The design of community-based mental health services to replace institutional patterns of service has proved a weighty responsibility for districts engaged in the task. A major challenge has confronted clinicians, planners and managers of change: to seize the not-to-be-repeated opportunity of redeeming the investment in outdated buildings; to revitalise forms of practice that have become increasingly divorced from the needs of those who use these services; and to set up valid systems of care which can stand the test of time.