«The psychiatric hospital is a concentration camp, a site of elimination, a prison where the inmate knows neither why nor how long the sentence will last, left as he is to the arbitrary judgment of subjective assessments that vary from psychiatrist to psychiatrist, from situation to situation, moment to moment." So wrote Franco Basaglia in 1973, introducing Maria Luisa Marsigli's book The Marchesa and the Demons, as he described the reality of the asylum. Five years later, on May 13, 1978, the law bearing his name was enacted.
The name belonged to a man who inspired one of the twentieth century's great reforms. By closing the asylums, Basaglia ferried Italian society—and beyond—across the threshold between two epochs. Much remains to be done, but much has already been accomplished.
It was 1959 when Franco Basaglia, born in Venice on March 11, 1924, arrived at the psychiatric hospital in Gorizia after his training in Padua. The assignment marked a turning point. Named director of the Friuli hospital with its 650 patients, Basaglia had no direct experience in psychiatric institutions. Yet he refused the conventional management of mental illness from the start, including the chilling practices embedded in standard protocols. The structures, rules, and customs of the asylum were, in his view, instruments of institutional violence—mechanisms of segregation rooted in class prejudice and animated by a clear desire to punish.
Basaglia ordered the removal of mechanical restraints and electroshock therapies. He tore down bars, grates, and nets. He opened the hospital to the outside world and introduced psychiatric medications. He retrained the staff. Taken together, these interventions were radically ahead of their time, especially because they led to the creation of a "therapeutic community."
What Basaglia did was to place the person with mental illness at the center of the picture—perhaps for the first time. He stopped sorting them into categories and began to listen. What had been entirely absent was communication, and that was what had to start.
Basaglia had a clear vision. He worked immediately toward the destruction of the asylum system, convinced that isolation and confinement only worsened symptoms. By 1964, he was calling openly for its abolition. In London, at the first international congress of social psychiatry, he presented a paper titled The Destruction of the Psychiatric Hospital. The title said it all.
The framework was clear, but the project was just beginning. In 1968, as discussion intensified and the public began to hear of this unusual doctor, Basaglia left Gorizia. He needed time to study, reflect, and travel—to encounter other contexts. He spent time as a visiting professor at a Community Mental Health Center in New York, then moved to Parma. In 1971, he arrived in Trieste as director of the San Giovanni psychiatric hospital. This was the pivot point: mental illness had to be moved beyond the barrier of separation, the boundary between inside and outside had to be broken.
The person in an asylum was the product of a confinement designed—like prison—to punish through separation. Creating new institutions that rejected violent methods would not solve the problem. As early as 1968, speaking in Rome at a conference on Society and Mental Illness, Basaglia warned against the risk that the therapeutic community itself, born as a break with the past, might become a new ideology. Behind the appearance of democratic relations, even "more tolerant institutions" would preserve the original function of social control.
The moment that changed history came on a precise date: Sunday, February 25, 1973, when the doors of the Trieste asylum swung open, years before its official closure.
Many books have been written by and about Basaglia—those wanting to explore further should consult his Collected Works 1953–1980, first published by Einaudi and reissued in 2017 by Il Saggiatore. But it is a children's book, The Big Blue Horse (Orecchio Acerbo 2012) by Irène Cohen-Janca, that captures most powerfully the profound and radical meaning of the revolution that began that day. The illustrations by Maurizio A.C. Quarello are essential to this—a play of shadows and colors in white, gray, black, and blue that guides us through a journey that has begun but is far from over.
In 1976, Basaglia won a university chair and was offered a position at the University of Pavia. Pushed to the margins of academia until then, "the professor" did not move. He stayed at San Giovanni.
It was at San Giovanni that Law 180 found him in 1978—Voluntary and Mandatory Psychiatric Assessments and Treatment. Despite his unspoken reservations, Basaglia would not deny paternity of the law. This framework law closed psychiatric hospitals and forbade the opening of new ones. It shifted the center of psychiatric intervention from hospitals to communities, through outpatient clinics and intermediate facilities. It created psychiatric services for diagnosis and treatment within general hospitals. From that moment on, everyone would simply call it "Basaglia's Law."
The work is far from complete. But it is to the intelligence, passion, and heart of this man—who walked the halls of San Giovanni without a white coat and asked to be called simply Franco—that the world owes the first law to abolish psychiatric hospitals. And to establish a principle denied for centuries of psychiatric history: that people with mental illness have the full rights of citizenship.