Italian Law 180 of 1978 is probably the most radical Mental Health Act ever passed. It forbade the admission of any new patients to mental hospitals forthwith and called for the rapid closure of such institutions. The Law crowned the work of the charismatic Italian psychiatrist Franco Basaglia and his ‘Democratic Psychiatry’ movement. The Italian reforms resulted in arguably the lowest number of psychiatric beds in any developed country, and have been widely debated and emulated. They have been adopted enthusiastically by several Mediterranean and South American countries. However, the implementation of Law 180 was patchy, with critics both internally and internationally. This book brings together historians and clinicians, including Basaglia’s colleagues and followers, for the first time. These authors report on the responses to the reforms from over 15 countries. These range from exuberant implementation in Brazil and Italy, through partial and localized initiatives in several countries, through to outright rejection in the UK and USA. These responses reflect differences in clinical and practical realities, but also professional rivalries and often profound conceptual differences. This is a transnational history of psychiatric debates, reform, and psychiatric practice. The excitement of Basaglia’s thinking and the Italian reforms is captured, as are the inconsistencies in both his thinking and practice. Basaglia and the Italian movement did not arrive from nowhere, and its global influences are also examined. Basaglia’s radical human rights agenda was expressed through psychiatric reforms. His ambivalences engaged artists and thinkers as well as clinicians, and his legacy, as this book vividly demonstrates, is far from straightforward.