Skip to 0 minutes and 10 seconds For much of the twentieth century, mental health in Europe and the rest of the world was centered around large asylums. These psychiatric hospitals were places of confinement, but rarely of therapy. I am in Bristol, on the site of an ex-psychiatric hospital - Glenside - which was opened in 1861 and closed in 1994. Glenside was a classic Victorian asylum, located out of town, and known as the ‘Lunatic Pauper Palace’. It had extensive buildings, a chapel, now a museum, and was built in a beautiful park setting. In Italy, around 100,000 patients were to be found in asylums of this kind in the post-war period. As with Glenside, these institutions were deliberately isolated from cities.
Skip to 0 minutes and 57 seconds In Venice, for example, separate male and female hospitals were built on adjacent islands in the lagoon. Patients were often restrained - electro-shock therapy was common. Treatment of all kinds was used, ranging from the humane to the brutal.
Skip to 1 minute and 18 seconds In the 1960s a radical movement started to develop in opposition to these asylums and the way they were run. The leader of the movement in Italy was the psychiatrist Franco Basaglia. During his career Basaglia ran a number of asylums, but his aim was, in his words, to ‘destroy them from within’. He believed that the patients inside should be treated in different ways, or simply released into society. Basaglia worked personally in Gorizia, Trieste, Parma and Rome and as his influence and ideas spread psychiatrists with similar ideas took charge of services across Italy. By 1978 the so-called ‘Basaglia law’ was passed which ended the use of asylums for mental health care in Italy.
Skip to 2 minutes and 6 seconds In order to bring about the closure of asylums, fences were pulled down, and patients were encouraged to knock down the walls that imprisoned them. Symbolic barriers which divided hospitals, patients and cities were also destroyed. Meetings were organised and run by patients, taking decisions over the running of the hospital. A movement developed across Italy that linked up to similar movements across the world. One of the slogans of the Italian movement was ‘Liberta e terapeutica’ - freedom is therapeutic. Basaglia’s edited book ‘The Negated Institution’ portrayed the new forms of understanding mental illness that he had experimented with in the northern Italian town of Gorizia in the 1960s.
Skip to 2 minutes and 50 seconds Attempts were made to reintegrate patients into society, and to dismantle the more oppressive aspects of asylums. The book became a best-seller. It would be described as ‘the bible of the 1968 movement’. But was freedom ‘therapeutic’? What happened to those 100,000 patients who had been in the asylums before Basaglia’s movement took hold? What happened to the 1000 people who were inside Glenside hospital in Bristol?
Skip to 3 minutes and 20 seconds Some of the psychiatric hospitals were closed fairly quickly, but most remained open until the 1980s and 1990s as ex-patients were found housing and jobs. This process caused controversy at a local and national level. Some patients simply went back into ‘everyday life’. Some never left the asylum. Others were cared for in decentralised mental health centres. Many found the outside world problematic. There were suicides, and a few tragic murders. Not everyone found freedom ‘therapeutic’. The dark, forbidding asylums had been closed - but the future was a difficult one for those with mental health issues, and there were no easy or utopian solutions. Today mental health services vary greatly in quality and organisation across Italy.
Skip to 4 minutes and 8 seconds Trieste, where Basaglia worked in the 1970s, has a 24-hour emergency drop-in centre, and local day care clinics. Basaglia’s influence can be seen in these places, with doctors who dress in civilian clothes and rooms that seem more like domestic flats.
Skip to 4 minutes and 26 seconds Despite Basaglia’s death in 1980, his myth lives on. But he is also a controversial-figure for many, and there are calls to re-open asylums. Care outside of big psychiatric institutions was not always effective. Was ‘freedom’ by itself therapeutic? Or did this slogan underestimate the issues at stake? This is a key question that is still relevant today. The history of the movements which opened up the asylums in the 1960s can help us understand ongoing issues relating to mental health care, its successes and its failures.
'Freedom is therapeutic' with Prof John Foot
This week, the course will be looking at slogans, with the first being ‘Freedom is therapeutic’, a phrase coined by the psychiatrist Franco Basaglia in the 1960s in Italy.
In this video, Professor John Foot will tell you more about the slogan.
It’s OK to pause the video or to watch it as many times as you like. The video subtitles do not show the accented characters, unfortunately. To see them you might like to refer to the transcript that is available below in the section ‘downloads’ - click ‘English Transcript pdf’.
(After you watch the video and click the pink circle ‘mark as complete’, move on to the next step and read the article ‘More about the slogan’.)
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