Tribute to Franco Basaglia at the “ground zero” of psychiatric reform – Nortes | Focused on the periphery

100 years have passed since the birth of the psychiatrist Franco Basagliathe man to whom mentally ill people around the world owe the conquest of large areas of freedom and personal autonomy since the 1970s.

Born in Venice In 1924, Basaglia fought as a teenager against fascism and the Nazi occupation, even being imprisoned for it. So I knew what the bullfight was about. After the war he studied medicine, specializing in psychiatry, and from the beginning he showed interest in renewing the methods used in hospitals, as well as in putting an end to the prison regime in which patients lived.

Through his work in TriesteBasaglia concluded that patients’ chances of recovery are greater when they receive care in the community in which they live, rather than locking them up in an institution.

Allied to the then powerful Italian left, Basaglia managed to get the Republic to approve the Law 180a pioneering legislation worldwide that established the progressive closure of psychiatric hospitals. His main promoter, however, would barely live to see the fruits of his struggle: in 1980 he died prematurely at the age of 56.

Asturies and the reform

Asturies was a pioneer in the 80s in the development of this psychiatric reform for which young doctors, inspired by Basaglia and other authors, and linked to left-wing parties and the anti-Franco struggle, had been fighting since the last years of the dictatorship.

The psychiatrist Victor Aparicioone of the young anti-Francoists who had participated in the Psychiatric Coordinatorassumed the direction of the La Cadellada Hospitalthe current HUCAa center that had been a hotbed of medical renewal and anti-Franco struggle between 1965 and 1972. This Tuesday he was in charge of discovering, together with the counselor Concepcion Saavedraa monolith in homage to the inspirer of those movements.

Aparicio came to Oviedo/Uvieu coming from the the Basque Country. He found a hospital with nearly 900 inmates, and in which punishment cells still existed. With the formation of the first autonomous government of Pedro de Silva things would start to change. Thanks to the policy of opening community health centers and psychiatric units in Asturian hospitals, the number of inmates would be drastically reduced in the following years until the definitive closure of the psychiatric hospital in 2005.

“La Cadellada was a more modern hospital compared to the rest, but the psychiatric hospitals of those years were terrible places, with a very poor quality of life, and in which the medical staff was very short,” Aparicio recalls about the hospitals prior to the reform of the 80s. A reform that arrived earlier in Asturies than in other places in Spainand which had its great promoter in the general director of health and future advisor Jose Garciaone of those anti-Franco psychiatrists who after the Transition integrated through the PSOE in the new democratic institutions.

The process of dismantling psychiatric hospitals generally improved the autonomy and quality of life of the patients, but it also had its shadow areas. All the necessary means were not always put in place to ensure that former internees were welcomed into the society to which they returned, sometimes after long confinements. As the psychiatrist and writer wrote Guillermo Rendueles earlier this year in NORTHwhen the doors of the Oviedo psychiatric hospital opened, a couple of inmates escaped and committed an agreed suicide in the waters of the San Lorenzo Beach. A case that may be the tip of the iceberg of many more episodes of patients adrift, misplaced and rejected in that community that in theory should welcome and integrate them:

“That model – undoubtedly with strong strains of utopianism – that prioritized freedom over security, collapsed in the face of the sum of several authoritarian forces. The families of the patients were mostly scandalized by these freedoms and each escape, or let alone each suicide, caused legal claims that began to scare the caregivers. Incapacitating the patients and assigning a family member as responsible decided the conflict: while the patients wanted open units, their families wanted them closed and that wish was fulfilled. Mandatory treatments and judicialization of control collaborated in medicating patients with delayed neuroleptics. These sometimes arrived handcuffed by the municipal police to receive the corresponding injection. Finally, the social outcry over crimes, vagrancy and begging of the patients released from the asylum gave the finishing touch to the reforming spirit. Once again, society demanded order.”

The tribute to Basaglia comes in the midst of the regression of some of the advances of the 80s that already seemed unquestionable and unquestioned, such as the elimination or at least reduction of so-called restraints, as well as in the midst of a strong social debate about the lack of resources public for a mental health policy that is increasingly demanded by citizens.