Geel - A Model of Psychiatric Care

A Model of Psychiatric Care

Geel is well known for the early adoption of deinstitutionalization in psychiatric care. This practice is based on the positive effects that placement in a host family gives the patient, most importantly access to family life that would otherwise have been denied. The legendary 7th-century Saint Dymphna, who had moved to the Geel area from Ireland, is usually credited for this type of care. The earliest Geel infirmary and the model where patients go into town, interact with the community during the day, and return to the hospital at night to sleep, date from the 13th century.

Originally, this practice was religiously motivated and organized by a chapter of canons, attached to the church of Saint Dymphna. By the 18th century, however, the placement of patients was mostly done directly, without the intervention of the canons. The number of patients grew in proportion to the growing city’s reputation abroad and the economic benefits flowing to the city provided further motivation to the inhabitants. Attracted by the gentle care of patients, Vincent Van Gogh’s father considered sending his famous son to Geel in 1879. The high point came in 1938, with a total of 3,736 placed patients, compared with only 700 a hundred years earlier.

This novel type of psychiatric care was evaluated by various other institutions around the world (see for instance Eastern State Hospital in Virginia), but often seen as too revolutionary to implement. It is only in the early 20th century that the idea of deinstitutionalization was adopted more widely elsewhere. Today, a modern psychiatric centre stands on the place of the old infirmary, and close to 500 patients are still placed with inhabitants.