"The Great Ferryman": A Life in Points

Franco Basaglia was born in Venice on March 11, 1924. After finishing secondary school, he went to Padua to study medicine. He joined a group of antifascist students; betrayed by one of them, he was imprisoned for six months in the jails of the Italian Social Republic. The experience marked him deeply—as he would recount years later, when describing his entry into another closed institution, the psychiatric hospital.

After earning his degree in 1949, he began working at the clinic for nervous and mental illness, where he served as an assistant until 1961. From the start, he combined clinical practice with extensive writing and public reflection. In 1952 he earned his specialty in nervous and mental illness; the following year he married Franca Ongaro (they would have two children), beginning an exceptionally fruitful intellectual partnership.

In 1958 he gained his lectureship in psychiatry but, facing resistance in academic circles, he abandoned the university career track. He won the competition to direct the psychiatric hospital in Gorizia and moved there with his family. His first encounter with the reality of the asylum was harrowing. "I will not sign" became one of his earliest decisions as the new director. By refusing the practice of restraining patients with leather straps, Basaglia set the course he intended to follow: to free the "mad," to humanize that non-place—that atrocious, dark, filthy, violent, and humiliating space. Working with a team of young psychiatrists, he adopted the therapeutic community model based on Maxwell Jones's work in Scotland. New rules of organization and communication began to take hold; physical restraints and electroshock were abandoned; attention turned to the living conditions and needs of the residents; assemblies were organized; social gathering spaces opened; workshops began. The innovations were many. So were the obstacles.

In 1968 he published The Denied Institution: Report from a Psychiatric Hospital, which brought Gorizia's innovative experience to international attention and marked the birth of the anti-institutional movement. It became a symbol of the broader social upheaval, selling sixty thousand copies in four years. Basaglia's name began to circulate, along with his conviction that therapy must restore the fragile person to the center—rejecting the asylum and recasting therapy not merely as medication but as "action, as (…) taking responsibility for people's fundamental needs: the need for a home, work, wages, affection, relationships." For Basaglia it was essential to "draw near to illness and to the sick" through work that was "deeply dialectical." He stressed this in an interview with Sergio Zavoli for the documentary Abel's Gardens, filmed in Gorizia and featuring the voices of patients, which aired in 1968. Two years later Basaglia left Gorizia for Colorno (near Parma), where he began a transformation process that quickly proved just as difficult.

From 1971 he directed the San Giovanni psychiatric hospital in Trieste, which within two years was recognized as a pilot facility for mental health services. It was not easy ("Those were the hardest years," Beppe Dell'Acqua would later recall, "for people we were the long-haired psychiatrists, the communist psychiatrists and southerners, many of us came from the South"), but it was possible. In 1972 Marco Cavallo was born there—a mobile wooden and papier-mâché statue. On Sunday, February 25, 1973, the hospital's doors swung open ahead of the official closure four years later, when the asylum became San Giovanni Park, still active and thriving today.

On May 13, 1978, Law 180 (Voluntary and Mandatory Psychiatric Assessment and Treatment) was passed, fundamentally transforming psychiatric care in Italy. Despite his open reservations, Basaglia accepted responsibility for this landmark law, which from then on everyone simply called the "Basaglia Law." It mandated the closure of psychiatric hospitals and banned the opening of new ones; it shifted the focus of psychiatric intervention from institutions to the community, through outpatient centers and intermediate facilities; it established diagnostic and treatment services within general hospitals. The law became a model worldwide.

After giving lectures in Brazil in 1979, Basaglia left the Trieste directorship in November, handing it to Franco Rotelli, and moved to Rome as coordinator of psychiatric services for the Lazio region. Even as the first attacks on Law 180 began, he launched major deinstitutionalization programs (demanding a free hand from the regional administration). But in the spring of 1980, he showed the first signs of a brain tumor. On August 29, 1980, Basaglia died in Venice. He was fifty-six.

In the shock of his sudden death, amid the turmoil of a health system in transition and families left to fend for themselves, difficult years began. It fell to Franca Ongaro to fight for the real implementation of Law 180, to complete the dismantling of the asylums and the asylum mentality, to train workers, and to support families. She did this, from 1983 onward, also as a senator (elected as an independent on the Communist Party slate for two terms). She drafted various regional measures to promote a "culture of welcome" for the psychiatric patient; she secured support for families (especially the women who bore the actual weight of asylum closure); she pushed through the repeal of special legislation for the mentally ill; she ensured legal parity between mental and other illnesses; she created adequate health facilities in prisons for inmates' mental disorders; and she built collaboration between penal authorities and community psychiatric services. The path has been marked. But much remains to be done.