Italy has experienced a significant change in its mental health sector, with a radical shift from old mental institutions to new community-based psychiatric services. The Italian experience attracted international attention and, in some instances, led to similar changes occurring abroad. Recently, economic considerations are imposing additional challenges on the health care system in general, with psychiatry facing distinct and peculiar problems due to its unique organisation and objectives. This paper aims:

(a) to provide a historical overview of the changes in mental health provision in Italy over the past century;

(b) to describe the present organisation of mental health services;

(c) to show the impact of financing on the mental health sector;

(d) to acknowledge the education and training programmes in mental health;

(e) to outline research directions and activities.