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. Yet its story is unique. For more than 700 years its inhabitants have taken the mentally ill and disabled into their homes as guests or ‘boarders’. At times, these guests have numbered in the thousands, and arrived from all over Europe. There are several hundred in residence today, sharing their lives with their host families for years, decades or even a lifetime. One boarder recently celebrated 50 years in the Flemish town, arranging a surprise party at the family home. Friends and neighbours were joined by the mayor and a full brass band.
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. When boarders meet their new families, they do so, as they always have, without a backstory or clinical diagnosis. If a word is needed to describe them, it’s often a positive one such as ‘special’, or at worst, ‘different’. 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. But the 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.
The origins of the Geel story lie in the 13th century, in the martyrdom of Saint Dymphna, a legendary seventh-century Irish princess whose pagan father went mad with grief after the death of his Christian wife and demanded that Dymphna marry him. To escape the king’s incestuous passion, Dymphna fled to Europe and holed up in the marshy flatlands of Flanders. Her father finally tracked her down in Geel, and when she refused him once more, he beheaded her. Over time, she became revered as a saint with powers of intercession for the mentally afflicted, and her shrine attracted pilgrims and tales of miraculous cures.
In 1349, a church was built on the outskirts of the town around Saint Dymphna’s memorial, and in 1480 a dormitory annex was added to accommodate the growing number of pilgrims. When the stream of visitors overflowed the allotted space, townspeople started to house them in their homes, farms and stables. 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. 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 that bind the rest of us in our social contract, who are no longer able to connect. If these ties can be remade so that the individual is reintegrated with the collective, doesn’t ‘family care’ amount to therapy? Even, perhaps, the closest we can approach to an actual cure?