The Law 180 of 1978, stipulates the closure of mental hospitals and the creation of community mental health services. However, the process of change of the Italian psychiatric institutions developed during the previous decade. The author highlights the role played by provincial authorities and psychiatrists in this process leading to, now and again, deinstitutionalization and the closure of psychiatric hospitals. This article analyses: a) the role of provincial authorities and psychiatrists in this process of change; b) the developments towards change in some local experiences during the 60s; c) the spread of diverse practices - during the decade 1968-1978 - that disrupt the traditional structure of mental hospitals. The author then examines the context created by these heterogeneous practices - present in different areas of the country - that become key elements for understanding why the Italian asylums were closed and the "Law 180" promulgated.
Keywords: Psychiatric reform, deinstitutionalization, provincial authorities, psychiatrists