Health chiefs in Tayside have stated having two centres of excellence is the only safe way forward for inpatient mental health services.
The decision was taken at a meeting of Perth and Kinross Integration Joint Board following months of consultation, campaigning and protest.
It will see general adult psychiatry acute admissions centralised at the Carseview Centre at Dundee’s Ninewells Hospital.
Learning disability inpatient services will be provided at Murray Royal Hospital in Perth alongside other specialist services, including rehabilitation and substance misuse.
The decision will see services relocated from the outdated Strathmartine Hospital and the Mulberry unit at Stracathro Hospital in Angus.
The board voted five to one (an abstention) in favour of the preferred option.
Clinicians believe the steps will secure the future of inpatient services, improve the quality of service and environment available to patients and make services more attractive to potential staff.
Individual health and social care partnerships in Angus, Dundee and Perth and Kinross will be working to enhance mental and health and learning disability services in local communities, where 94% of mental health care is delivered.
More than 100,000 people took part in an often-criticised consultation process and more than 57% of those who responded said they were against the proposals.
NHS Tayside’s medical director Andy Russell, however, said the present model of care could not continue, with the redesign proposed “the only safe option”.