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Family

The families in this town have welcomed the mentally ill into their homes — for the last 700 years.

At first glance, Geel seems like any other quaint farming village in the Belgian countryside.

There's a cute market square with plazas and cafes that feels fresh out of 1627, and plenty of delightfully eccentric townsfolk strolling through the streets. Geel (pronounced like "Hyale," kind of) could be just about any town in the province of Antwerp — at least, on the surface.


Photo via Odcdtd45/Wikimedia Commons.

But the casual visitor might not realize how many of these inhabitants are struggling with mental health.

That might sound like the start of a horror movie, but it's the reality that the residents of Geel live with every day — and there's absolutely nothing scary about it (nor should there be; we'll get to that).

In fact, these individuals are welcomed into the homes of any townsfolk who will have them. After undergoing a psychiatric evaluation at one of Geel's many mental health care facilities, those seeking help are integrated into the lives of host families in a system known as "family care."

And some of them stay for as long as 50 years.

That's the other thing: No one actually uses the phrase "mentally ill."

The preferred term is "boarders," although people are also known to refer to these guests (at worst) as "special" or "different."

While the host families do receive a stipend for their care (about $730/month), they are not provided with any background information or clinical diagnoses. This helps cut down on stigmas against people with mental illnesses as being sick or scary or dangerous. If a boarder requires medication or other treatment, the local hospitals will handle it outside the home.

Quite simply, boarders come to Geel when they've had difficulty coping on their own and have no one else to help them. Whatever reason, condition, or situation brought them there is irrelevant. (If that sounds dangerous or risky, remember that people with mental illnesses are significantly more likely to be the victims of violence than the perpetrators.)

"I've got it! What if we treated people with compassion and care and like actual people through the course of their psychiatric care?" "I guess that could work. Or we can just shove an icepick through their eyeball socket and cut their frontal lobe." "Yeah, you're right, that makes a lot more sense." Photo by Harris A. Ewing/Wikimedia Commons.

This might sound like a radical treatment, but Geel's been at it since the 13th century.

It all goes back to the story of St. Dymphna, the patron saint of mental illness and nervous disorder (and also incest). Dymphna was an Irish princess whose pagan father kinda went off the deep end after her mother died.

Dymphna's father, Damon, loved his late wife so much that he ... uhhh ... fell in love with his daughter. But Dymphna had taken a vow of chastity for Christ (and also, gross, Dad!), so she fled her father's madness and ultimately settled in Geel ... until Damon tracked her down and cut her head off because she wouldn't marry him. Yay?

The Church of St. Dymphna in Geel. I imagine most of the cognitive behavioral therapy in the town consists of "Hey, at least your life's not as messed up as Dymphna's, huh?" Photo via JH-man/Wikimedia Commons.

A church was eventually built around Dymphna's grave, and the town began to gain a reputation as a mental, spiritual, and emotional sanctuary. The residents of Geel welcomed these asylum seekers with open arms — both as an act of Christian charity and because they needed help on their farms.

As modern psychiatry gained prominence in the 19th century, some people began to look on Geel as a backwards relic of the church. But the family care system continued to demonstrate success, and those skeptics eventually came around, leading to the hybrid of state-run psychiatric oversight and family care for boarders that still exists today.

Plenty of other places have used this revolutionary treatment, too — though none the size of an entire town.

In fact, "moral treatment" is the official name for this kind of psychiatric care (which, if you think about it, is pretty messed up and says a lot about how we approach mental health).

In the United State alone, there was the Quaker-run Friends Hospital, which opened its doors in 1817. (It was originally called the "Friends Asylum for the Relief of Persons Deprived of the Use of Their Reason," though I can't imagine why they changed it.) This was followed a few decades later by the similarly successful Pennsylvania Hospital.

It's a wonder that such a wild idea as "treating people with dignity" didn't catch on any faster.

Photo by Mike Renlund/Flickr.

Although the boarder population has declined in recent years, Geel's centuries-old system still stands as an exemplar of how communities can handle mental health.

At its height, Geel hosted some 4,000 boarders. Today, there are around 300 out of town's population of 35,000. This certainly isn't due to a lack of people struggling with mental health, but rather a decline in families willing to host boarders — though the reasons for this are also unclear (some people theorize that it has to do with the decreased need for farmhands).

What is certain is that Geel's revolutionary mental health care system had a positive impact on countless lives throughout the centuries. Sure, there's no catch-all cure for the wide range of psychiatric and neurological afflictions in the world. But imagine the difference it would make if we were all more willing to embrace empathy and create more communities that let people with mental illnesses live like they are — as people.

Here's a short video about a host family and their boarders in Geel:

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

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It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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