by Lavina Nocelli
from La Stampa 18 June 2023
We have just got into Marco’s car when the sky closes in, wishing the day pouring rain and gusts of fresh wind. “Matteo is waiting for you, he’s been asking me about you since last night. We are going to visit him at work ”, he anticipates me, taking a steep road that goes up the center of Perugia. “He’s curious to meet you.” Marco Casodi, general manager of the ‘La Città del Sole Foundation’, closes himself in his black leather jacket, then puffs out a puff of a cigarette: “We’ve been living together for twenty-seven years. At first he got up every thirty seconds at the cinema, ditto at the restaurant: he couldn’t sit still. I forced my hand a bit ”, he explains as we enter Monimbò, a social cooperative with which the Foundation collaborates. Matteo comes towards us with a quick step, scrutinizing long black eyelashes behind us: “Which street do you live on”, he says, tugging at my sleeve, “and what’s your last name”, he repeats biting his fingernail. “We lend a hand in running the shop, Monimbò is available to host work placement experiences for our patients”, including Matteo, explains Marco, who comes twice a week. It was 1996 when they moved in together: the idea of the Foundation came on the wave of their coexistence, in 1998, with the aim of innovating the psychiatric field through the creation of projects that put the person first at the center of the recovery process , then the family and the reference community. The goal is to activate the personal, environmental, dormant and residual resources that each individual possesses, avoiding institutionalization. The PRISMA Project Mental Health and Autonomies Research-Intervention Program is the first response that the foundation gives to the community: “Our home remains a hybrid, we let it float outside the rules: it has created a family. The project foresees that at least two people live with the patient”, explains Marco. Born as an alternative to ‘family’ coexistence, this constitutes a prospectus that revolves around ‘living at home’, oriented towards self-determination and fulfillment. In the encounter between a housing need and supervised coexistence, ten patients in charge of the Foundation are placed in a light residential experience where, in collaboration with the local DSMs and CSMs, they are supported and supervised by educators and the clinical staff of the Foundation . “What is your surname”, Matteo repeats again, “and in which street do you live”. “There were several people who passed by the house,” explains Marco, now it’s just the two of them. “Tomorrow are you there?” asks Matteo. Marco reassures him, “sleep with us tonight”. Then Matteo asks me for the street, my surname, where I come from. In the evening he spreads a first veil over the city.
Casa di Lorenzo is just outside the walls. “Ours is a network in constant motion, where the nodes are the realities that the foundation has set up. We strongly believe that living independently, in a house where you can share your spaces and your emotions, is fundamental,” explains Antonio Imperato, socio-pedagogical educator of the Foundation, as we climb the stairs. “It’s not a linear path. The patient is free to be able to communicate freely with these nodes”, respecting his own dynamics of desire. Lavinia, a roommate, puts on the coffee while Lorenzo finishes getting ready. “A friend of mine asked me, ‘Is that a sure thing? Isn’t that maybe he comes and does something to you?”, but it was an episode. The concept of mental illness is also this, a link with the figure of danger: stripped of the individual, of his identity and his will, the diagnosis remains, a nuanced human outline. The Foundation does this, it overturns the static position of the patient: it rehabilitates him for relationships, work, the community and its movements. Because the reforms, the laws that structure the interventions and organize the territory are there, but then they must also be applied according to the reference context. “I changed several roommates. I’ve been here for six years: in the morning I go to day care, in the afternoon I play tennis. Three times a week I work at Numero Zero”, the inclusive restaurant wanted by the Foundation, explains Lorenzo, hanging out his wet clothes. At home we organize ourselves according to a mutually agreed calendar: in the evenings Elisabetta stays at home with Lorenzo, other times Lavinia, or we go out together. Then there is also the work, the study: the intertwining of the clinic with life, the disease as overcoming a rigid paradigm. “Relationships create identity and shape behavior: our job is not to create projects, but to create relationships”, explains Antonio. Educating for care, the concept of mental health.
The FuoriPorta Psychiatric Day Center was born out of necessity in 2019, with the aim of carrying on the PRISMA project, which by law ‘must become fully operational’. However, a structure that follows the experience and operating model of the Foundation is needed, and not a building located outside the city walls, sheltered from the gaze of the community, where this kind of reality is often located. The former San Giacomo Hospital is emptied of its original connotation as a health facility. Already intended for catering in the past, it becomes a container of people, stories and activities: a socio-medical and socio-cultural structure. Going beyond the norm, Numero Zero is inaugurated inside FuoriPorta, the first inclusive restaurant in Umbria, where the staff is made up of at least 50% psychiatric patients. While Vanni goes out and Alessio enters for the evening shift, with Livia who stops at the entrance to talk to Antonio, the room changes shape and takes on the tone of a restaurant. It’s Saturday, it’s full: the lights are dimmed, and the tables rearranged according to reservations. Placemats are placed where the points where to place forks, knives and glasses are indicated. “There must be a gaze that must not take anything for granted”, explains Vittoria Ferdinandi, the director. We need to start from a concept to work in mental illness: respect for individual functioning. “Everyone works differently, and everyone can be put in a position to function”, but it is a demanding, unusual vision that escapes the community. “The need was a bit double. On the one hand, restoring a dimension of life to patients, and on the other, inserting ourselves in the dominant discourse: work for patients exists, but they are always hidden, decentralized jobs. We were interested in putting the work of the different and the disabled in contact with the community”, to try to rehabilitate it. “Challenge this fear of diversity,” which mental illness controls. Numero Zero works with its time, which is different from the standard one in which we are used to moving. Daniel is waiting for me outside with a lit cigarette, his hair between milky white and bright fuchsia. He dreams of the sea, he would like to open a place one day overlooking the beach: the scent of the waves, the freedom that only an imprecise horizon emanates. “Perugia is a bit tight for me,” he confesses to me. He then aspires: “If I ‘get bad’ in the service I can count on Vittoria, who helps me and comforts me. In other jobs, everyone has to think for themselves: if you’re sick, you’ll end up staying at home, and goodbye to work. It’s different here”, because the employment contract can be modified, or rest granted. Above all, you can always come back. “I have to be a little more professional with clients, I have to improve, but I have my aficionados”, who only come for him.
Eventually the purple of the downpour engulfs Perugia. With Raffaella Serra, director of the Foundation’s clinical staff, we take refuge in the recording studios of Stazione Panzana, the structure’s web radio, behind the kitchens of Numero Zero. “We take care of an encounter, which is the one between different worlds that experience the same reality through completely different coordinates, and which normally fail to understand each other. Our psychiatry works with the relationship, with subjectivity”, which seems to be taken for granted, but we no longer take care of the encounter with the other. For this, an even deeper step is needed to understand each other. “Mental illness as a breakdown of a dialogue, and treatment as a reconstruction of communication with the other. We do this within scenarios of everyday life, of real everyday life”, giving space back to identity, crushed under the burden of diagnosis. An idea of mental health.