Geel: Living with the Mentally Ill

Geel is a small town in Belgium with a modern population of about 39,000. In the center of the old town is a medieval church dedicated to St. Dymphna, a protectress of the mentally ill:

According to legend, Dymphna was a 7th-century Irish princess who fled to Geel from a maddened father and devoted her life to serving the mentally disabled. But she became a martyr when her father discovered her location and traveled to Geel to behead her.

The town built St. Dymphna's church in the 14th century to honor the saint and enshrine her supposed remains. It became a popular pilgrimage site for people across Europe, who would bring loved ones to the shrine in the hopes of finding relief from their mental distress.

That tradition continues to this day:

For over 700 years, residents of Geel have been accepting people with mental disorders, often very severe mental disorders, into their homes and caring for them.

It isn't meant to be a treatment or therapy. The people are not called patients, but guests or boarders. They go to Geel and join households to share a life with people who can watch over them. Today, there are about 250 boarders in Geel. One of them is a Flemish man named Luc Ennekans. He's slim and has green eyes, and he's 51 years old. . . . Like all of the guests in the town today, Ennekans first went to a public psychiatric hospital in Geel that manages the boarder program. Ennekans saw medical professionals and received treatment and an evaluation. Then he was paired with a household.

At times there have been many more borders than this, more than 3,000 in the 1930s. There is no treatment as such, just tolerance and acceptance:

That acceptance of mental differences has become something of a tradition in Geel. It's at the heart of the boarder program, and some observers think it's also responsible for the system's success. Around the world, many different experiments have been attempted over the centuries to provide humane care for people with mental illness and mental disabilities. Geel is one that has endured. . . .

The integration of people with mental disorders into Geel society has fascinated scholars for centuries. In 1862, Dr. Louiseau, a visiting French doctor, described it as "the extraordinary phenomenon presented at Geel of 400 insane persons moving freely about in the midst of a population which tolerates them without fear and without emotion." Nearly 100 years after that, an American psychiatrist named Charles D. Aring wrote, "The remarkable aspect of the Gheel experience, for the uninitiated, is the attitude of the citizenry."

Early psychiatrists who observed Geel noticed that the treatment prescribed for mental patients was, in fact, no treatment at all. "To them, treating the insane, meant to simply live with them, share their work, their distractions," Jacques-Joseph Moreau wrote in 1845. He and others advocated for that communion. "In a colony, like in Geel, the crazy people ... have not completely lost their dignity as reasonable human beings." In the next half-century, many would uphold Geel's model as the best standard of practice for mental disorders.

I don't want to be utopian about this. One reason families took in "boarders" was to have help around the farm or the house, and there are tales of abuse. But considering all the horrible ways we have treated the mentally ill over the centuries, how wonderful that this kind medieval model has survived.