The Belgian Town Where the Mentally Ill Are Part of the Community

Hugo Minnen, Geel Wellcome Library, London. Wellcome Images

Photograph from Hugo Minnen’s series ‘Een Gelaat van Geel’ (1980s) (courtesy Wellcome Library, London)

The treatment of mental illness has often involved removing patients from society and placing them in their own institutions. Since the 13th century in Geel, Belgium, families have taken in mentally ill strangers and hosted them as undistinguished members of their small community. The ongoing unconventional family care system is a counterpoint to the mental institution in Bedlam: The Asylum and Beyond, opened this month at the Wellcome Collection in London.

Photograph from Hugo Minnen’s series ‘Een Gelaat van Geel’ (1980s) (courtesy Wellcome Library, London)

“The exhibition is framed around the history of the asylum, taking Bethlem Hospital [in London] as its emblematic case study,” Mike Jay, co-curator of Bedlam, told Hyperallergic. “This provokes an obvious question: what was the alternative to the asylum? We’ve used the story of Geel to answer this.”

In the Bedlam exhibition, more than 150 objects chronicle the asylum, with archival material from Bedlam and the Wellcome Collection, as well as contemporary art, patient art, and individual testimonies of experience. “Bedlam interrogates and reclaims the root of the concept of asylum as a place of sanctuary and care, whether this is a physical or virtual space nowadays,” Bárbara Rodríguez Muñoz, co-curator of Bedlam, told Hyperallergic. “It does so by looking at different systems of care and notions of community through history, including Geel as a pioneer on what we now consider ‘care in the community’.”

Plan of Central Geel (courtesy Archives of the Openbaar Psychiatrisch Zorgcentrum Geel [OPZ], Belgium, via Wellcome Library, London)

On view is a series of images taken of Geel by photographer Hugo Minnen in the 1980s. There’s no indication which people in the black and white photographs are mentally ill, just as walking through Geel you might not be aware of who was a patient. An old man strides determinedly by with a fanciful cane, a group of women in headscarves pass a brick building, one woman wearing large glasses and pants that seem a bit too long, glances distractedly at the ground.

“Hugo Minnen’s photos show the presence of Geel’s boarders in the life of the town, not segregated but an inseparable part of it, so integrated as to be unremarkable,” Jay explained. “This is the impression that visitors to Geel get today: something striking to outside observers in its very normality. It’s the impression that visitors to Geel have recorded for centuries.”

Photograph from Hugo Minnen’s series ‘Een Gelaat van Geel’ (1980s) (courtesy Wellcome Library, London)

London’s Bethlem Royal Hospital, better known as Bedlam, has been around for about as long as Geel, and likewise continues to offer mental healthcare. Both also have their supporters and critics. “In parallel with the rise and fall of the asylum, Geel has at some points in its story seemed like a throwback to the Dark Ages and at others as an optimistic model for the future,” Jay said.

Geel’s role as a “colony of the mad” can be traced back to the 7th-century Saint Dymphna, who is said to have been murdered there by her father, who’d tracked her to Geel from Ireland. A medieval church promoted the belief in her miracles for the mentally ill, and soon pilgrims were traveling from around Europe, many with nowhere else to go; others were abandoned there by their families. The locals took them in, putting them to work on their farms and inviting them into their humble homes.

Photograph from Hugo Minnen’s series ‘Een Gelaat van Geel’ (1980s) (courtesy Wellcome Library, London)

Jay, who also wrote This Way Madness Lies — out this month in conjunction with Bedlam — delved into the history of Geel in a 2014 essay for Aeon:

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.

As NPR’s Lulu Miller reported for the Invisibilia podcast in July, there are still around 250 boarders in the community near Antwerp. While violent incidents are low, and a local hospital is available for more severe care, life with the boarders can be complicated. Miller describes a family sleepless from a man’s hallucinations, and another overly affectionate boarder who is straining a couple’s marriage. However, the integration of psychiatric patients into the community, which is supported by stipends from the Belgian government, remains a persuasive form of personal care, and an example of how it can challenge attitudes toward the mentally afflicted.