ABSTRACT
Since the early 1970s the leaders of the alternative psychiatry movement had been looking increasingly to promote change at the national level. The original strategy had been to work ‘from within’, to transform individual institutions by mobilizing their own staffs and by ‘sensitizing’ the surrounding communities. This approach had proven, at least in some places, remarkably effective; but since it characteristically focused attention intensively on a given locale, it was inevitably a rather limiting strategy. The risk was to produce only isolated pockets of reform, which would be hard to extend or generalize into the larger, unreformed system. There was in fact a strong network linking the locales where alternative approaches were becoming established, from Trieste to Arezzo, Ferrara, Perugia, Parma, and so on. But that list reveals another apparent limitation of the original strategy, that it seemed to work best in smallto medium-size cities, and often where there was already a strong civic tradition. The relative lack, or failure, of initiatives in the big cities (with the partial exception of Napoli), and in the South generally, was striking.
