The Belgian town Geel has been known as a refuge for the mentally ill for over 700 years. Mike Jay describes how the town’s “family care” treatment tradition developed:
Among the people of Geel, the term ‘mentally ill’ is never heard: even words such as ‘psychiatric’ and ‘patient’ are carefully hedged with finger-waggling and scare quotes. The family care system, as it’s known, is resolutely non-medical. … [T]he most common collective term is simply ‘boarders’, which defines them at the most pragmatic level by their social, not mental, condition. These are people who, whatever their diagnosis, have come here because they’re unable to cope on their own, and because they have no family or friends who can look after them. …
During the Renaissance, Geel became famous as a place of sanctuary for the mad, who arrived and stayed for reasons both spiritual and opportunistic. Some pilgrims came in hope of a cure. In other cases, it seems that families from local villages took the chance to abandon troublesome relatives whom they couldn’t afford to keep. The people of Geel absorbed them all as an act of charity and Christian piety, but also put them to work as free labour on their farms.
Today, the system continues along much the same lines. A boarder is treated as a member of the family:
involved in everything, and particularly encouraged to form a strong bond with the children, a relationship that is seen as beneficial to both parties. The boarder’s conduct is expected to meet the same basic standards as everybody else’s, though it’s also understood that he or she might not have the same coping resources as others. Odd behaviour is ignored where possible, and when necessary dealt with discreetly. Those who meet these standards are ‘good’; others can be described as ‘difficult’, but never ‘bad’, ‘dumb’ or ‘crazy’. Boarders who are unable to cope on this basis will be readmitted to the hospital: this is inevitably seen as a punishment, and everyone hopes the stay ‘inside’ will be as brief as possible.
The people of Geel don’t regard any of this as therapy: it’s simply ‘family care’. But throughout the town’s long history, many both inside and outside the psychiatric profession have wondered whether this is not only a form of therapy in itself, but perhaps the best form there is.
The Dish 