Geel: Psychiatric Community Care

Psychiatric community care: Belgian town sets gold standard

There’s nowhere on Earth quite like the town of Geel, a foster-care centre for psychiatric patients

By Karin Wells, CBC News Posted: Mar 09, 2014

In the obscure little Flemish town of Geel in Belgium, Dis and Luc sit at the dinner table squabbling. Luc is going to camp for 10 days, Dis for only five.

Dis’s voice gets more and more shrill. Toni Smit, their foster mother, says quietly, “Dis gets jealous.” But after a few minutes they get up and together they clear the supper table.

Luc and Toni

Luc (left) has lived with Toni Smit and her husband for the past seven years. “No one tells us what the problem is” says Smit. “Nobody says oh this person has schizophrenia or anything. The only thing we know about Luc is what he told us himself.” (Courtesy Gary Porter, Milwaukee Journal Sentinel)

Luc is 48 and suffers from obsessive compulsive disorder. He was shunted off into a  psychiatric hospital after his father died.

“He hated it,” she says, butLuc eventually wound up in Geel, where he has lived with Smit and her husband for the past seven years.

Dis is 89, and no one even labels his psychiatric disorder. He came to Geel in 1938 and lived with one family through three generations. Then he came to live with Smit.

​“They are part of the family – we love them,” she says.

Hundreds of families in Geel take in psychiatric patients; people who suffer from schizophrenia, from obsessive compulsive disorder, serious mental illnesses. About half  of  “the boarders” as they are known, also have what is described as “a mild mental handicap.”

Families in Geel have been looking after mentally ill people for centuries. When the numbers were at their highest in the late 1930s, there were 3,800 psychiatric patients living with families in Geel, a town at the time of only 15,000. A quarter of the town was noticeably mentally ill.

The tradition continues today. A young woman dressed like some sort of ragged angel scurries past on the street; a few minutes later a man with a vacant gaze wanders by muttering to himself. No one bats an eye.

“We are known all over the country as the place where there are insane people.” says tour guide Alex Martens. “There’s also an expression instead of saying you’re crazy. You can say you belong in Geel.”

There really is nowhere on Earth quite like it. Geel has become the gold standard of community care of psychiatric patients, and it’s a model that others are starting to adopt.

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