Geel, a town with a narrative stretching back to the 7th century, has long been recognized as a sanctuary for individuals grappling with mental illness. While formal records trace back to 1693, the ethos of Geel’s distinctive approach to mental healthcare, particularly its family foster care system, is rooted in a much earlier epoch. To truly understand when did the foster care programs in Geel begin when, we must delve into the captivating legend of St. Dymphna and the unique societal fabric of this Belgian town.
The genesis of Geel’s compassionate system is interwoven with the tale of St. Dymphna, an Irish princess of the 7th century. Raised in devout Christianity in what is now County Tyrone, Dymphna’s life took a tragic turn when she fled her homeland to escape the unwanted advances of her father, who had succumbed to madness. Pursued and ultimately murdered by her father in a forest near present-day Geel around 600 AD, Dymphna was buried at the site. This location later became revered, marked by the erection of the Church of St. Dymphna.
During this era, symptoms of mental illness were often misconstrued as demonic possession. A prevailing belief held that contact with religious relics of saints could alleviate this perceived ‘possession’. St. Dymphna, due to her story of resisting a ‘possessed’ king, emerged as a potent figure believed to intercede and cure such afflictions. Pilgrimages to Dymphna’s tomb became common, with fervent hopes for miraculous cures for the ‘possessed’, or mentally ill. Geel’s reputation as a center for healing those with mental health conditions began to solidify through reported miraculous recoveries attributed to St. Dymphna’s intervention.
Crucially, the burgeoning pilgrimage to Geel inadvertently laid the groundwork for its pioneering foster care system. Inhabitants of Geel, along with farmers from neighboring villages, started offering lodging to pilgrims and patients during their sojourns. Remarkably, some of these pilgrims, seeking continued solace or care, remained in Geel even after their religious observances concluded. This organic evolution, arising from community hospitality extended to those seeking healing, marks the true, albeit informal, beginnings of family foster care in Geel. Significantly predating the establishment of the first psychiatric hospital in Valencia, Spain, in the early 15th century, Geel’s family foster care system was already a functioning reality. Unlike institutions founded by church officials or physicians, Geel’s initiative was community-driven, born from the compassion of the local populace – the peasants and townspeople of Geel.
The Church played a custodial role in this developing system until 1852, after which the state assumed governance, introducing medical oversight. The Geel model flourished, reaching its zenith just before World War II, accommodating nearly 4000 patients within its family foster care network. Patients hailed predominantly from Belgium, but also from the Netherlands, France, England, and even further afield, including Spain and Russia, representing a wide spectrum of mental health conditions. The financial responsibility for patient care rested with the patient’s family or their originating community.
A noteworthy aspect of Geel’s system was the rigorous selection process for foster families. Families aspiring to host patients underwent a certification process, a matter of considerable social prestige. Certification, in essence, required an impeccable family record, devoid of any legal or moral transgressions by any family member, judged against the prevailing moral standards of the time. This certification was not merely a bureaucratic step but a badge of honor, signifying the family’s esteemed standing and moral integrity within the community. The tradition of caregiving became deeply ingrained, passed down through generations, evolving into a raison d’être for many families. Certain families even developed reputations for specialized care, adept at supporting specific types of patients, a source of both community recognition and personal pride.
To complement the family-based care, an infirmary was established in Geel. This served as a short-term admission facility for patients who became acutely unwell or unmanageable in their foster homes. Upon stabilization, patients were typically reintegrated back into their respective foster families. In instances where continued foster care was deemed unsuitable, patients were transferred to more conventional, enclosed mental hospitals. The admission process at the infirmary typically involved a brief observation period. Subsequently, medical professionals, in collaboration with town representatives, determined the most appropriate care pathway for each individual. Placement decisions were often informal and consensus-based, with staff members suggesting suitable family placements based on patient needs and family capabilities. Remarkably, Geel demonstrated a high degree of success in patient retention, with approximately 80% of individuals sent for foster care remaining within the Geel system. This enduring commitment and community-based approach underscore the profound historical significance of Geel as a pioneering model in humane mental healthcare, answering the question of when did the foster care programs in Geel begin when with a narrative that spans centuries, rooted in the 7th-century legend of St. Dymphna and evolving into a structured system by the medieval period and beyond.
