As early as the 14th century, a small town called Geel in Belgium was visited by mentally ill pilgrims from across Europe. Geel houses a shrine to St Dymphna, the patron saint of mental illness. Rather than building an asylum outside of the city walls, the medieval town organised itself into a ‘boarding out’ system which still exists today, in which people were supported in ordinary family homes. This early example of ‘care in the community’ recognised the ability of ordinary people to provide support to people who might more normally have been shunned and feared. Geel became a place which gave asylum rather than building them.

In the centuries that followed, few places followed Geel's example, but many asylums and institutions were built to keep disabled people, those with mental health problems, the sick and the old outside of our communities. In more recent history, most asylum, workhouse and long-stay hospital buildings have been closed and the services they housed moved into ordinary houses. Conversely, the work that took place in those buildings has become increasingly professionalised and further removed from what we expect ordinary people to be able to do. Despite these outward changes, many of the assumptions first rejected by the people of Geel centuries ago persist, invisibly but tenaciously, in the new ‘community settings’ of our health, care and other support services.

The people of medieval Geel chose a way of thinking about care for people who need long-term support which still seems both shockingly radical and entirely natural. They refused to see living as part of community as incompatible with either receiving or giving care. It is a way of thinking that has flickered in and out of the consciousness of those who seek to help others for seven centuries. I work for the charity that is charged with keeping alive that idea, which we now call ‘Shared Lives’ and which currently offers support, a home, and often love, to over 13,000 people across the UK.

Seven centuries later, it's an idea which may finally be about to have its day.