We have just left behind the “World Mental Health Day”, promoted on October 10th. Italy had good reasons to be in the front row, but there was little response, even from the media. The topic is certainly not at the top of the government agenda and public interest has waned despite a bright past. Those who speak out today to document the mental health situation receive little attention, despite the number of disturbing episodes that continually occur, testifying that we have gone backwards and that violence, here, often shows its dramatic face.
There are still those who try to lift the veil of silence and try to relaunch initiatives to denounce what has not been done and how things have gone backwards, but they are islands of critical survival that act underground. Through the philosophy magazine (!) “aut aut”, I tried to revive a little interest with a recent issue edited by Mario Colucci, Mauro Bertani and Pierangelo Di Vittorio and entitled “Psychiatry and the future of mental health”, where we discussed it, there was a lot of attention but then everything remained fenced off there. In the sense that the cultural drive is certainly not dead, however institutional deafness is now invasive and dominant.
With a Manzonian emphasis one could say: “Basaglia, who was he?”. Of course, we all remember him and 2024, now close, one hundred years after his birth, will be full of initiatives, conferences and republications of his writings: his name will often resonate, but who will really return to reflect on the doors he opened over the years Seventies and Eighties of the last century? Few, I imagine, despite the resumption of some initiatives such as, for example, the “180 Series” (which will be relaunched by the publisher Meltemi). Books and debates will immediately be placed in that oblivion that now dominates the scenario of our psychiatry.
Almost no one will be led to ask themselves why we should go back to reading and thinking about what Basaglia did and wrote: I wonder if we have really moved forward and if we have really made use of what he tried to communicate to all of us by closing the mental hospitals, what represented this closure as a leap of civilization and culture. It seems that we cannot and should not go back, we continue to delude ourselves that we have gone well beyond that decisive goal.
Trieste, specifically, should know something about it because, in its San Giovanni park, it hosted a “revolution” that we now almost hesitate to call that but which has set an example in many areas of our planet. Do we want to summarize this example? In my opinion, it consists less in the same law 180 that we are continuing to defend from those who would like to empty it and make it inoperative, but rather in the way that it should characterize the work of psychiatry and, starting from here, in the way in which we could and should build the future mental health. Not only have we not kept Basaglia’s thought and practice close to us, but we are behind, as can easily be seen.
A practice and a thought that are declared enemies of individualism, which today characterizes all knowledge and all know-how, and which have nothing in common with the technicality that now prevails everywhere, even in the field of psychiatry. Basaglia taught us the opposite: before individual closure there is social openness, the ego cannot be isolated (perhaps this is precisely how we get sick) and its need for sociality comes before any other need. This applies to the so-called “patient” and also applies, where absolutely necessary, to the so-called “doctor”.
Yes, “who was he?”. It is precisely for this reason that we push him away in an almost vague memory, because today the scene is everywhere being reversed in terms of distancing and medicalizing attitude: the patient must stay there, at a certain distance, and the doctor is in any case higher up, protected by his technical professionalism. This applies to any patient and, even more dramatically, to those who are defined as “mentally ill”.
In other words, Basaglia-Carneade tried to teach us that abolishing such distances is the cultural (and political) task of the psychiatrist, however this turned out to be such an uncomfortable and out-of-time teaching that we have forgotten it, making Basaglia almost a desk saint , something symbolic and useless.