The state of the psychiatric reform in Italy since 1978 is now examined. The reform has faced many difficulties due to the economic crisis, political instability and inadequate implementation of regional facilities stipulated by law. However, it has had some positive effects and has awakened public opinion to the problem of the mentally ill. The study area chosen is the Veneto region of Italy. It is a widespread belief that with some modifications, particularly regarding the problem of long-term patients, the psychiatric reform can be carried out with success. The principles which have inspired it are worthy but its application is not easy as we are dealing more with a cultural reform than with a new organization of services; this will require more time.