Pier Aldo Rovatti, Rosy Bindi and Gianni Tognoni
Celebrating one hundred years since the birth of Franco Basaglia, Salute Internazionale has decided that the best way to honor this fundamental figure of the twentieth century is to ask some protagonists who have contributed, and continue to contribute, to reflect and fight for social inclusion against any form of total institution, for rights and for just and universal public health, to formulate in a few lines their thoughts on the relevance of Basaglia’s work.
Pier Aldo Rovatti, philosopher.
Thanks Basaglia
We have created a wall of silence, or rather of rhetorical words that we need to celebrate the work of Franco Basaglia. He is now far from current psychiatry, at the same time he is so close to our social discomfort and the needs that arise from it that he is, with his thoughts and practices, a legacy capable of still bringing light into the twilight that is enveloping us. For this to happen, however, we should agree on what contains the thanks that we owe him today and which we will probably have to maintain for a very long time.
In a few words it seems inappropriate to give an account of the content of a “thank you” that will not end any time soon: to say that Basaglia has transformed the idea of mental health into a commitment that concerns each of us, inhabitants of a present that is asphyxiated and declining in experiences old and empty, it is only the beginning of a critical process to be put back on its feet, a self-criticism that has to do with the generalized way of misunderstanding our subjectivity.
Ten years ago I titled a collective essay, which arose from a course of lessons held at the University of Trieste, “Restoring subjectivity”. Perhaps this title is the best thing in the whole book because, the more time passes, the more I am convinced that Basaglia spoke to each of us, warning us that we have been robbed of the very sense and practice of being subjects, in a perspective that does not he only knows mental distress but has to deal with an overall here and now that becomes more threatening every day.
Those who think they are “healthy” and therefore believe they stay out of the fray delude themselves at their own risk: mental distress (in short “madness”) – Basaglia warns us – belongs to everyone and no one can believe they can move it outside of themselves, indeed, it is only by working on it that we can try to get out of the mud in which we live and “restore” to ourselves a subjectivity that has faded so much as to become almost unrecognizable. Basaglia sends a worrying message, warning us that mental health is not a problem we can leave aside, but it is our problem, without exception.
Rosy Bindi, politician and former parliamentarian
Realist and visionary, Franco Basaglia was the protagonist of a revolution that questioned the violence and classism of the mental hospital and profoundly marked Italian medical culture and society in the second half of the twentieth century. He freed madness from the stigma that accompanied the mad, with its corollary of social control and indicated a new way of conceiving illness, treatment and health. All of Basaglia’s work is aimed at restoring dignity to the sick person and responding to suffering with a therapeutic approach that aims at social inclusion.
Tearing down the walls of mental hospitals does not mean denying madness, on the contrary it requires a stringent assumption of collective responsibility. This is the spirit of law 180 which brings together the deinstitutionalization practices of Basaglia on a legislative level. And thanks to 833, mental health will enter the network of territorial services of the NHS.
One hundred years after its birth, the horizon of freedom and responsibility outlined by Basaglia continues to challenge us. The overcoming of the former Ops was not accompanied by an adequate political and cultural investment in community medicine.
The privatization of public health that has been underway for some time has impoverished and gradually disqualified local services and the management of health needs. And we return to talking about deviance, the forms of segregation and institutionalization multiply: prisons, health residences for non-self-sufficient elderly people, repatriation centers for migrants.
This centenary begins as the centenary of the birth of Don Lorenzo Milani ends.
Both affirmed the rights of the last and the discarded. Both practiced cultural, civil and nonviolent disobedience to an unjust power that caused marginalization. Both have inspired more just and supportive laws and practices in healthcare, education and the inclusion of foreigners. Both leave a precious legacy that we must not squander.
Gianni Tognoni, epidemiologist, general secretary of the Permanent People’s Tribunal, Rome
We live in a time very similar, albeit upside down, to the time of Basaglia’s fundamental intuition, which was at the same time political, cultural, and rigorously methodological.
Psychiatry is, as then, the border between healthcare-medicine and a society-social culture in profound transformation: the strictly technical ‘knowledge’ available is the same. To discuss the relevance of Basaglia it is necessary to deal with the reversal of the context.
Then, with all the contradictions, the transformation was a ‘paradigm change project’: today we live in the time of arrival and expression of a long degradation of the ‘rules’ of a democratic project without horizons.
In this context, psychiatry finds, symbolically and concretely, the role of indicator of a society of inclusion or expulsion with respect to everything that threatens the “rules”: from diseases not attributable to economically sustainable technologies and services, to all productive disabilities for any reason, to the many ‘migrants’, national and otherwise, from all ‘diversities’ and exclusions.
Basaglia’s current situation is very simple: only a denial of the institution can restore visibility to the priority of people, never signing the legality of violating dignity and autonomy: psychiatry cannot be an excuse for crimes of peace, disguised and unpunished.
Practicing the Basaglia methodology in times of ‘administrations’ specialized in ‘restraint’ of people is not at all easy. In fact it is perhaps impossible. It therefore becomes even more urgent to at least start remembering it again as current, appropriately declined, in a flexible, diversified way.
And the safest and most immediate way (and it is my last memory of/with Basaglia) is that of an epidemiology of people and their lives: none excluded: of the ‘first cases’, of the ‘non responders’of the ‘unmet needs’….Care is a misleading word if it does not coincide, in the individual services, with transparent, shared documentation, especially of what is NOT possible to do, and which requires habeas corpus.
This is the third collective memory of Franco Basaglia. See previous articles Franco Basaglia 100 (1) Franco Basaglia 100 (2)