CULTURAL STUDIES

AND MODERN LANGUAGES

UNIVERSITY OF BRISTOL

WEEK 1 SLOGANS
Freedom is Therapeutic with Professor John Foot
0:00
For much of the twentieth century, mental health in Europe and the rest of the world was
centred around large asylums. These psychiatric hospitals were places of confinement, but
rarely of therapy.
I am in Bristol, on the site of an ex-psychiatric hospital - Glenside - which was opened in
1861 and closed in 1994. Glenside was a classic Victorian asylum, located out of town, and
known as the Lunatic Pauper Palace. It had extensive buildings, a chapel (now a
museum), and was built in a beautiful park setting.
In Italy, around 100,000 patients were to be found in asylums of this kind in the post-war
period. As with Glenside, these institutions were deliberately isolated from cities. In
Venice, for example, separate male and female hospitals were built on adjacent islands in
the lagoon. Patients were often restrained - electro-shock therapy was common. Treatment
of all kinds was used, ranging from the humane to the brutal.
1:17
In the 1960s, a radical movement started to develop in opposition to these asylums and the
way they were run. The leader of the movement in Italy was the psychiatrist Franco
Basaglia. During his career, Basaglia ran a number of asylums, but his aim was, in his
words, to destroy them from within. He believed that the patients inside should be treated
in different ways, or simply released into society. Basaglia worked personally in Gorizia,
Trieste, Parma and Rome and as his influence and ideas spread psychiatrists with similar
ideas took charge of services across Italy.
By 1978, the so-called Basaglia law was passed, which ended the use of asylums for
mental health care in Italy. In order to bring about the closure of asylums, fences were
pulled down, and patients were encouraged to knock down the walls that imprisoned them.
Symbolic barriers which divided hospitals, patients and cities were also destroyed.
Meetings were organised and run by patients, taking decisions over the running of the
hospital.

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2:25
A movement developed across Italy that linked up to similar movements across the world.
One of the slogans of the Italian movement was Libert terapeutica(Freedom is
therapeutic). Basaglias edited book The Negated Institution portrayed the new forms of
understanding mental illness that he had experimented with in the northern Italian town of
Gorizia in the 1960s. Attempts were made to reintegrate patients into society, and to
dismantle the more oppressive aspects of asylums. The book became a best-seller. It would
be described as the bible of the 1968 movement.
But was freedom therapeutic? What happened to those 100,000 patients who had been in
the asylums before Basaglias movement took hold? What happened to the 1,000 people
who were inside Glenside hospital in Bristol?
Some of the psychiatric hospitals were closed fairly quickly, but most remained open until
the 1980s and 1990s as ex-patients were found housing and jobs. This process caused
controversy at a local and national level. Some patients simply went back into everyday
life. Some never left the asylum. Others were cared for in decentralised mental health
centres. Many found the outside world problematic. There were suicides, and a few tragic
murders. Not everyone found freedom therapeutic. The dark, forbidding asylums had been
closed - but the future was a difficult one for those with mental health issues, and there
were no easy or utopian solutions.
4:01
Today, mental health services vary greatly in quality and organisation across Italy. Trieste,
where Basaglia worked in the 1970s, has a 24-hour emergency drop-in centre, and local
day care clinics. Basaglias influence can be seen in these places, with doctors who dress in
civilian clothes and rooms that seem more like domestic flats.
Despite Basaglias death in 1980, his myth lives on. But he is also a controversial figure
for many, and there are calls to re-open asylums. Care outside of big psychiatric
institutions was not always effective. Was freedom by itself therapeutic? Or did this slogan
underestimate the issues at stake? This is a key question that is still relevant today. The
history of the movements which opened up the asylums in the 1960s can help us
understand ongoing issues relating to mental health care, its successes and its failures.

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