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And in 1861, a hospital appeared on the outskirts of town: a two-storey building with an elegant portico and large arched windows, designed in every detail to resemble a country mansion rather than a prison. Throughout the 20th century, the family care system prospered and expanded, and the towns fame spread. Care in the community, of which the town was once the leading example, has become the norm. He praised the tolerance of a system where the mad are elevated to the dignity of the sick. Within the family home they might still be boarders, but outside it they are now patients or clients. Yet this would demand a reform not simply of medicine but of society itself. Dozens of towns in Belgium, France and Germany established their own versions of the Geel system, some of which still survive. More optimistically, the decline of the system can be seen as a reflection of modern improvements. At times, these guests have numbered in the thousands, and arrived from all over Europe. By the late 1930s, there were almost 4,000 boarders among a native population of 16,000. We might define mental ill-health in medical terms, but this is not enough to confine its treatment within the medical frame. The people of Geel dont regard any of this as therapy: its simply family care.

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At the same time, Geels story does suggest that psychiatrys role could be limited, perhaps dramatically so: not at the centre of mental healthcare but on its periphery, as a backstop to the community. Visit m, global rank, daily visitors 550, daily pageviews 550, pageviews per user. The boarders conduct is expected to meet the same basic standards as everybody elses, though its also understood that he or she might not have the same coping resources as others. These are people who, whatever their diagnosis, have come here because theyre unable to cope on their own, and because they have no family or friends who can look after them. While many locals believe family care will endure, it has become a markedly smaller part of town life, and others suspect that this generation will be the last to maintain. One wealthy family even took in a Polish prince, who came with his own butler and carriage. The fact that these checks could be performed outside rather than inside meant that, for most boarders, the smell of the hospital and the sight of asylum wards vanished from their lives. Philippe Pinel, the founding father of French psychiatry who was legendary for striking the chains off the mad at the Salpetrière asylum in Paris, declared that the farmers of Geel are arguably the most competent doctors; they are an example of what may turn out. As mental illness proliferates and outpaces the psychiatric resources available to manage it, Geels story offers a vision, in equal parts sobering and inspiring, of what the alternative might look like. But throughout the towns 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. Yet its story is unique.

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The boarder who celebrated 50 years in residence is by no means exceptional: another, recently deceased at the age of 100, had spent 80 years with the same family, in the care of successive generations to whom she had been first like a daughter, then. However we might categorise or diagnose their conditions, and whatever we believe their cause to be whether genetics or childhood trauma or brain chemistry or modern society the mentally ill are in practice those who have fallen through the net, who have broken the ties. Increasing wealth is also a disincentive: most of the burden of care always fell on the poorer families, who counted on the supply of free labour and state payments to lift them above subsistence. En cliquant sur le bouton de validation ci-dessus, vous consentez expressément à notre. Half an hour on the slow train from Antwerp, surrounded by flat, sparsely populated farmlands, Geel (pronounced, roughly, Hyale) strikes the visitor as a quiet, tidy but otherwise unremarkable Belgian market town. This might in fact be more accurate than mentally ill, since the boarders have always included some who would today be diagnosed with learning difficulties or special needs. In recent decades, the two-layered system family care supported by a medical safety net has been constantly recalibrated to reflect developments in psychiatry, but its most abrupt shift came in the 1970s. For most mental health service users, the combination of medication and community mental health teams has made the line between inside and outside more porous, with outside the preferred option for doctors and patients alike, on grounds both of cost and quality of life. IP address, server Technologies, nginx, backend server, dNS Records.