Geel, Belgium

Geel, in the center of an agricultural region in Kempenland, is known for its pioneering method of treating psychiatric patients and the mentally ill.

Patients receive treatment at a large hospital in town, but live in the community with host families and are able to take part in everyday life. Originally facilitated by the church and then eventually organized directly between the hospital and residents, Geel was one of the first to adopt deinstitutionalization.

The revolutionary psychiatric system still basically follows the same outline it has since the 13th century—the hospital releases those thought capable of family living to volunteer boarders. While they are given leeway for their impairments, the boarders are expected to follow a certain level of civil conduct, and their odd behavior is ignored whenever possible. They are encouraged to bond with the family and especially the children, relationships considered beneficial to all involved. If the boarders’ coping skills degenerate to a point that this arrangement is no longer functional, they are returned to the hospital until they can once more be integrated into family life.

This system, which has been in place for more than 700 years, is derived from the legend of Dymphna, the patron saint of the mentally ill. Saint Dymphna was an Irish princess who fled to the Belgian village of Geel in the seventh century. Her father’s mental condition had deteriorated after the death of his wife, and he was convinced that Dymphna was the only suitable replacement for her mother. He followed Dymphna to Belgium, and when she refused to marry him he killed her. Dymphna was seen as a martyr, and was eventually named patron saint of the mentally ill.

This “family care” philosophy has only improved over the centuries as mental health awareness grows and treatment methods develop. In modern Geel, the two-layer system of family care with a medical safety net has led to the town’s ill boarders spending less and less time in the hospital and more and more time living as useful and functional family members.

The idea is that, with more opportunities for community integration and interaction, the patients will be able to live more meaningful lives and enjoy a greater chance of receiving successful treatment. This, in turn, would allow them to function as active and important members of their community.

Despite its success, participants in the system are rapidly declining, due to lack of homes willing or able to board, as well as a sharp decline in those unable to live independently through medication and other advanced treatment. Currently, Geel has roughly 300 “patients” receiving Saint Dymphna’s brand of care, and it’s projected that this may be the last generation in Geel that has the demand to support this ancient and compassionate community’s methods.