This article explains how a marginal method for the provision of health care became public policy in Soviet Russia and shows the role of psychiatrists within the Soviet transformative project. In Russia, as in the West, asylums were chosen as the nucleus around which to develop psychiatry. On the eve of the First World War, few psychiatrists were demanding that the network of hospitals be completed by more socially-integrated institutions whose aim would be not only to provide care in the community but also to develop prevention