The Basaglia movement in Italian psychiatry is described and analyzed in several contexts: the historical, the cultural, and the "practical" in terms of outcomes. Those who began the movement of democratic psychiatry grasped interesting elements of "critical theory": the definitions of madness, power structures, and medical discourse itself. A backward look at the sea change, however, reveals states and rates of dysfunction that disappoint and indicate that political ideology divorced from cultural awareness can often harden the opposition.