4 ideas
Medieval pilgrims brought mentally ill relatives to the shrine of St. Dymphna in Geel, Belgium, seeking a cure. When the church's accommodation overflowed, local households began taking them in, and the arrangement outlasted the pilgrimage. The Belgian state brought it under medical supervision in the nineteenth century, and today hundreds of patients still live as boarders with Geel foster families, a practice some seven centuries old.
Geel families do not accept boarders because they are unusually saintly or because they understand psychiatry. They handle odd behavior through practical know-how passed down from parents who also kept boarders: when to ignore something, when to correct it, and how to keep household routines stable. Acceptance of the mad is a learned cultural competence rather than a personal virtue, so it cannot simply be decreed in a new place.
Boarders in Geel share meals, chores and family life, but unwritten rules keep them in a separate, lower status. They are treated as permanent dependents, and romantic or marital ties with locals are discouraged. Community inclusion here works because the boundaries are clear rather than absent, which shows that normalization and hierarchy can coexist in one arrangement.
The number of boarders in Geel has fallen from thousands in the early twentieth century to a few hundred. Farm households with a spare room and a woman at home have given way to smaller homes, dual incomes and professionalized expectations. The practice depended on the informal labor and domestic structure of a particular kind of household, so it shrinks when that household disappears, however well the care model works.