The town of Geel, Belgium, holds a unique place in the history of mental health care. Far from modern institutional settings, Geel fostered a tradition of family care that stretches back centuries. This practice, deeply rooted in local legend and community spirit, offers a compelling example of early foster care for individuals with mental illness. But when did the foster care programs in Geel begin? The answer lies in tracing the fascinating story of St. Dymphna and the evolution of Geel into a haven of healing.
The Legend of St. Dymphna and Geel’s Sacred Beginnings
The narrative of Geel’s compassionate approach to mental illness is inextricably linked to St. Dymphna. According to local lore, dating back to approximately 600 AD and documented from the 13th century onwards, Dymphna, an Irish princess, sought refuge in the Geel area. Fleeing from her father’s disturbed advances, she was tragically murdered in the forests surrounding present-day Geel. This event, traditionally placed on May 30th, 600 AD, led to Dymphna’s veneration and eventual recognition as the patron saint of the mentally ill.
In a time when mental illness was often attributed to demonic possession, St. Dymphna became a figure of hope. Pilgrims flocked to her burial site, believing that contact with relics associated with her could bring about miraculous cures and alleviate suffering. The Church of St. Dymphna was later erected on this sacred ground, solidifying Geel’s emerging identity as a place of healing for those afflicted by mental distress.
From Pilgrims to Patients: The Birth of Family Foster Care
The influx of pilgrims seeking intercession from St. Dymphna inadvertently laid the foundation for Geel’s pioneering family foster care system. As Geel’s reputation as a place of potential healing grew, so did the number of visitors. Local inhabitants and farmers in the surrounding villages began offering accommodation to these pilgrims, many of whom were accompanied by individuals struggling with mental health challenges.
Over time, some of these pilgrims and their companions remained in Geel even after completing their religious observances. This marked the organic beginning of family foster care in Geel. Families opened their homes and lives to individuals needing care, not as a formal program, but as a natural extension of hospitality and community compassion. Remarkably, this system was already operational in Geel before the establishment of the first psychiatric hospital in Valencia, Spain, in the early 15th century, highlighting its unique and early origins.
Geel’s Unique System: Community-Driven Care
What distinguishes Geel’s foster care system from later, more formalized approaches is its grassroots nature. Unlike initiatives driven by church authorities, as in Valencia, or medical professionals, such as Pinel’s reforms in Paris, Geel’s system arose directly from the community itself. The people of Geel, comprised of peasants and townsfolk, took the initiative to care for those in need. This community-driven ethos became a defining characteristic of Geel’s approach.
The Church played a role in the early guardianship of this project, providing a framework of support and religious significance. However, in 1852, the responsibility for the Geel project transitioned to state control and medical oversight. This shift reflects the evolving understanding of mental health and the increasing influence of medical perspectives on care.
Growth and Recognition: Geel’s Foster Care System Through the Centuries
The family foster care system in Geel flourished over the centuries, reaching its zenith just before World War II. At its peak, nearly 4000 individuals were integrated into Geel families. While most patients were Belgian, Geel’s reputation attracted people from across Europe, including Dutch, French, English, Spanish, and even Russian individuals. The range of mental health conditions represented was comprehensive, demonstrating Geel’s capacity to accommodate diverse needs.
The costs associated with this family-based care were typically covered by the patient’s family or the community they originated from. This financial aspect underscores the collaborative nature of the system, involving both personal and communal responsibility.
Community Standards and Patient Well-being
To maintain the integrity and quality of care, Geel developed a system of “certification” for families willing to foster patients. This certification process was deeply ingrained in the community’s social fabric. Families seeking to participate were vetted to ensure they had a “good record,” meaning no history of legal or moral transgressions within the family.
Certification became a matter of social prestige and community standing. It signified a family’s adherence to moral values and their commitment to the well-being of others. The desire to engage in this work became a cherished tradition passed down through generations, a raison d’être for many Geel families. Certain families even became recognized for their specialized skills in caring for specific types of patients, fostering a sense of expertise and pride.
Recognizing the need for more intensive care in some situations, Geel also established an infirmary. This facility provided short-term care for patients who became acutely unwell or unmanageable. Once stabilized, patients would ideally return to their foster families. If long-term institutional care was deemed necessary, patients were transferred to closed mental hospitals, indicating a tiered system of care within Geel.
A Model of Informal and Personalized Care
The admission process to Geel’s foster care system was characterized by its informality and personalized approach. Upon arrival at the infirmary, patients underwent a period of observation. Following this, medical staff and town representatives collaborated to determine the most suitable placement for each individual.
Placement decisions were often based on informal assessments and a deep understanding of the community’s foster families. A staff member might suggest a particular family based on their known strengths and the patient’s needs. If a consensus was reached, the placement proceeded. While initial placements were usually successful, adjustments were occasionally made to ensure the best “niche” for the patient. Importantly, Geel consistently had more families willing to foster than patients needing homes, allowing for a degree of choice and careful matching, and contributing to an impressive 80% retention rate of individuals sent to Geel for care.
In conclusion, the foster care programs in Geel did not begin at a specific date with a formal decree. Instead, they emerged organically from the unique circumstances of Geel’s history as a pilgrimage site dedicated to St. Dymphna. Starting as early as the 13th century, and arguably with roots reaching back to the 7th century legend, the community of Geel gradually developed a system of family-based care that predates modern psychiatric institutions and reflects a deeply ingrained tradition of compassionate community support for individuals with mental illness. Geel’s story provides a valuable historical perspective on the evolution of mental health care and the enduring power of community-based approaches.
