A small but perfectly formed residential TC for adults with longstanding mental health needs

We could see a whole panorama of snow-topped Alps as Edoardo drove us north from Udine. The temperature in the car was 1C when we started, and we thought it might drop below zero with the altitude – but as the day warmed up, it didn’t. In fact our destination, San Daniele del Friuli, was not quite in the mountains. It is a town of 8,000 souls in the province of Friuli Venezia Giulia about 20km north west of Udine, 50km south of the Austrian border and 33km west of Slovenia. Edoardo, our guide, teacher and raconteur of all things Italian gave us a prodigious introduction to the geography, history, culture, literature, architecture and languages of the region as we drove there.  

We arrived at the pretty little town of San Daniele and, after a quick look in its ‘Sistine Chapel of the North’, then went through a door off a gracious arcade and up a colourful mural-covered flight of stairs to be greeted with warmth and hospitality by Valeria, who leads the ‘Group Apartment’ there. I often maintain that you can ‘smell’ a TC as soon as you walk in – but not through your nose, but by the whole sensory and social experience that hits you in the first few seconds. And this place, simply called ‘Group Apartment Via Garibaldi’, had it in abundance. We sat and talked about it for an hour or so, before being given lunch by, with and from the residents. Salmon with a pepper/tomato/caper sauce, salad and bread; followed by home-made tiramisu. Just lovely. Edouardo admits that, although he has worked in many different services, this is his favourite – and he thinks it is probably the best in Friuli.

When I asked what was ‘the magic ingredient’ I got two different answers, one for my left brain and one for the right. Edoardo provided the one in the rational universe – about good communication with the local statutory MH services, and a tightly defined contract with the service provider, ‘Cooperativa Itaca’ – a large third sector organisation with many projects across the area. But I preferred Valeria’s instant response, possibly slightly flustered by the question, of ‘passion’. Exactly! Almost indefinable, but life-affirming and enough to give you a reason to jump out of bed every morning and fight for what you believe in.

Here's a few facts about the service – which, although called a ‘group apartment’ should certainly be thought of as a TC as far as I could judge:

·         A ‘small outpost’ of Udine’s services
·         Two apartments on adjacent floors in city centre, has balconies but no garden.
·         Previously council-owned but transferred to MH service
·         Funded by the local MH service
·         8 beds maximum (equivalent of 1 bed per 1000 population)
·         12 staff – educatori and operatori.
·         Useful concept for staff is as ‘pedagogists’ – more social and less didactic type of training
·         None are clinically qualified (doctor, nurse, psychologist, psychotherapist)
·         Residents chosen and referred by local MH service, and receive continuing care from them
·         Difficult culture change process (to being open and relational)

·         Long-term sustainability threatened by
o   Gradually diminishing resources, year-by-year
o   Staff stress and burnout
o   MH economy being increasingly opened to for-profit enterprises

So, many thanks to Valeria, Umberto and all the residents for their hospitality – and congratulations to them and the other staff for maintaining something so special in adverse circumstances.

No trip to Italy is ever complete without the food and wine, and Edoardo was, once more, an extraordinarily knowledgeable guide. We went to atmospheric and sometimes tiny restaurants, trattorie, and pizzerie that tourists would never know about – and I doubt many locals would.

We sampled wines which were only available in the towns and villages in which they were made. Never ostentatious or expensive – just homely, local and wonderful. And thanks again, Edoardo – for a thoroughly excellent and thoroughly Italian experience of a day!