Patrick Williams | *Tsiganes ou ces inconnus qu'on appelle aussi Gitans, Bohémiens, Roms, Gypsies, Manouches, Rabouins, Gens du voyage...*, Paris, Presses Universitaires de France, 2022, pp. 601.

Lise Foisneau

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OpenEdition
Journals

**Electronic version**

URL: https://journals.openedition.org/anuac/506

DOI: 10.7340/anuac2239-625X-6063

ISSN: 2239-625X

**Publisher**

Società italiana di antropologia culturale

**Printed version**

Number of pages: 179-182

**Electronic reference**

Lise Foisneau, "Patrick Williams | Tsiganes ou ces inconnus qu'on appelle aussi Gitans, Bohémiens, Roms, Gypsies, Manouches, Rabouins, Gens du voyage..., Paris, Presses Universitaires de France, 2022, pp. 601.", Anuac [Online], 12 (2) | 2023, Online since 31 December 2023, connection on 14 October 2024. URL: http://journals.openedition.org/anuac/506 ; DOI: https://doi.org/10.7340/anuac2239-625X-6063

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RECENSIONI

**Francesco SCOTTI** | *Per una storia della riforma psichiatrica in Umbria. 1.2 Nascita ed evoluzione di una psichiatria di comunità in Umbria*, Perugia, Morlacchi, 2021 (vol. 1, pp. 448), 2022 (vol. 2, pp. 506).

Despite the extraordinary breadth and importance of radical psychiatry in Italy in the Sixties, Seventies and Eighties, there has been too little critical and historical work which has reflected on this complicated and fascinating “movement”. Much of the material which is available has often been celebratory, or merely descriptive. The monumental work of Francesco Scotti, when added to that already published by the late Ferruccio Giacanelli, is the exception. It would be no exaggeration to argue that these three volumes provide us with a full, open, detailed and critical account of the extraordinary role played by radical psychiatry in the region of Umbria, from the Sixties onwards. Scotti’s work has the great merit of openness – it never celebrates change, or pats itself on the back, but rather analyses, discusses, questions and deconstructs. As both the protagonist of the movement in Umbria, and its historian and chronicler, it would have been easy for Scotti to exalt the vast progress made by the movement in that region – in closing down repressive and damaging systems of care for mental health and in opening up new institutions and systems. But this is never the way these volumes work.

No other regional movement has taken this approach to its own history, with the possible exception of Arezzo. These volumes represent a vast historical, pedagogical, and psychiatric project – a narrative but also – crucially – a forward-looking account which takes the story up to today, and is always open to questions, to errors as well as successes, and to divisions debates and fissures which also marked this movement. It is also a global account, not inward-looking, but always looking outwards. This critical approach, like the meetings which were held with patients and doctors during the “heroic” phase of the movement within the asylum – is in the spirit of the movement it re-counts and analyses.
There is so much in here which is of interest, it is difficult to choose what to discuss – so I will draw out some of the overarching themes which emerge from the books. First, there is the asylum itself – the *manicomio* – in Perugia a vast institution in both a physical and a medical sense, which dominated everything else. Scotti shows time and again how the asylum, despite the efforts of the movement, was extremely difficult to “destroy”. Even when the radical psychiatrists had moved onto mental health centres and decentralised care, the asylum didn’t go away – and continued to absorb resources, energy, politics – both in the city and the region but also in the minds and consciousness of the general public concerning mental health and illness. Even when the psychiatrists tried to ignore it, they were drawn back to it time and time. It took decades for this presence to finally fade, and even now, it remains part of the debate. One conclusion to be drawn from these books is how difficult it was to move on from the asylum system, and how its power was embedded in the health system and in the minds of those who had to deal with mental illness.

A second key theme is the ferment of ideas, meetings, discussions, debates and innovation, often discussed with global experts and thinkers, which moved around the world of radical psychiatry in Umbria from the Sixties onwards. This was a set of themes and problems which mobilised an entire region, and which created new forms of institutions, of care and of thinking about mental health. Of course, there was often discussion, and division, over the “correct” path towards mental health – through society, through the family, through the treatment of children. Which therapies, where, and how? Which kinds of treatment? Who was to be treated? Who decided? These are all questions which run throughout Scotti’s book and open up issues which are still relevant today. Umbria in this sense had the distinction of always concentrating on the resolution of problems, not on the creation of over-arching “theories”.

A third theme lies in the increasing bureaucracy and its dead weight which Scotti details, and critiques, in the latter parts of the volume. The proliferation of acronyms and organisations, which Scotti treats with his usual sense of lightness and irony, are a symptom of this problem. Rules, regulations and problematic power structures have been imposed on systems which were marked by creativity and freedom. Judicial power, once liberatory in Umbria in the earlier stage (in some instances) became more oppressive, as psychiatrists lived under fear of criminal prosecution for simply doing their job or taking the risks they saw as necessary in difficult, daily situations. Scotti’s use of stories and micro-histories is especially effective here. Certain extraordinary personalities from the move-
ment emerge with force from his account – Carlo Manuali, for example – who has been more or less ignored in many studies of the Italian radical psychiatry movement, but who was, undoubtedly, one of the most original practitioners and thinkers around themes of mental health and society from that period.

Scotti also details the role of politics, and of a series of reforms, including what he refers to as *Aziendalizzazione* – the business-type approach to health care. Here we are presented with a story of fragmentation, of a loss of autonomy and freedom to experiment, and of – at times – a sense of a return to the past – with patients being treated as a problem rather than with care and attention, and the political system tinkering dangerously with a system which had worked so well, and had been recognised not just in Italy, but also elsewhere, as an exemplary set of institutions in terms of mental health care. Here, we can see issues with the lack of coordination between services, and, at times, the excessive use of forced treatment provisions which were adopted so sparingly in the past, when the idea of “non-ricovero” was the over-arching aim of all those involved in the system.

Finally, these books also provide a rich social history of Umbria through many of the stories and vignettes which Scotti recounts. Psychiatrists working in the system in the period of change never saw mental illness in isolation, but also in line with social context, the family, the territory. Factory work and conditions could lead to forms of addiction and illness in themselves, and some extraordinary examples of this are detailed in this book.

On every page of these books I found something which was worth thinking about and reflecting upon, so much so that I covered my volumes with pen marks, questions, queries, notes to myself to follow up on certain points, and bookmarks. This experience with all its richness, and with all its highs, and lows, successes, and failures, experiments and tragedies, deserves to be studied by all those interested in what happened with mental health systems in Italy (and the world) between the Sixties and the Nineties and beyond, and by all those with an interest in mental health today. The danger is that this whole period, this whole movement, this entire period of radical change, will be forgotten, and that the asylum will return – in another form, of course. These volumes are also a warning, and an incentive, to stop this happening.

John Foot
University of Bristol
j.foot@bristol.ac.uk