Putting Diagnosis Into Brackets: Franco Basaglia,Radical Psychiatry,and Contemporary Mental Health Services

Abstract

Mental health services in England and Wales are facing a crisis. The vision of properly funded, flexible, and service-user focused community-based services, that was one of the key drivers of deinstitutionalization, has never been realized. This article argues that the failure of community care was the result of underinvestment. The current crisis is linked to the politics of austerity. The current landscape is a bleak one with a shortage of community-based alternatives, a shortage of beds leading to delays in admissions or patients being admitted to units far from their homes, and the Criminal Justice System becoming a default provider of mental health care. Mental health services have become dominated by a bureaucratic, risk assessment focused model of practice. The article uses John Foot’s recent magisterial biography of Franco Basaglia—a key figure in the anti-psychiatry movement of the 1960s—as a basis for a different approach to the provision of mental health care. Basaglia, a charismatic intellectual led a series of radical reforms to asylums in Italy in the 1960s and 1970s. These resulted in Law 180 sometimes referred to as Basaglia’s Law which resulted in the closure of the Trieste asylum. At the core of this work is a belief that services need to be based on relational therapeutic approaches. It concludes that far from being banished to the shores of 1968 radical movement excesses, Basgalia’s work has many important insights for mental health services today.