Across Trentino, Pergine was long synonymous with the asylum. The sprawling buildings of the old psychiatric hospital sit at the edge of town on broad, fenced grounds that rise up the mountainside toward an ancient castle. Halfway up the slope, in a forest of larch, fir, and birch, stands the renovated maso—a mountain farmstead—that now houses the community. Father Beppino Taufer tells the story of the Community he founded and directs.
The Community was born five years ago amid countless obstacles and suspicions.
The Camillian proposal awakened fears that the asylum would be resurrected, that there would be "interference" in public psychiatric care. For context: the Pergine hospital still holds 350 elderly patients who could not be discharged during the psychiatric reform, though I must say the staff work genuinely to improve their quality of life. To be precise: the initial Camillian proposal won favor from political administrators, who saw a chance to launch an "intermediate structure." But it faced opposition from psychiatric doctors, who suspected an attempt to rebuild a custodial institution. Fortunately, misunderstandings were eventually cleared—especially as the more "avant-garde" positions of Law 180 registered a series of setbacks—and today there is good collaboration. In fact, attempts are underway to replicate this model of Maso San Pietro elsewhere.
The Community hosts adult schizophrenic patients, average age 35, each followed by their own psychiatric service to ensure therapeutic continuity: their doctors visit periodically. The current 36 residents are divided into two "centers." Here at the Maso, there are 20—mostly young people we believe can be treated and reintegrated into their home environments. The others, older and in chronic conditions, are housed in Building 14.
In five years, roughly eighty patients have passed through the Community—a measure of its rehabilitative effectiveness. Of those who have left, more than thirty are in their own homes, doing something with their lives, supported by family. None are on the street or institutionalized.
We close on Saturdays and Sundays to avoid creating institutionalized residents. Some, though few, return to family. Others go to diagnostic and care units at hospitals, others to more or less protected facilities, others to wherever they can find. This is an urgent problem we are committed to solving.
A serious challenge is that because we are not "custodial," we lack the proper tools to handle residents' crises adequately. Bear in mind they move about freely, yet at least half are high-risk cases who would find placement only in specialized diagnostic and care services.
Training staff has been a primary task. I hold a degree in psychology from the Lateran University, with specialization in diagnostic psychology and counseling. I spent a year studying programs being tried elsewhere. Over these years I have traveled a long personal journey, moving from traditional positions of superiority, fear, aversion, and distrust toward the mentally ill to positions that now seem nearly opposite. Naturally these carry the risk of a kind of symbiosis with the patient. I believe the middle ground—neither excessive distance nor excessive involvement—is best for appropriate psychiatric intervention. I advocate for the most human psychiatry possible, in a welcoming environment that reduces the weight of other residents' tensions. I believe in integrated intervention, with diverse professional figures. I hold firm faith in the dignity of the mentally ill.
For staff here without specific psychiatric training, I have committed to organizing training courses and various pilot programs.
Non-medical staff are hired by us Camillians. Medical staff are provided by the Health Service.
Beyond the doctors following individual patients, our team includes two full-time psychiatric physicians; a psychologist and a female psychologist for initial contact with residents; and various consultants (social workers, art therapists, etc.).
We have no money problems here. I do not have to beg or negotiate with the Health Service. Expenses are paid by the public authority. We have a garden, greenhouse, and orchard that bring in some income, but resident work serves only therapeutic purposes, so we have not formed a cooperative. No family member pays the patient's pension—I do not wish to involve myself in that. Here we use a bimodal method: training in behavioral skills for the resident's psychological wellbeing, and more dynamic activities aimed at activating communication and expression (music therapy falls into this second mode). We nurture relationships with residents' families, following the family program of ARS (Association for Schizophrenia Research). We believe contact between our team and the family is one of the most crucial moments toward our goal: reintegrating the resident into his world.
This is a pilot program even for the Camillians, who have no tradition of psychiatric care like this. We do not perform miracles, but we are cited in scientific publications.
I believe it is our Camillian duty to be available 24 hours a day to these people, to whom others may dedicate only minutes a day. We are also forced to spend greatly in vital resources—both because our staffing is lean (21 operators working 36 hours weekly, with holidays) and because of the residents' particular needs. Living with them costs us no small amount in peace of mind, for me and the other staff, among whom there is therefore some turnover.
At first, I enjoyed talking about what mental illness is, what the problems are, what ought to be done. Later, I found it unseemly. Time spent working alongside the sick, changing their reality day by day, is worth far more than talking about their problems.
- Sergio Sciascia, 1990
How It Works
Maso San Pietro Community welcomes adult psychotic patients, male and female, from Trento province whom it is believed possible to treat. The community is open Monday through Saturday morning, when residents return home or elsewhere.
All residents are followed by their respective specialists from their home Health Service, with whom treatment and rehabilitative activities are agreed upon.
The Community's goal is to reintegrate patients into their home environments. It is managed by Camillian fathers (currently a priest and a deacon) with whom the Local Health Service has signed an agreement.
The Health Service guarantees specialized medical care and necessary nursing staff.
The Community's staff includes: the two Camillian religious, professional nurses, social-health auxiliaries, occupational therapists, leisure-time coordinators and activity leaders, consultants for psychotherapy and administration, volunteers, and conscientious objectors.
Life in the Community
Maso San Pietro is welcoming, well-furnished (with fixtures and equipment usually absent from facilities for the mentally ill), and clean (residents themselves maintain cleanliness). Rooms are pleasant, single or double occupancy. Residents may freely use the elevator and may go out, provided they write it in the register each morning. Being difficult cases, they may face difficulties in town, though the community has largely accepted them: they go to the public pool and theater like any other visitors. There is a library.
Friday morning Father Taufer celebrates Mass. "It is a beautiful moment," he says, "to which residents come willingly, and sometimes offer homilies based on ideas they suggest themselves."
The weekly program is precisely structured: group discussions on plans and weekend reviews, group therapy, swimming, music therapy, art therapy, exercise, meals, cleaning, medication, rest…