Geel, a town in Belgium, boasts a remarkable history as a sanctuary for individuals with mental illness, with roots tracing back to the 13th century and even earlier legends suggesting origins as far back as 600 AD. This enduring legacy is intrinsically linked to the story of St. Dymphna, revered as the patron saint of the mentally ill, and the unique development of family foster care programs within the community. But precisely when did the foster care programs in Gheel begin to take shape? Delving into the historical narrative reveals a fascinating evolution of compassionate care rooted in faith, community, and a unique approach to mental health.
The narrative of Geel as a haven commences with St. Dymphna. According to legend, Dymphna was an Irish princess from County Tyrone, raised in the Christian faith. Fleeing conflict with her father, she was tragically murdered by him in a fit of madness in a forest near present-day Geel around 600 AD. Dymphna was buried at the site, which later became the location of the Church of St. Dymphna. In an era where mental illness was often attributed to demonic possession, St. Dymphna became associated with the ability to cure such afflictions. Pilgrims flocked to her tomb, hoping for miraculous intercession and relief from suffering.
The burgeoning reputation of St. Dymphna’s shrine transformed Geel into a pilgrimage site for those seeking cures for mental distress. The local inhabitants of Geel, along with farmers from surrounding villages, began offering accommodation to these pilgrims and patients during their religious sojourns. This act of hospitality inadvertently laid the foundation for a unique system of care. Crucially, some pilgrims, finding solace and perhaps improvement in their condition, chose to extend their stay in Geel beyond the completion of their religious rituals. This organic development marks the nascent stages of the family foster care tradition in Geel. Long before the establishment of the first psychiatric hospital in Valencia, Spain, in the early 15th century, Geel already had a functioning, albeit informal, family foster care system in practice. This distinguishes Geel’s approach as a grassroots initiative driven by the community itself, rather than originating from ecclesiastical or medical directives as seen in Valencia or later in Pinel’s Paris hospital reforms.
The church played a guardianship role in this evolving project until 1852, after which the state assumed responsibility, placing it under medical supervision. The family foster care system in Geel reached its zenith just before World War II, accommodating nearly 4000 patients. These individuals came from diverse backgrounds, primarily from Belgium, but also from the Netherlands, France, England, Spain, and Russia, representing a wide spectrum of mental health conditions. The costs associated with this family-based care were typically covered by the patient’s family or their home community.
The selection process for host families in Geel was rigorous, emphasizing moral standing and community reputation. Families seeking to be “certified” to care for patients needed to demonstrate an impeccable record, free from legal or moral transgressions. This certification became a matter of social prestige and community standing, highlighting the deep-seated value placed on this form of care within Geel’s society. The tradition of providing foster care was deeply ingrained, becoming a generational raison d’être for many families. Certain families even developed reputations for specializing in the care of specific patient types, a source of considerable pride and recognition within the community.
To manage more acute situations, an infirmary was established in Geel. Patients who became unmanageable or acutely ill could be admitted for observation and care, with the aim of returning them to their foster families upon recovery. For those whose needs exceeded family-based care, transfer to a closed mental hospital was an option. The admission process to the infirmary typically involved a brief observation period, followed by a collaborative decision by medical staff and town representatives to determine the most appropriate placement for the individual, often involving informal recommendations based on patient needs and family suitability. This flexible and community-integrated approach enabled Geel to successfully retain and care for a remarkable 80% of individuals sent there for boarding care, showcasing the effectiveness and enduring nature of its family foster care programs, which began organically centuries ago and evolved into a sophisticated system of community-based mental health care.
