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Virgadaula analyses from an A&O-psychological perspective the last 35 years of reform psychiatry in Trieste; their health services and effects on nursing and management staff, affected persons and their relatives. It spans an arc from differentiated observations and descriptions of the organizational representations of the actors to the related organizational conditions and the resulting, ongoing need for change and redesign. He contrasts his historical evaluation of the continuing transfer of knowledge to all actors and various occupational profiles with representations of the reform pioneer Franco Basaglia. A dialectical connection emerges between democracy, humanization of the world of work and scientific (e.g. OE) as well as social responsibility. This opens up possibilities for work structuring in the complex field of psychiatric care, since healing and control, in an increasingly privatized and culturally global scenario, must rethink itself as a professionalized regulatorypower. It requires the permanent further development of a participative/democratic coexistence of all.