In Italy, Mental Health Departments represent the result of an important political history, that of Franco Basaglia and his colleagues who, in the 1970s, fought to close mental asylums and implement community-oriented psychiatric services (Foot 2014). Despite these premises, Italy today faces an impoverishment of community mental health and a return to custodialism in psychiatry (Fakhoury, Priebe 2007). Almost fifty years after their opening, Mental Health Departments are now subject to neoliberal policies that favour the private sector (Ghio, Peloso, Ferratini 2012), impacting on therapeutic projects and on the patients’ sense of being taken care of (Carpiniello et al. 2020; Mezzina 2023). In this context, public mental health workers try to build caring relationships within an uncertain landscape of decreasing funding and state attention to mental health (Starace 2023). Not only do they have to abide by their deontological mandate of care, but also to the changes in the organisation of the healthcare service that the Italian NHS has been recently facing (Cardano, Giarelli, Vicarelli 2020). Today, the work of care that takes place within Mental Health Departments is linked to the workers’ ability to overcome technical and economic pressures, and to gain social legitimacy (Powell, DiMaggio 1991), constantly adapting to a fastly changing environment. This paper aims at presenting the first findings of my ongoing PhD research, based on fieldwork carried out inside a Mental Health Department in Northern Italy. By bringing together anthropology of organisations (Wright 1994) and anthropology of subjectivity (Bihel, Good, Kleinman 2007), I intend to analyse the strategies that mental health workers put in place locally to resist and negotiate pressures from the institutional environment in which they work, especially when they are perceived to be irrelevant or even detrimental to their care mandate.