Mental Health Association in New York State, Inc.
(Publication Archives)

Community Connections, Spring 2003

An Alternative Approach to Recovery - St. Dimpna
Excerpted and edited from “Geel, Belgium: A Radical Model for the Integration of Deviancy,” in the Community Imperative, by Ellen Baxter.

The system of care for the mentally ill and retarded in Geel, Belgium is based on a religious tradition stemming from the legend of St. Dimpna. Currently 1,000 families within this town of 30,000 citizens have in their private homes one, or a maximum of two patients, or boarders as they are called. Families care for a total of 1,100 individuals; the back-up central hospital houses 250 in-patients. There has been no recruitment of caretakers by the central administration; in fact, a waiting list has always existed. The families are not given any specific training, psychiatric history or diagnosis before they receive an individual boarder. They are expected to rely on intuitive understanding and skill, which they have developed over years of continual exposure to other boarders within their homes or neighborhoods. Hundreds of families have housed mentally disabled persons for generations.

Excluding the families who "inherit" a boarder from their parents, other caretakers are initially motivated to take a patient for the supplemental income it offers and the work he/she will do with the family. The policy of limiting the number of patients to two per family insures that boarding cannot be the sole source of income. Children and boarders develop attachments, the boarders become involved in family festivities and crises, and over time, emotional bonds develop which turn the boarder into an integral part of the family group. The boarders, most of whom are referred by traditional institutions, are considered to be a chronic population in need of supportive, long-term care.

Many of the boarders in Geelian families are severely mentally ill and retarded individuals who are not considered to be suitable candidates for the majority of community care programs in the United States. To the dismay of professionals, Geelians just do not see the boarders as psychiatric patients. Boarders are included in the work and recreational activities of their families and are also free to participate on their own in the community sphere.

Boarders are quite visible in the churches, cafes, local fairs, the movie house, and at sports events. Cafes are places of social interaction for all Geelians. Boarders socialize with others in cafes, some spend their time actively hallucinating at a corner table, others cannot be distinguished from the “normal” customers. When a boarder begins to take off his clothes or begins to direct traffic, a passerby will intervene and take the individual home. The police, too tend to be protective of the boarders. According to the chief of police, Geel has a lower crime rate than the surrounding communities.

posted 6/13/03