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Franco Basaglia (; 11 March 1924 29 August 1980) was an Italian psychiatrist, neurologist, professor, and disability advocate who proposed the dismantling of psychiatric hospitals, pioneer of the modern concept of mental health, Italian psychiatry reformer, figurehead and founder of Democratic Psychiatry, architect, and principal proponent of Law 180, which abolished mental hospitals in Italy. He is considered to be the most influential Italian psychiatrist of the 20th century.
He died in Venice.
When Basaglia arrived at Gorizia, he was revolted by what he observed as the conventional regime of institutional 'care': locked doors only partly successful in muffling the weeping and screams of the patients, many of them lying nude and powerless in their excrement. And Basaglia observed the institutional response to human suffering: physical abuse, , ice packs, bed ties, ECT and insulin-coma shock therapies to 'quiet' the melancholy and the terrified, and to strike terror in the agitated and the difficult.
In 1961, Franco Basaglia started refusing to bind patients to their beds in the Lunatic Asylum of Gorizia. He also abolished any isolation method. From this initiative started a wide theoretical and practical debate all over Italy. Such a huge debate resulted in the endorsement in 1978 of a national reform bill in 1978 that provided the gradual but radical closure and dismantling of the mental hospitals in the whole country.
Basaglia insisted that much in the inveterate stereotypes of madness was actually the consequence of institutional conditions, but not a real danger which the walls of a mental hospital had been required to contain. He considered psychiatric hospital as an oppressive, locked and total institution in which prison-like, punitive rules are applied, in order to gradually eliminate its own contents; and patients, doctors and nurses are all subjected (at different levels) to the same process of institutionalism.
Basaglia recognized that many of the characteristics of his patients which were believed to be inherent in their mental illness, such as the vacant stares and the repetitive gestures and movements, appeared to dissolve as the patients left the confines of the asylum. Basaglia concluded from this that society would not know what mental illnesses were, or what limitations they would inherently put on persons with them until both staff and patients were freed from the beliefs, attitudes and culture of the asylum. Basaglia was concerned that, without the complete closing of asylums, mental health professionals would unknowingly reconstitute the asylum culture in community facilities. As long as confinement remained possible, professionals would continue to regard themselves as the ultimately responsible parties, and patients would continue to regard their agency and freedom as dependent on the doctor's will.
Basaglia considered mental illness as the consequence of the exclusion processes acting in social institutions. He stated: "The mental illness is not reason and origin but the necessary and natural consequence of the power dynamics–related exclusion processes potentially and concretely acting in all social institutions. It is not sufficient to liberate the ill to restore life, history to the persons who were deprived of their life, their history.""La malattia mentale non è ragione e origine, ma conseguenza necessaria e naturale dei processi di esclusione legati alla dinamica del potere, potenzialmente e concretamente attivi in tutte le istituzioni sociali. Non basta liberare i malati per ridare una vita, una storia, a persone che sono state ptivate della loro vita, della loro storia." See:
Basaglia and his followers believed that psychiatry was used as the provider to the establishment of scientific support for social control. The ensuing standards of deviance and normality brought about repressive views of discrete social groups. This approach was nonmedical and pointed out the role of mental hospitals in the control and medicalization of deviant behaviours and social problems.
In 1968, L'istituzione negata ('The Institution Denied'), edited by Franco Basaglia, was published. Widely read all over Italy, this book not only documented and analyzed the changes at Gorizia but also carried anti-institutional debate into other areas: factories, universities and schools.
Giovanna Russo and Francesco Carelli state that back in 1978 the Basaglia reform perhaps could not be fully implemented because society was unprepared for such an avant-garde and innovative concept of mental health. Thirty years later, it has become more obvious that this reform reflects a concept of modern health and social care for mental patients. The Italian example originated samples of effective and innovative service models and paved the way for deinstitutionalisation of mental patients.
Giovanni de Girolamo with coauthors argues that Basaglia's contribution was crucial to move psychiatric practice into the realm of health care and give visibility to psychiatry.
P. Fusar-Poli with coauthors argues that thanks to the Basaglia law, psychiatry in Italy began to be integrated into the general health services and was no longer sidelined to a peripheral area of medicine.
In the 2001 National Mental Health Conference, Italian neurologist and laureate of the 1986 Nobel Prize in Physiology or Medicine Rita Levi-Montalcini expressed her admiration for Franco Basaglia by calling him the founder of the new conception of mental illness, a magnificent scientist and fine human being who really lived the tragic problem of mental illness.See 7:45 from the start of the film fragment:
British clinical psychologist Richard Bentall argues that after Franco Basaglia had persuaded the Italian government to pass Law 180, which made new hospitalizations to large mental hospitals illegal, the results were controversial. In the following decade many Italian doctors complained that the prisons had become depositories for the seriously mentally ill, and that they found themselves "in a state psychiatric-therapeutic impotence when faced with the uncontrollable paranoid schizophrenic, the agitated-meddlesome maniac, or the catatonic".Bentall cites Palermo's article: These complaints were seized upon psychiatrists elsewhere, eager to exhibit the foolishness of abandoning conventional ways. However, an efficient network of smaller community mental health clinics gradually developed to replace the old system.
The president of the World Phenomenology Institute Anna-Teresa Tymieniecka states that Basaglia managed to pull together substantial revolutionary and reformatory energies around his anti-institutional project and created the conditions which within a few years brought to the reform of mental health legislation in 1978. This reform was introduced amongst great enthusiasm and bitter criticism, hostility and perplexity, critical and sometimes unconditional support. Basaglia thereby managed to inflict a salutary shock on Italian psychiatry, which had previously been torpid.
American psychiatrist Loren Mosher called Basaglia the most innovative and influential European psychiatrist since Sigmund Freud.
Francine Saillant and Serge Genest assert that Basaglia's reform of psychiatry in Italy, a renewed vision of Italian society, and radical critique of public institutions made him one of Italy's greatest, most progressive intellectuals and a leading figure of the second half of the 20th century.
Thomas Szasz had a radically critical opinion about the work of Basaglia. In 1986, in the preface to the book by Giorgio Antonucci 'I pregiudizi e la conoscenza critica alla psichiatria', Szasz writes the following words about the misunderstanding of the ideas of Basaglia:
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