Uncertainty of psychiatric institutions in Colombia has scientific, economic, market and regulatory aspects that hinder the provision of decisions for adequate, efficient and effective care, facing the changing conditions of the provision of health services. The research explores how psychiatric institution will be in 2025. Materials and Methods: Delphi methodology, quantitative and qualitative analysis. Findings: There is great uncertainty about how to adapt the psychiatric institution in the future; according with changes in legislation and sociopolitical expectations at time of study. Education of professional team, improved infrastructure and increased services, including ambulatory ones, total and partial hospitalization, specific clinical and community care is expected. The ideal institution looks like a comprehensive set of services developed on the basis of the current provision, assuming acute and chronic patients. The scope of the psychiatric clinic is expected to continue assuming the lack of development of primary care and community facilities.