The reform of the penitentiary system (law 103/2017) which is about to enter into force in Italy represents a Copernican revolution for the management of psychiatric patients who are also authors of a crime. The change would have consequences similar to what happened with the law 180 of 1978. The basic principles on which the new Law is based are: 1) the extension of the faculty to suspend the sentence also for inmates and prisoners affected by a serious mental illness; 2) the full integration of the National Health System (SSN) and DSM in the penitentiary institutions; 3) the establishment of "sections for prisoners with disabilities", special sections for exclusive management for individuals with mental disorders, to be implemented inside the prisons and jails; 4) the possibility probation and parole for prisoners with sentences up to 6 years if suffering from mental illness with a procedure similar to the one already enacted for persons with drug dependency. The article deals with the positive aspects of the reform, but also with the critical aspects it presents in its implementation aspects: training of prison police officers and health workers; substantial and decisive employment of psychiatry in penal institutions; control functions by the DSM on patients; lack of staff and funds. The final aim of the reform is to contain recidivism, and the system must be organized on this goal.