Deinstitutionalization…Old or New?

thinkerSeven hundred years before we coined the term “deinstitutionalization,” the city of Geel in the Antwerp province of Belgium was on its way to perfecting just such a model of community-based care for people with behavioral health problems.

Since the 13th century, all the families in Geel have welcomed people with mental illnesses into their homes. Initially, this was decreed by religious canon, but after the 18th century, it just became a part of community life. There is no stigma to being different in Geel; indeed, uniqueness is cherished.

When Western health practitioners visit, they marvel. “This is fantastic, what programs do you have?”

They always receive the same reply from the citizens of Geel: “We have no programs.” All family members, adopted or otherwise, are included in all aspects of life (leisure, meals, religion, sports, holidays). When Western practitioners comment on how well the citizens of Geel pull off this seeming miracle, Geel citizens just humbly note that they have a 700-year jump on the rest of the planet.

It is simply amazing to see the therapeutic results with the individuals and their families who are proud of the uniqueness of their city’s culture.  It’s a powerful lesson in what could happen by removing stigma as a factor. Let’s consider taking a page out of the Geel playbook.

Sam Bauman, PhD
Sam Bauman, PhD
Sam’s leadership is informed by his thirty years of experience managing juvenile justice, mental health, and human service agencies. He has developed and implemented wraparound programs for youth and family services, school-based behavioral health services, primary prevention family strengthening services, rehabilitation services, domestic violence treatment, homeless case management, crisis intervention, jail-based substance abuse treatment, and dual diagnosis services. Presently, he works in the areas of clinical assessment, consultation, treatment planning, training, and technical assistance.
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