Eugenio Borgna: “That unpredictable death, I defend the Basaglia law”
by Marcello Giordani
from La Stampa of 27 April 2023
The pioneering professor of modern psychiatry in Novara and the case of the murder of the female doctor by one of her patients
Borgna was among the first in Italy to apply the principles and spirit of the Basaglia law
The murder of psychiatrist Barbara Capovani by a former patient cannot send the law that closed the asylums and radically changed the relationship between “normality” and “madness” into the attic. Professor Eugenio Borgna is convinced of this, who was one of the first in Italy to apply, in the women’s psychiatric hospital of Novara, the principles and spirit of the Basaglia law which required humane treatment of psychiatric patients and no longer a relationship based on jailer-inmate scheme.
Professor Borgna, doesn’t Dr. Capovani’s death put psychiatry itself in crisis?
«Certainly, this terrible story fills us with anguish but it also tells us of the limits of psychiatry as well as of any other discipline. Limits that we must be aware of».
In these cases, is it not possible to prevent or in some way understand the intentions of the patient in advance?
“Not when psychotic symptoms erupt so suddenly and lead to tragedies like this. Violence can explode in such a rapid and unpredictable way that any interpretation of the symptoms, provided they are felt, does not allow to prevent the explosion».
Does that mean that nothing can be done or are there margins?
«The drugs that are available today have a very great efficiency; it is essential to intervene when psychotic symptoms are accompanied by gestures of violence which can then lead to the dramas we are talking about. It should be remembered that there is a limit to our ability to probe the mystery of madness, a complex world that in part escapes a purely rational approach; in any case there is always a part that we cannot decipher, and perhaps from there we can unleash what leads to drama».
What did you think when you learned of this tragedy?
«My thoughts went to a very good colleague who placed herself at the service of fragility, to accompany her, help her, alleviate her suffering. I felt tremendous pain for this amazing doctor who gave her life to help others.”
But now there are those who are calling for a radical change or the cancellation of the Basaglia law: if that patient had been closed in a psychiatric hospital it would not have happened. Is that it?
“Absolutely not. This is a purely emotional reaction, contrary to rigorous reflection. If anything, the opening of asylums has decreased violent behavior, it has allowed the human and social recovery of many people. Reopening asylums is like reopening prisons: unfortunately we look at that structure as if it were the solution to problems, but it is not like that; violent events happened even in the most supervised asylums. Today, to deal with the most serious cases there are the Rems, the residences for carrying out security measures. They are health facilities for accommodating offenders, deemed to be infirm or semi-mentally ill and socially dangerous; fundamental difference with asylums is that here there is a path of rehabilitation of people».
In your experience in the psychiatric hospital of Novara, have you ever found yourself managing violent patients and therefore dangerous for healthcare workers as well?
«Novara was a female structure and it is certain that acts of violence in this sector are fundamentally male. Situations of this kind have never happened to me, on the contrary, I have found a lot of humanity in the patients ».