Udine was there 60 years before Basaglia

The artwork gets everywhere...

Not far to go today - just across to the other side of Udine to Parco di Sant’Osvaldo, the old asylum which is now a park for the use of the surrounding community.

It was built in 1904 as a state-of-the-art and progressive hospital for care of the mentally ill, to minimise any sense of oppression - a whole self-sufficient village on the outskirts of the town with its own farm, orchards, vineyards, bakery, kitchens, laundry, a maternity facility with ‘children’s colony’, theatre and cinema, electricity generator and - of course – church and nunnery. A garden city, Berenice Pegoraro, our guide, told us, with health-promoting activities in the fresh air. It was part of the Catholic Church’s influence and domination of all civic life at the time, and the ward staff were all nuns. Its buildings are small and spread out in green and leafy gardens, with the old male wards on the eastern side and female on the west. In the middle were all the facilities; a central building with bar, restaurant and social club remains open – we parked next to it and had our morning coffee there.

Once a staff bar and restaurant, now for everybody in the city

Unfortunately, the early history of being a progressive and bold experiment in more humane mental health provision only lasted about twenty years: the numbers being sent there increased substantially, and it became very overcrowded by the 1920s. Also, this was the beginning of Italy’s fascist years – and the level of general repression and lack of freedom increased the restrictive, heartless, and punitive practices in the hospital. This brought it into line with ‘normal’ psychiatric provision of the time – and its bold experiment, sixty years before Basaglia, was over.

We went into the shell of ward 9, on the female side, and saw the starkly bare corridors, dormitories, and layout. We were shown the ECT room and the seclusion cell, where misbehaving women were locked up for a week; its door had a viewing hole and slot at the bottom for meal trays. All rather grim – and the architecture not far away from my medical student time at Littlemore Hospital in Oxford in 1980, although the programme there was a therapeutic community. Short biographies of many of the women patients are hung up to make it into a type of museum – and pupils from local schools often visit for class projects.

Ward 9

The peak population was in the 1950s – with about 2000 patients and 1000 staff in the ‘total institution’, almost completely isolated from life outside. Many stayed all their lives there, and the commonest form of discharge was by dying: a chapel of rest amongst the central buildings is testament to this. The asylum itself finally died in 1999, twenty years after Law 180 was passed. ‘Territorial Services’ had been set up by this time – and all the patients in the hospital (who were still alive) had been discharged to them! The ‘territorial services’ are the part of care that is mostly provided by the cooperativa – in Udine’s case, Cooperative Itaca. I suppose the closest UK equivalent, though much less coordinated, is probably the third sector MH social care provision, plus maybe the new arrangements for social prescribing.

The whole site now has a slightly sad air, which might be at least partly due to it being a grey drizzly December day, but it clearly now has its new post-asylum life as a public park. Some of the buildings are used by the local services, some have been renovated and rented out, and many are very dilapidated. The offices of the central mental health administration for Udine are there - the city now has five geographically divided mental health services with two in the city and three for the smaller towns and cities in the province. For three months every summer, the whole park hosts a festival of arts and public events for the public to come to – theatre, book fair, music, art and craft exhibitions, discussions, celebration of cuisine, activities for children and much besides. 

The programme for the 2023 park festival

Although many good things continue I had the feeling that the festival itself has seen better days – as in so many places, the public domain is being slowly starved of institutional support and made to rely on individuals’ energy and enthusiasm, and cooperation with external organisations. For example, one of last year’s proposed events – a competition for young rock bands – was not given permission to take place in the park, or to be on the programme, because of deliberate bureaucratic obstruction.

We walked to a far corner of the site to a modern building, which was the reincarnation of Ward 9. Before moving to its current home, in 1995, while a few residents remained in the hospital, it was re-designated as ‘Comunità Nove’.  Although it was still in the old ward, it took on new principles of being OPEN, FREE and COOKING, and was staffed by ‘open-minded nurses and operatori’. There was no formal programme at the beginning, but simple ‘open house’ where those wanting to come would be treated with warmth and friendliness, and given a meal in good company. Over the following years more social functions grew, and in 2001 it moved to its new home.

When we walked in, it was clear we had walked into a different universe to the old Ward 9: it was a large room with about twenty multicoloured tables (painted by the residents) in the centre. As well as the atmosphere of bustle and purposeful activity, there was a drum kit, piano and guitar amp at one end, numerous potted plants everywhere and an extraordinary and range of artwork and sculpture – mostly abstract and multicoloured – covering every available wall, space and alcove. A three-metre monochrome Christmas tree was being constructed out of paper shreddings. They call it ‘cheap art’ – mostly made out of recycled rubbish. Katia, the artist behind most of it, has been with the community for many years – and has recently retired, but returned as a part-time volunteer. The aim was to have an ‘art revolution’ as transition from the old Ward 9, and indeed one corridor was like a museum of modern art, including having had its doors symbolically removed and painted with wild and provocative pictures, abstracts, cartoons and patterns. ‘Art is health’ we were told!  Although so much artwork is produced, it cannot be sold – but some is commissioned by external organisations. In one of the activity room proudly sits Basaglia’s original table from Gorizia, around which he and the equipe must have held many of their meetings, discussions and debates. There is also a poster of the community’s ‘identity card’:

 ID Card

NAME	Nine
TYPE OF SERVICE	District mental health day centre managed by Cooperative Sociale Itaca.
WHO ATTENDS	People with experience of hardship who risk social isolation and marginalisation who require personalised rehabilitation programmes; mental health workers; volunteers; friends.
HOW MANY	Approximately 80 people altogether, about 25 per day 7 staff (educatori & operatori) mostly part-time
ORDINARY ACTIVITIES	Cooking, cleaning, growing food, art laboratory, choir, rock band, discussion group, reading group, organisation meeting, sport (with Éventa Nuova Associazione).
EXTRAORDINARY ACTIVITIES	Sport; Artistic, Cultural, Theatrical and Musical events; book presentations and launches; debates; conferences
FOUNDING PRINCIPLES	Hospitality, collaboration, taking care of oneself and others, sharing, discussion, respect, equality in rights and duties, remembering, cultivating hope.
OBJECTIVES	Helping people on a path to feel better Finding their own balance and peace Promoting social inclusion Supporting relationships with others Acquiring and maintaining everyday skills Sharing problems and resources Demonstrating in various ways that change and transformation are possible!

Written by the ‘Current Affairs and Reality’ group of the Comunitá Nove

...and the original in Italian

Art is only one of many activities that the community has on offer. There is also a vegetable garden which produces food for their lunches as well horticultural training for members. Music is also important: there is a choir and a rock band, and numerous other group activities scheduled throughout the week. There are also two important talking meetings every week: community meetings for up to two hours on Monday mornings, and ‘current affairs actualite’ (for planning and decisions) for 2 hours or so every Friday morning. There are many contacts with the local community, including musical and artistic special events on the site, and often at weekend. The community prides itself on working with people’s strengths rather than their disabilities; they do not concentrate on diagnosis, and members are all seen as assets and not illnesses.

When it started, staff were recruited from enthusiastic but untrained individuals who were interested, particularly artists, but now regulations require them to all have professional qualifications as educatori or operatori. There are no clinically qualified staff; all the members of the community need to be engaged with the statutory mental health services. The members stay as long as they need, and usually move on to other services or independent living after several months or many years; some are scheduled to come every day, and others come only to special events – and all points between.

Thanks again for such a unique and special day: to Berenice Pegoraro for the tour and history, to Sandro Carpini who manages the community and to Katia the extraordinary creative force behind the wonderful art. I do hope to visit again – and to show younger contemporaries how things could, and can, be done.