Teramo Psychiatric Hospital
The Teramo Psychiatric Hospital was one of the largest and most famous mental hospitals in southern Italy and Europe. It was named after Antony the Great . The building, created in 1323, is one of the most famous structures in the historic old town of Teramos . It was used with changing functions, including 117 years as a psychiatric institution, which was closed on March 31, 1998.
history
Creation as a hospice
It was the plan of a certain Bartolomeo Zalfone, citizen and benefactor of the city, to provide accommodation for the sick and needy on February 28, 1323. He dedicated it to Saint Anthony the Great. For this purpose he made parts of his house available and entrusted the care and administration of the church.
The Sant'Antonio Abate functioned as a hospitium (ital. Ospizio ), which is still evidenced today by the marble slab hanging above the main entrance. The function of the House of Sant'Antonio Abate was mainly to provide food and accommodation for the needy, but also for pilgrims traveling through. Herbs and medicines were also distributed to the sick, and orphans were cared for and brought up.
When Joachim Murat created the Hospitien Commission in 1811, the house in Teramo also came under the direct control of the new organization. In 1816 the administration returned to the church.
With the Italian unification there was another change to the government, since with the law of July 17, 1890 a " Congregazione di Carità " was set up in each municipality . This took over the administration of all hospitals and other health care facilities. The health and charity aspects remained closely linked.
Conversion as a psychiatric hospital
On the initiative of the then President of the Congregazioni di Carità, Costantini, a department for psychiatric care for 20 patients (7 men and 13 women) was opened in a room on the first floor of the building in July 1881. Costantini himself was responsible for the medical areas in this department, supported by nurses and nuns.
A stone tablet in this hall today commemorates this event: This hall was the first of the mental hospital. It opened in July 1881. President Costantini
The decision to care for patients with psychiatric illnesses in its own facility made the hospital a contact point for patients from Teramo and the surrounding provinces who could not stay with their families and were turned away by other clinics or orphanages. Over time, the psychiatric department had to accept more and more patients, which is why the case history and the complexity of the diseases treated changed. Thus the congregation was forced to gradually increase the number of psychiatrists and nurses with both secular and ecclesiastical forces. Psychiatric services were later taken over by in-house medical staff.
From 1892 to 1916 Raffaele Roscioli was head of the psychiatric department; he previously worked as a doctor in the “Vittorio Emanuele II” hospital in Nocera Inferiore. It was Roscioli's achievement to turn a custodial accommodation into a place of treatment by introducing permanent observation of the sick as well as the documentation of the course of the disease and having a medical record created for each patient.
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In 1894 a wing was added to the existing parts of the building. In the following years between 1895 and 1900, work on the extensions continued, including the acquisition of adjacent buildings and the construction of new buildings. Buildings that, like Porta Melatina, had previously served other purposes were also assigned to the psychiatric department.
In the first phase after the opening of the neurological department (1881), the medical function and care of bedridden people were taken over by the hospital's secular and ecclesiastical staff for about 10 years.
At the end of the 19th century, the living conditions of the population in the region were difficult, as malnutrition , high child mortality , inadequate and unhealthy housing as well as poor hygiene and health had an impact on their mental and physical condition. The hospital, which was supposed to provide shelter and help for the so-called mentally disturbed, became a place of refuge for a part of the population who went beyond this function.
Roscioli introduced occupational therapy : the so-called "peaceful" patients could work in external labor colonies that were created in February 1905, or in the internal workshops that emerged over time. This enabled the psychiatric hospital to take care of itself. This form of occupational therapy enabled new workshops for shoemakers , tailors , joiners and blacksmiths to be created. Straw processing for brooms and mattresses was added later. The residents cleaned the premises and worked in the laundry and in the warehouse. The women were mostly occupied with cooking, embroidery, sewing and weaving.
The constant commitment of Roscioli was the training of the staff, who were mostly employed without prior training. As a rule, people who were strong and robust were employed to monitor the residents. The director founded an in-house nursing school that lasted for decades.
In order to reduce overcrowding and the inconveniences caused by lack of space, a special accommodation for the chronically but calm, mentally ill was opened in 1910 in Corso di Porta Romana in Teramo.
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The changes implemented by Roscioli were adopted by the new director Guido Garbini, who ran the hospital from 1917 to 1919. He made it his goal to develop and strengthen the educational and rehabilitative social functions of the hospital. In this way, he created the prerequisites for the emergence of a more modern structure, which saw itself not as a place of safekeeping but of treatment. He introduced the new clinical laboratory and founded an extraordinary library that still exists today. He ordered the removal of an excessive number of closing gates and bars. This dismantling provided the forge with work for two years (1917/18). He also had some isolation cells torn down; the stones that fell were used to pave the largest courtyard. A kind of grotto was set up in the cellars, which was used for slaughter, both for direct consumption and for preserving the meat.
As a testimony to the scientific impetus of Garbini's management, numerous publications by him have been preserved in the hospital.
As a result of the admission of war-traumatized soldiers from the First World War , the situation of the hospital deteriorated due to the overcrowding and dilapidated rooms. There were shortcomings in health services and staff shortages.
The transformation into a modern psychiatric hospital took place under the psychiatrist Marco Levi Bianchini , who headed the clinic from 1924 to 1931 and was a staunch supporter and promoter of psychoanalysis . The existing treatment rooms were restored and new rooms laid out, laboratories created and a library set up, as well as advanced training and retraining of the nursing staff. He ensured that further departments were created that specialized in particular clinical pictures.
Bianchini went to great lengths to put the hospital in a better light in public and to increase trust in the medical facility. The Teramo Psychiatric Hospital was also successful in teaching and research under his leadership. In 1924, for example, he founded the journal “Archivio generale di Neurologia, Psiciatria e Psicoanalisi” as the hospital's official language. On July 7, 1925, the “Italian Psychoanalytical Society” (Società psicoanalitica italiana) was founded in the psychiatric hospital in Teramo. This still exists today with its seat in Rome. A plaque on the outside wall of the hospital in Via Aurelio Saliceti reminds of the director Marco Levi Bianchini.
Furthermore, the steady increase in the number of patients required more rooms, so that at the meeting of May 28, 1925, the Congregation made the decision to build a new general hospital in Viale Francesco Crucioli. As a result, the entire premises of Sant'Antonio Abate were now available for psychiatric care. Antonio Abate took over the management of the new hospital.
In order to reduce the constant influx of patients, Bianchini opened the Treatment Center for Mental Hygiene in February 1928, which was intended to avoid inpatient admission through outpatient treatment.
By the end of his tenure at the Psychiatric Hospital in 1931, there were 1,000 patients, over 100 nurses, 5 full-time medical professionals, many servants and staff working in the workshops and the agricultural colonies.
History of the psychiatric hospital from 1940
The war years (1940-45) again meant difficult socio-economic conditions and a challenge for the institution under the leadership of the new director Danilo Cargnello.
He was followed by Carlo Romerio, under whom psychiatry could fall back on well-trained and motivated staff consisting of young, specialized doctors who tried out new and modern forms of therapy. The following decade saw an operational change. The new neuro-psychiatric complex was created in the suburb of Casalena a Teramo. In the new premises, the numerous patients who were previously housed in the old and dilapidated buildings could be given improved care.
The authority “Ospedali e istituti riuniti di Teramo” then managed the Sant'Antonio Abate until a change in the law was announced in February 1968, by which the welfare and social functions were separated from the purely medical treatment in Italy.
In the course of the Italian reform of psychiatry , the authority “Ospedali e Istituti riuniti di Teramo” was defined as the provincial hospital authority.
It should now include the following facilities:
- the municipal hospital "Giuseppe Mazzini"
- the psychiatric hospital "Sant'Antonio Abate"
- the sanatorium "Alessandrini Romualdi"
In 1974 new buildings were built as branches due to overcrowding in the psychiatric hospital. The male patients of the hospital were housed there. From this point on, only female patients lived in the main building. In 1976, a therapeutic residential community was opened at Antonio Abate, which was intended as an open ward to overcome the difficult conditions in which long-term patients lived. In 1977 there were 870 inpatients and 358 nurses were employed. In these years the first attempts began to open the "mental hospital" and to end the home character.
Another law in December 1978 passed a state health system that included local health services. This law excluded the Church from health care, with the general hospital, psychiatric hospital and sanatorium being transferred to Teramo's local health services.
In 1978 it was also decided to close the Italian psychiatric clinics. The Sant'Antonio Abate Psychiatric Hospital was finally closed on March 31, 1998 after the last of the patients had been discharged.
List of directors
- Berardo Costantini (1881-1889)
- Tommaso Gaspari (1889-1892) - Deputy
- Lorenzo Paris (1889-1892) - Deputy
- Cleto Pierannunzi (1889-1892) - Deputy
- Raffaele Roscioli (1892-1916)
- Guido Garbini (1917-1919)
- Cleto Pierannunzi (1920-1924) - Deputy
- Marco Levi Bianchini (1924–1931)
- Cesare Roncati
- Danilo Cargnello
- Ignazio Passanisi
- Carlo Romerio
- Antonio Bernardini
- Giuseppe Francesconi
- Michele Colleluori
- Franco Cesarini
Structure of the complex
The first core of what is now the Psychiatric Hospital was built in 1323. The last important expansion measures took place in 1931. Considering the numerous interventions, alterations, restorations, additions and other building measures, it is understandable why the building of Sant'Antonio Abate, as it is today, is asymmetrical.
The hospital consists of a central original core; this corresponds to the buildings in the area of the Porta Melatina and the adjacent archway of Vico delle Recluse and the baroque church of Sant'Antonio Abate. Six building complexes, which were built in different eras, are connected to this with asymmetrical connections.
Entrance to the laundry and the ironing room (ironing room)
The interior of the complex develops over 3 floors with few exceptions: the ground floor and 2 storeys. In some buildings there are also cellars. In two wings there are terraces on the roof, which are fenced in with metal bars, intended for the courtyard walk of the inmates or the nursing staff.
The size of the structure is immense: over 32,000 m². This corresponds to a stately part of the old town. Almost all tracts where inmates stayed or walked through have bars on the windows. The dimensions of the hospital are so enormous that it is bordered by six streets: Piazzale San Francesco, Via Aurelio Saliceti, Vico delle Recluse, Via di Torre Bruciata, Via del Baluardo and Via Getulio. The Via Aurelio Saliceti belonged exclusively to the hospital until the 1970s and was therefore not open to the public. It was locked to cars and pedestrians by a chain.
From the very beginning, the hospital was divided into different sectors: according to age, sex or the severity of the illnesses. There was the women's wing, the men's wing, the children's wing, the one for the "quiet" inmates, the one for the "partially calm" patients and the one for the agitated. There were also - but gradually fewer - special, closed departments for difficult cases. There were essentially 3 areas of activity and treatment areas for the mentally handicapped: neurological and neuropsychodiagnostic.
The main entrance to the hospital is located in the original central wing, which dates back to the Middle Ages: a marble slab above the gate testifies to the original use of the building as a refuge and place of help for the sick and needy. The porter's lodge, the main staircase, the elevator, the access to the two inner courtyards and the nuns' apartment are located near this entrance. Under the arch of the Porta Melatina there are two wrought-iron gates: one as an entrance to the hospital, the other as an entrance to the church of Sant'Antonio Abate.
These two entrances were seldom accessible during the long time of the hospital.
Infirmary (built in 1894)
The church of Sant'Antonio Abate, now decorated in the Baroque style and of exceptional elegance and brightness, served as the internal chapel of the hospital. It could be reached from both outside and inside; it is connected to the building by a spiral staircase. A sacristy is attached.
As a result of the countless expansion work on the complex, the buildings that adjoin the older part show very different architectural eras. The buildings on the Prota Melatina side, along Via Saliceti, house the technical and administrative departments, the pharmacy, the operating room and some outpatient departments, the headquarters of the Congregazione di carità (on one side) and the laundry, the mangle room, Storage rooms, doctor's rooms and nursing rooms, the central sterilization and the first terrace (on the other side). On the Vico delle Recluse are the tracts that contain the sacristy of the internal church, the morgue and some patient rooms, as well as the tract (built in 1894) with the storage rooms, the slaughter room and the cold room (built in 1917 in an underground grotto) administration, hospital rooms and the second terrace. There is also another courtyard at Vico delle Recluse - a time used as a hospital garden, from which another wing leads off. This is the Giuseppe Cerulli wing, built a bit away from the rest of the hospital and connected to it by a semicircular wing - intended as a sick wing for the "partially agitated" and then equipped as the dining room of the Tamburini department.
The director's office and library are on the second floor of the administration wing, from here you can reach the laboratories and workshops (carpentry, blacksmith's, tailoring, bakery and other handicrafts). From here you can see the largest of the inner courtyards, paved with the stones that were left over from the demolition of the isolation cells, at the suggestion of director Guido Garbini. The kitchen wing can be reached from this inner courtyard; it is so big that food for more than 600 people could be prepared there. The two main corridors, which connect the administration wings, the outpatient departments and the hospital rooms, lead towards Piazzale San Francesco and are therefore very bright. A large number of passage rooms, corridors, staircases, rooms and storage rooms complete this complex.
Current situation
As a result of the closure of the Psychiatric Hospital, the necessity arose immediately to protect and enhance this immense common property, bearing in mind its extraordinary historical, architectural and anthropological value. The enormous archive was divided into two departments: the patient files were entrusted to the USL's Mental Health Department, as the owner of the complex. The rest of the archive was given to the USL historical archive. The Abruzzo archives supervisor and the university are currently studying the files, inventorying and sorting the vast treasure of the hospital archive. At the same time, the most valuable furnishings from the buildings are preserved by the mental health department, as is the large and valuable library.
Numerous furnishings (costumes, furniture of little value, everyday items) are still in the complex, which has been closed for a long time. The risk of decay and damage is more and more concrete, and so is the risk of forgetting the activities that took place here. From a historical and anthropological point of view, the preservation of the traces of this life still preserved, which was of great importance for the region and the country in its time, would be very desirable. The establishment of a psychiatric museum on the basis, as in other projects with a partial restoration of the old mental hospital complexes, could lead to saving not only the buildings but also objects and facilities (medical and everyday items) from their permanent disappearance.
Since the buildings have not been used since 1998, the structures of the hospital are currently in a deplorable condition and some important stabilization and restoration work is required. The conditions that currently affect the complex take into account the special precautions and respect for future use.
literature
- Guido Garbini, L'assistenta dei malati di mente nel Manicomio di Teramo (1880-1918) , Teramo, 1919
- Marco Quarchioni, Il Manicomio di Teramo e Marco Levi Bianchini , in Abruzzo contemporaneo , Teramo, giugno 1991
- Cappelli - De Laurentiis, Storia dell'Ospedale Civile di Teramo o dell'Ospedale S. Antonio Abate , in L'Elzeviro , Teramo, maggio-giugno 1998
- Fabrizio Primoli, L'Ospedale Psichiatrico di Teramo , Teramo, ottobre 2011
- Annacarla Valeriano, L'ospedale psichiatrico Sant'Antonio Abate di Teramo nelle lettere degli internati (1892-1917) , in Storia e problemi contemporanei , n. 60, a. XXV, maggio-agosto 2012, pp. 137-169
- Annacarla Valeriano, Ammalò di testa. Storie dal manicomio di Teramo (1880-1931), Roma, Donzelli, 2014.
- L'Ospedale Psichiatrico di Teramo , sito a cura di Antonella Cicioni, Nicola D'Anselmo, Anna De Carolis, Roberto Di Donato, Luigi Ippoliti, Fabrizio Primoli, Teramo, 2013
