Franco Basaglia - Views

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According to Renato Piccione, intellectual legacy of Franco Basaglia can be divided into three periods:

1. university period which initiated the process of criticizing psychiatry as "science" that must cure and liberate a person but in fact oppresses him;
2. institutional negation which coincides with experience in Gorizia (1962—1968);
3. deinstitutionalization which coincides with direction of experience in Trieste (1971—1979).

When Basaglia arrived at Gorizia, he was revolted by what he observed as the conventional regime of institutional ‘care’: looked doors and keys only partly successful in muffling the weeping and screams of the patients, many of them lying nude and powerless in their excrements. And Basaglia observed the institutional response to human suffering: physical abuse, strait jackets, ice packs, bed ties, ECT and insulin-coma shock therapies to ‘quiet’ the melancholy and the terrified, and to strike terror in the agitated and the difficult.

In 1961, Franco Basaglia started refusing binding patients at their beds in the Lunatic Asylum of Gorizia. He also abolished any isolation method. From this initiative commenced a wide theoretical and practical debate all over Italy. Such a huge debate resulted in the endorsement of a national Reform bill in 1978. The bill provided the gradual but radical closure and dismantling of the mental hospitals in the whole country.

Basaglia insisted that much in the inveterate stereotypes of madness was actually the consequence of institutional conditions, but not a real danger which the walls of a mental hospital bad been requited to contain. He considered psychiatric hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents, and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism.

Basaglia recognized that many of the characteristics of his patients which were believed to be inherent in their mental illness, such as the word salad, the vacant stares, the perseverative gestures and movements, appeared to dissolve as they left the confines of the asylum. From these observations, Basaglia concluded that we would not know what mental illnesses were, or what limitations they would inherently put on persons suffering from them, until both staff and patients were freed from the beliefs, attitudes and culture of the asylum. Basaglia was concerned that, without the complete closing of asylums, mental health professionals would unknowingly reconstitute the asylum culture in community facilities.. As long as confinement remained possible, professionals would continue to regard themselves as the ultimately responsible parties, and patients would continue to regard their agency and freedom as dependent on the doctor’s will.

Basaglia considered mental illness as the consequence of the exclusion processes acting in the social institutions. He stated: ‘The mental illness is not reason and origin but the necessary and natural consequence of the power dynamics-related exclusion processes potentially and concretely acting in all the social institutions. It is not sufficient to liberate the ill to restore life, history to the persons who were deprived of their life, their history.’

Basaglia and his followers deemed that psychiatry was used as the provider of scientific support for social control to the existing establishment. The ensuing standards of deviance and normality brought about repressive views of discrete social groups. This approach was nonmedical and pointed out the role of mental hospitals in the control and medicalization of deviant behaviors and social problems.