Beginning with the careful historical examination of the de-institutionalization of psychiatric hospitals in Europe, this work focuses its attention on the Italian territory and Law 180 of 1978 on psychiatric reform, which has led to the closure of mental institutions and the creation of replacement institutions such as the Mental Health Departments that are present throughout the Italian territory for every certain number of inhabitants. Mental Health Departments have the goal of caring for psychiatric patients within their context of life. Therapy is not organized anymore as a “solution-cure,” but rather as a complex entity – while also daily and elementary – of indirect and multidisciplinary strategies geared toward socially rehabilitating the patient affected by psychic disturbances. In this regard, out-patient institutional structures, semi-residential structures, and residential structures with the objecttives of being responsible for the patient during his or her psychological and pharmacological therapies, insertion in a protected work field, and in helping the patients’ families. In particular, this article will describe the out-patient activities and semi-residential activities put into action by a mental health department in an Italian city with the population of over a million people. In some cases, alternative hypotheses for intervention will be proposed in lieu of those already existent.