"A Normality for Us Without Confinement for Them": Notes On the Associations of Families of the Mentally Ill

Associations of families of the mentally ill arose in Italy in the early 1980s mainly in the country's northern and central regions. They denounced the inadequacies of an extramural service conceived of as an out-patient clinic filling the void left by the shutting down of asylums. The positions elaborated by these associations focus on four main themes: the distribution of the "burden of care" for the ill between ser vices and families; the ill-conceived interpretation of the families' needs owing to the professional's alleged tendency to "point the finger of guilt" at the families themselves; the demand for greater power in regard to decisions made by the services; the interac tion with the rights and liberties of the mentally ill. Two different ranges of problems are discussed. First, there is the conflict within the family between the interests and rights of its income-producing and its "dependent" members. This conflict points not to a loss but to an overload of functions shifted to the family at a time of rising expectations for the satisfaction of needs. It therefore calls for services of a new kind, i.e. services capable of making these conflicting interests and rights compatible. Second, extramural services either reject or misinterpret the asylum's labour-saving function. These services thus ascribe care for the material life of the mentally ill to the family's own resources alone. Hence the need in the field of mental health to rethink the type of approach to the family, and the necessity—crucial throughout the welfare system—of deep-going organizational and cultural transformations in order to revise the distribution of the time to care among families, public and private institu tions, conventional and voluntary services.