evolution, comparing the past and
present. It is learned that despite of many challenges, PSR in Malaysia has now continued to progress with increasing supports from the stakeholders and is in keeping with the current PSR concept.