Law 180 of 1978 started a deep change in psychiatric assistance in Italy, promoting new approaches to mental disease and leading toward new patterns of intervention: from the mental hospital-based model to a territory-based one. Going back over legislative and structural evolution of psychiatric assistance in our Country, we want to highlight how this new approach is still far, for some aspects, from attaining full efficiency. The last contribution to its improvement has been given by National Sanitary Plan 2006-2008, in which several critical points of our assistance system, and the objectives to reach in order to improve it, are pointed out.