The intervention carried out at the Leros PIKPA asylum with the assistance of European Community funds has proved beyond all doubt that financial resources, essential as they may be, are not in themselves sufficient to ensure the success of an effort to reform a custodial care structure. It might seem a unique opportunity for a country to receive financial support to improve its public mental health care system, especially during a period of economic recession, and one might have expected that, if the financial resources were sufficient, reform would be relatively easy. However, our experience has shown that this is not the case and that much time and effort are needed. Emphasis needs also to be placed on a number of factors that we have found to be of decisive importance.