by Stefano Cecconi
and https://archiviopubblico.ilmanifesto.it/Articolo/2003287410
Psychiatry as a concrete utopia
Franco Rotelli had a very rare quality: that of wanting to transform dreams into reality, and the talent of knowing how to do it. Of course, not always and not all dreams come true. But if Rotelli has been defined, even in recent days, as a “concrete visionary”, it is because he “dreamed and acted”, in the various roles he held, to improve people’s lives, social contexts, services and the work of the welfare.
He did it, together with Basaglia, and later, to destroy the asylums: from Castiglione to Trieste up to Leros. And to build alternatives to the non-life of the asylum: freedom, income, home, work, affections, and services that are always open and welcoming.
In his extraordinary professional and political work, in his being a promoter of the movement for the right to health, he taught us that, in order to take care of a person, it is first of all necessary to guarantee his rights, his freedom, respect his dignity. This means acting against all exclusion, repression and discrimination.
All of this assumes that there is a public and universal health system, capable of integrating its policies and actions with all the other components of welfare: social, housing, training, employment. This is why Rotelli often said: it is necessary to tear down the walls, not only of the asylum, but also between institutions, between local health authorities and municipalities, between different professions. Because the person, especially if ill, expresses global needs, not just strictly medical or merely clinical ones. Because the determinants of health and illness, the very hopes of recovery, can be traced far beyond the narrow boundaries and powers of traditional medicine: income, education, environment, employment, working conditions, social and family context, gender, mark the fate of a person, even his life expectancy. It is the “global” vision of the WHO concept of health, which has often remained a mere declaration, which instead with Franco Rotelli has become a possible goal to achieve.
In remembering him these days, it has been written that his intuitions have caused extraordinary innovations in the social and health welfare system, far beyond Trieste. We were certainly referring to the enormous de-institutionalization work done in the former psychiatric hospital of Trieste, with the opening of 24-hour mental health centers, finding “normal” housing solutions in the city, the creation of social cooperatives for the right to work , up to the radical transformation of the park of San Giovanni, a place of repression and pain that has become a magnificent example of urban regeneration. He was referring to the support, always lucid and affectionately critical, that he gave to the stopopg struggle that led to the closure of the judicial asylums, and to the campaign against restraint «And you untie him immediately». We were referring to the ingenious intuition of the micro-areas, outposts of the services of the «Città che cura», which act in «difficult» neighborhoods (today 14 areas of Trieste), demonstrating that you can change, starting from the smallest and in the most disadvantaged places. We were referring to the centrality that he assigned to the social health district, the public engine of a system of services, actions and integrated professions to provide community health, proximity, in people’s places of life, even anticipating some reforms of the Pnrr.
The one promoted by Rotelli – and by those who have worked with him in recent years – has been an extraordinary path of innovation and change in the public welfare system, based on deinstitutionalisation and the centrality of the person.
Today this model is questioned by the majority that governs the Region (and by a Government that abandons public health): preventing it from happening is not just a local issue, it is a reason to resume, precisely in the sign of Franco Rotelli, a national mobilization .