Since the medieval ages, the small town of Geel, Belgium has had an eccentric but vital vocation: its inhabitants have created a safe home of sorts for the mentally insane. Inspired by St. Dymphna, patron saint for the mentally ill, Geel became a place of sanctuary for the mad: patients were lodged in the homes of local townspeople as “boarders,” and were expected to work alongside and participate in family life. Mike Jay shares the town’s story at Aeon Magazine:

The family care system, as it’s known, is resolutely non-medical. When boarders meet their new families, they do so, as they always have, without a backstory or clinical diagnosis. If a word is needed to describe them, it’s often a positive one such as ‘special’, or at worst, ‘different’. This might in fact be more accurate than ‘mentally ill’, since the boarders have always included some who would today be diagnosed with learning difficulties or special needs. But the most common collective term is simply ‘boarders’, which defines them at the most pragmatic level by their social, not mental, condition. These are people who, whatever their diagnosis, have come here because they’re unable to cope on their own, and because they have no family or friends who can look after them.

Sadly, Geel’s patient population has been steadily declining—partly because of modern medicine and psychiatry, but also because of modernization’s effect on the familial, vocational life of Geel: “Few families are now able or willing to take on a boarder,” writes Jay. “Few now work the land or need help with manual labor; these days most are employed in the thriving business parks outside town … Modern aspirations—the increasing desire for mobility and privacy, timeshifted work schedules, and the freedom to travel—disrupt the patterns on which daily care depends.” Even as people remark upon Geel’s incredible familial, communitarian response to mental illness, the societal structures necessary for its existence are fading away.

The traditional community is often derided for its tribal instincts: for possessing a dangerous tendency toward discrimination and judgment. But Geel’s story exemplifies an idealized community: one in which care is dispensed freely and charitably within small, private associations. The needy find solace within a family structure, rather than within the solicitude of the state. As Jay notes, “The people of Geel don’t regard any of this as therapy: it’s simply ‘family care’.”

Geel also shows us community’s vital role in humans’ mental health. Geel’s population is not huge, and its landscape is largely rural. This simplicity and closeness—to the land and to people—seems to have healing powers for the mentally ill. Even without medication, psychiatrists, and specialized care, “boarders” have flourished in Geel for hundreds of years. Perhaps what we really need, more than drugs or doctors, is human nourishment. “However we might categorise or diagnose their conditions, and whatever we believe their cause to be—whether genetics or childhood trauma or brain chemistry or modern society—the ‘mentally ill’ are in practice those who have fallen through the net, who have broken the ties that bind the rest of us in our social contract, who are no longer able to connect,” Jay writes. “If these ties can be remade so that the individual is reintegrated with the collective, doesn’t ‘family care’ amount to therapy? Even, perhaps, the closest we can approach to an actual cure?”

It’s a vital question to consider, especially as we confront urbanization and individualism within our culture. What happens if private associations begin to die away—if the familial and vocational structure of small communities erodes with the rise of more atomized lifestyles? Such social structures may lead to larger paychecks and prominence, but if Jay is correct, they may also harm human flourishing.