The psychiatric hospital "Maria Immacolata" in Guidonia, outside Rome, was founded by Don Uva in 1955 and is run by the Congregation of Handmaids of Divine Providence.
In 1978, when Law 180 went into effect, the hospital held 900 patients. Most remained because their conditions were far too severe for discharge. New admissions stopped after that, but about 650 people are still there—now carrying not only their illness but the weight of years.
For more than 15 years, Prof. Ezio Maria Izzo, head of the hospital's second ward, set out to help these patients—men and women destined to live out their lives there, in isolation and immobility. What he began has become, for many doctors and care workers, a model. Two small sheltered work cooperatives were created inside the hospital. Over the years, roughly 80 patients have become members. Some of them—about 10 percent—were eventually discharged thanks to this rehabilitative work. The rest found in these jobs their lasting ground for psychological and social recovery. The first cooperative runs a meeting space, a café, a small shop, and an embroidery and sewing workshop.
The second works in agriculture and raises farmyard animals. A few years ago, within this second cooperative, a community home was born—a shared house for 18 people, permanently set in a building attached to the hospital but meaningfully distant, about 300 meters away. Here the patients have living quarters and a large green space for vegetable gardens and their chickens, rabbits, turkeys, and sheep.
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The patients themselves manage the organization and make the decisions, with help and supervision from care workers who shield them from anything that might prove too difficult or cause anxiety.
The results show that work can become—together with minimal doses of medication—a tool and means of treating schizophrenic psychosis. This effort, sustained for 15 years despite many hardships and struggles, and the improvements in the patients themselves, prove the validity of the underlying principles and goals.
But this kind of work requires four basic rules, according to Prof. Izzo:
- The work must not require a high degree of specialization.
- The work must be freely chosen, and freely left and taken up again. It must therefore have creative value and no disciplinary function.
- The work must leave room for imagination and gradually bring the person doing it into contact with the outside world.
- The work must always result in creating an object directly connected to the person who creates it.
Because of all this, the air in these Guidonia cooperatives is stimulating, warm, and full of trust. As Prof. Izzo said at a recent OREUNDICI conference in Nocera Umbra: "In human relationships, and especially in the relationship between patient and therapist, lies the most important factor in determining a patient's fate. The trust experienced in a good therapeutic relationship is the foundation on which a person builds the capacity to hope."
The doctors and care workers in the team are convinced that every person always possesses at least some—and sometimes more than some—mental health. On that part of the person that still functions, tremendous work can be done. Starting from there, the person can truly take their life back into their own hands and become its author.
If this can happen in a psychiatric hospital, with the most severely ill, it can happen anywhere.
- Natalia Livi, 1993