Dan Snow's History Hit - The Psychiatric Hospital that Fought the Nazis

Episode Date: March 9, 2023

There are descriptions of suffering early in this episode that some listeners may find distressing. As hospitals and institutions across the European frontline were taken over to serve the war effort in the 1940s, what happened to psychiatric hospitals, housing some of the continent's most vulnerable in often prison-like conditions? Well, approximately 45,000 psychiatric patients died of starvation and disease in France alone. One psychiatrist described the scenes he witnessed during that time as being as bad as the concentration camps. But there was one hospital that, not only defied this fate but thrived during the war. Saint-Alban-sur-Limagnole, in Southern France, had a death rate of less than 10 per cent – and no deaths from malnutrition. Not only did staff and patients stay alive through pooling skills to create food, foraging in the local area and keeping livestock, it actually became a hub of the French Resistance - storing ammunition, and acting as a safe house for Jewish refugees and freedom fighters. The hospital not only fought fascism but also provided a more community-focused treatment that proved to have a revolutionary effect on patients.Joining Dan on the podcast to tell this extraordinary story is Ben Platts-Mills, a writer who has worked in the mental health sector for 16 years. He came across it when he was looking into the work of French painter Jean Debuffet and saw that much of the artwork he’d collected was done by inpatients at Saint Alban during the war.You can read more about Saint Alban-sur-Limagnole and Ben's other work here: https://www.benplatts-mills.com/Produced by Mariana Des Forges and edited by Dougal Patmore.If you'd like to learn more, we have hundreds of history documentaries, ad-free podcasts and audiobooks at History Hit - subscribe to History Hit today!Download the History Hit app from the Google Play store.Download the History Hit app from the Apple Store.

This is History's Heroes. People with purpose, brave ideas, and the courage to stand alone. Including a pioneering surgeon who rebuilt the shattered faces of soldiers in the First World War. You know, he would look at these men and he would say, don't worry, Sonny, you'll have as good a face as any of us when I'm done with you. Join me, Alex von Tunzelman, for History's Heroes. Subscribe to History's Heroes wherever you get your podcasts. Hi everybody, welcome to Dan Snow's History Hit. This is a very special episode because it's the first time this story really has been told in English.

It's a story that's pretty well known in France. A wartime story of heroism, of enlightened humanistic thinking, working with some of the most marginalized people in society, keeping them alive through the horrors of the Second World War. But it's not really known about in the English-speaking world. I'm very grateful to the guest today, Ben Platts-Mills, for coming on and talking about it. Ben is an author, he's an artist, he's worked with survivors of brain injury, he's worked with groups who have suffered psychiatric disability, and he came across the story of Saint-Aubin Hospital. It bucked the trend in France, where hospitals for the mentally

ill suffered something like 50% mortality during the Second World War at the hands of the Vichy government and direct German occupation. This hospital though was different. Some enlightened people in leadership mobilized the staff, mobilized the patients, and managed to create enough food by foraging, keeping livestock. But it goes even further. This mountainous psychiatric hospital became a hub of the French resistance. Ammunition was stored there. It became a safe house for Jewish refugees, for freedom fighters, for intellectuals, for political prisoners. This psychiatric hospital actually became an island of sanity in a sea of madness. It is a really special story this everybody. I'm very grateful for Ben Platts Mills coming on to talk about it.

Enjoy. God save the king. No black-white unity till there is first and black unity. Never to go to war with one another again. And liftoff, and the shuttle has cleared the tower. Ben, thanks so much for coming on the pod. It's a pleasure. Nice to meet you. In the early to mid-20th century in France, what were some of the popular responses towards psychiatric illness and disability? I mean, I guess they were common across Europe by that time. People with disabilities and psychiatric challenges,

there was already a long history of people being neglected and ostracized and cast out or tortured or starved to death if you're in the medieval period, right? That was standard operating. Even with the sort of scientific, you know, enlightenment psychiatry that came in, in the 19th century, people were still being routinely imprisoned or mistreated. Eugenics, right, 1900 eugenics, a sort of pseudoscience of eugenics was pretty common currency. The idea that these people were a threat to the population, to the species, widely, widely accepted across Europe and the United States. So by the time the war came, these large populations of people were imprisoned under already pretty desperate circumstances.

They'd been, as one psychiatrist called it in 1979, being interviewed about the period, he said there was pretty much a universal indifference to psychiatric patients. People didn't care. Their well-being was not centralised in any way. And then it's terrifying to think that then on top of that, if that's your starting position, then Europe descending into the sort of most extraordinary dislocation, the chasm of death, destruction, shortages, violence, hatreds, those people are going to find themselves even more marginalized in those kind of situations. Yeah. So already imprisoned, they were at the mercy of government policy around food supply. So when rationing came in,

which everybody knew, everybody in France knew that the rationing system didn't supply enough food for a person to survive. It just wasn't enough. Everybody knew it. And they worked around it. That's how the resistance operated, by workarounds. But people in these institutions didn't have access to those networks, right? If you're locked in on a ward and you've got a thousand people in this hospital and no effective way of getting food in and out, and it's more scrutinized, right, by the administration, if food is supplied in a much more official way, there are no unofficial routes, you starve to death. And that's what happened. Incredibly high mortality rates

of the 96 psychiatric hospitals in operation. Many of them were losing up to half their patients by the end of the war. Just huge, huge numbers of dying people. And no one was witnessing it. There was nothing. It took another 40 years for this story to reach the wider public. It's astonishing. Tell me some of the challenges that psychiatric hospitals would have faced during the Second World War and German occupation. Oh, that's a good question. I mean, I can quote you, if you like, from one of the psychiatrists working in France at the time. It's pretty bleak. It's not pleasant reading. The psychiatrist interviewed in 1979 described the situation as terrible.

He said it was a terrible period at the hospital. The food supplies we received were completely insufficient for feeding 3,000 people. I lived through scenes as terrible as those in the concentration camps. Patients were chewing off their own fingers. I mean, it was starvation. And that was deliberate.

Was it deliberate? I mean, that's a really interesting and quite controversial question. So about 45,000 people died in psychiatric hospitals in France during the war. And when that sort of finally came to light, when those figures started coming out, a lot of people speculated that it was part of a deliberate policy, kind of initiated by the Nazi government and the Vichy command. But subsequently, quite a lot of historical research has been done and it doesn't really seem to be borne out. No direct policy has ever been found, nothing in writing. But did it need to be deliberate? That's really the question. I'm sure the Nazis were perfectly happy to see this atrocity taking place. In fact, the first people they killed when they entered Poland were psychiatric patients. And the first policies written into Nazi law were, you know, the first genocidal laws were around the sick and the disabled psychiatric patients.

So it was definitely part of the plan, but in a way they didn't need to do it deliberately because these people were already imprisoned. Does that make sense? All they had to do was put rationing in place, make it impossible for these people to get fed. So deliberate, I don't know. It's a very ambiguous situation. Yeah, well, I mean, that obviously gets to the heart of,

the Holocaust doesn't have a neat paper trail in terms of the decisions by Himmler, Hitler. It is, I think, in their case, they left it deliberately obscure whilst definitely encouraging the murder, the atrocities in so many ways. Tell me about this hospital before the Second World War. Yeah, so it was in a similar position to a lot of psychiatric hospitals in France at the time. It was already desperately underfunded. There is a long, long history through the 1800s through to the early 20th century of these institutions being collected and underfunded by government. It had about 550 patients at the start of the war. It had one psychiatrist.

So it was originally a Catholic monastery and it was run by a combination of nuns and wardens it had no real like modern sanitation it didn't have decent plumbing had no heating it was basically a medieval castle and patients were sleeping on straw often in locked rooms or locked dormitories sometimes sharing with animals in stables. You know, it's pretty bleak already. And obviously the winters of 1940 and 41 were exceptionally cold. So as the war started and food supplies sort of dried up, there was the additional challenge of it being extremely cold. And it's in a mountainous region in the Lazare, so it's a pretty harsh place to live in the winter. Before the war

what was the hoped for outcomes for the people that would be sent there? Is this just basically imprisoning people that were mentally ill? There's some interesting quotes from the records. The person that was running it before the war, Paul Barvet, said that all he'd been told to do was make sure there were no escapes, no deaths and no pregnancies. That was it. It was just really, it was about containment and control. It was about keeping these people away from the rest of the community and preventing them from doing anything suspect. So it was pretty basic, yeah. It wasn't humanistic, if you want to say that.

It wasn't humane. And war breaks out. Presumably war just makes that situation worse. They would have lost staff to the army, I suppose. And as you say, food supplies dislocated and fuel and things. So the situation for most psychiatric hospitals was horrific. Almost all of them failed their patients. Almost all of them had incredibly high mortality rates. St Albans was the exception due to some pretty radical thinking from some

of the people working there. Let's talk about the radical thinking, but we should say that it got worse as well because more people were sent there. So it had about 550 at the start of the war. Hospitals were also being requisitioned across the country. So some of the big places were being requisitioned by the army and by the government. So that meant patients were displaced. So the population at Saint-Albon went up from 550 to about 800. So yeah, a big spike in a very short time in terms of the number of mouths to feed. You're listening to Dan Snow's History Hit, talking about one very special French psychiatric hospital. More after this. Over on the Warfare podcast by History Hit, we bring you brand new military histories from around the world. Each week, twice a week, we release new episodes with

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too. Subscribe to Warfare from History Hit wherever you get your podcasts and join us on the front lines of military history. This is History's Heroes. People with purpose, brave ideas, and the courage to stand alone. Including a pioneering surgeon who rebuilt the shattered faces of soldiers in the First World War. You know, he would look at these men and he would say, don't worry, Sonny, you'll have as good a face as any of us when I'm done with you. Join me, Alex von Tunzelman, for History's Heroes. Subscribe to History's Heroes wherever you get your podcasts. So what did the, well, there was a doctor in charge. What did he do? How did he start to remedy this situation?

I guess if you imagine living in the middle of the mountains in a pretty remote region, it's not like you can just sort of go ring up the local university because there isn't one. You know, like, where do you get staff from? It's not easy and everybody's caught up in the war. So he hit on the idea of going to the nearest refugee internment camp at Sète Fond, which is a little bit southwest of the hospital. nearest refugee internment camp at Sète Fond, which is a little bit southwest of the hospital. They'd been set up by the government, the French government, to house refugees from Spain who were fleeing Franco's regime. And actually, Belvé himself was a bit doubtful. He was like, well, I guess I'll give it a go. There might be someone there who I can recruit, but it's full of reds

and criminals. Those are his words. So I doubt I'll find anyone. And he found this guy called Francois Tusquelles, a Catalan, who was absolutely a red. He'd been fighting with the communists and anti-fascists in Catalonia during the Spanish Civil War. But he was also a psychiatrist. And he'd run clinics at the front line during the Civil War. When Balde found him at the internment camp he was running a clinic there just like a shoestring off his own bat he was running a psychiatric clinic for the refugees so balve said yeah i guess you'll do can you come and help me i've got 800 patients and i'm the only psychiatrist but in the winter of 1940 tuscay has arrived-Albain and got stuck in.

And what did he do? How did it go? I mean, he brought with him this very radical leftist attitude. I think because he'd seen so much strife already and he'd seen fascism up front, right? He'd seen it firsthand. He'd seen what Franco was doing in Spain and that was horrific. I think he knew in a way perhaps that some people in France didn't know how bad things might get and that there wasn't time to kind of about ethics or you know practicalities so he immediately said look forget everything you know like forget psychiatry in essence is what he said this is about survival and they set about together essentially doing whatever was necessary to secure food supplies so they held like foraging classes with local people

they sent patients out into the woods picking mushrooms basically talked to the client and said what do you know how to do they already had farmland there and of course psychiatric patients they're not just patients they're people with with lives, they've had backgrounds, they've grown up in the local area, right? So they have skills. And they straight away started putting people to work doing what they were good at, whether that was farming or foraging, going out begging and bartering, talking to the local villagers. They really put everything into it in terms of dissolving this distinction between the patients and the staff, because they knew that that was the only way they were going to keep everyone alive. And it worked worked they had no deaths from starvation

that was astonishing and whereas their equivalent hospitals across the country there was a 50% mortality rate yeah really shocking and they started subverting the system so under Toscaise's guidance they knew that there were special rations cards provided for TB patients. So the minute anyone started looking a bit malnourished, they diagnosed them with TB, just straight away, to get the extra rations. Toscaise just didn't care. He was an anarchist, essentially. He was like, this is war, we're under occupation. The normal rules, the normal ethical principles cannot apply. We can't afford to apply them. Were they lucky?

And were they in the heart of nature's bounty? I mean, was there deer in the woods and fish in the streams? Or could this have been done anyway? That's a great question. I mean, yes. I mean, the Lozere, you know, they are in the middle of, as you say, nature's bounty. There are woods.

I couldn't speak to the number of deer. Well, I'm very disappointed. I'm sorry. I don't have those the number of deer. Well, I'm very disappointed. I'm sorry, I don't have those numbers that I had. But I think, as I understand it, one advantage they had was that they could fly a little bit under the radar in terms of the visual administration because they were so remote. It wasn't like they had lots of kind of officers checking in and scrutinizing their books. So I think the remote location helped in that way. Was there any psychiatric benefit? I mean given they weren't really receiving any treatment before are there reports that actually people perhaps it was a way to recovery or to happiness that

there was all this purposefulness and outdoorsiness and foraging and all sorts of things? I'm showing my English early 21st century middle class roots here by just assuming that assuming that the answer to all anxiety and depression is to go out foraging. A good walk, yeah. I'm very of the moment. Right. Apologies for that. No, no, I think there's some wisdom in that.

If it works for you, Dan. I'm aware one thing they weren't doing was maintaining because of the sort of straightened times they weren't maintaining like rigorous records using validated psychiatric scales to assess people's progress on a regular basis so it's difficult to give you kind of like concrete evidence of the psychiatric impact but one thing I would say is it's really worth watching there's a really wonderful documentary by someone called Martine De Rez. It's called Our Lucky Hours. It's a French film. She found this incredible archive footage in the hospital. She went to visit and just found it sitting there,

this real tons of footage shot from the early 1940s through till the 1970s, 80s. And it shows there's black and white footage from the hospital at early times. And gradually as this work took hold, this kind of more communal, more humanistic work to hold you can see this incredible population of like flourishing people they had shoe workshops they had carpentry they had massive kitchens they had parties and dances and theater and it's this astonishing community of like rich cultural life and the fascinating thing is you can't distinguish

who's a patient from whose staff it's very difficult to spot because actually the patients are just getting on with life i don't know if you'd call that evidence i don't know if it counts you know depends on your perspective but to me this is reflected in the work i've done in community building and working with people with complex needs which is that if you create a situation where you emphasize what people can do what they can make rather than what's making them sick if you create opportunities for people to act as fully formed human beings the emphasis shifts and there are always benefits people don't stop experiencing psychosis they don't stop experiencing the complex implications of brain injury or whatever the things they've been learning disability.

Those things don't go away. But with time and with the right kind of support, people's lives do unquestionably improve. And it becomes something more relational, becomes collectively held. So this kind of intra-psychic emphasis on, look, you are the sick person, that starts to move out of the frame. And what you start to see person, that starts to move out of the frame. And what you start to see is people being able to take responsibility and being able to feel good

about themselves. That's such a big deal. So important. So they survive and they even, dare we say, thrive. But it doesn't stop there, does it? Because it starts to get involved actually in the course of the war. Yeah. So this is where it gets to me really fascinating and kind of like breathtaking. The idea that someone or that an institution would not only recruit its own client group to the work, which to me is like, yes, that's amazing. That's revolutionary and exciting and important. But they didn't stop there. They started opening the doors to, first of all, Jewish refugees. So a couple of people made it out of Germany and presented themselves. They were just there.

And there's an interesting quote from Balavé where he talks about his initial reservations. He's like, well, these people are not psychiatric patients. I feel uncomfortable about taking them in. And Tuskegee's response was, well, we'll just diagnose them. It's fine. Balfe said it took him a while, a few days. You know, you have to think about this for a while. Took him a couple of days to get over his scruples.

But he said, you know, he was right. Tuskegee was right. And they chatted to them, the two refugees, and said, you know, what kind of diagnosis do you think would be most appropriate? And they set upon paranoia so they started there and again what they noted was that the patient the client group started seeing a role for themselves so tuskaya said he found patients going to the kitchens making food and bringing it to the refugees independently just their humanity was coming forward so they started taking the refugees in. Then they had a change of staff.

Balve left to go to another hospital and was replaced by a man called Lucien Bonafé. He was a psychiatrist, but had been also pretty active in the resistance. He was a pretty hardcore leftist and had armed militant contacts. And he was actually fleeing persecution, you know, fleeing arrest at that time.

And he brought those contacts with him. And Tuskegas, unsurprisingly, was immediately like, yeah, they could come. Yeah, there's a free ward. So it didn't take long before they were sheltering armed militants, partisans, and gun running, you know, they were hiding stuff and moving stuff for the resistance. So it's a psychiatric hospital. It's a refugee camp, and it's a hub for the resistance. So how did those different communities then mix? I mean, you've said a little bit about how the refugees were received, but suddenly you've got men of action, young men, potentially violent,

quite a different cadre to those who are already there. How did that change the atmosphere so one of the things that's talked about with Santa Ma is the meetings but I think it worked because there was already this kind of radically inclusive approach taking place so they would talk about everything nothing was off the cards there was no idea that the staff should sit in a room together and discuss the client group without them in the way that you might imagine in a medical setting might have, you know, kind of war drowned or something. Everybody was already talking about everything all the time. And I think the resistance fighters just kind of joined in.

They had a printing press at the hospital, so they started printing dissident material and distributing it and running leaflets and storing stuff. And I think the patients as well as the staff and the resistance fighters and the refugees were kind of all having the same conversation. I think there was a recognition that they were all being made vulnerable by Nazism, right? They were all kind of at the receiving end of this thing. They were all wanted dead, right? It was as simple as that. Every single person there was on the hit list for the Nazi regime. I imagine there would have been moments of like tension or fear or doubt about what was happening. But I think there was a unifying principle that superseded all of that. We have to get through this.

We have to survive. And the only way we're going to do this is together. Interestingly, they also started having other people who were targeted by the Nazis, intellectuals, artists, people with complex disabilities who are also becoming artists. So these visitors would encourage the patients in their art practices. You get people like Auguste Favestier, who was already making things, but who Paul Éloard identified as a, you know, this guy's really talented he bought some of his art he then showed that to Pablo Picasso after the war these kind of strange and fascinating kind of tendrils of influence move out and you can see the influence of this what's called I guess

outsider art what was in France called art brut really began here began with this work in this hospital and it touched all parts of French culture eventually so yeah fascinating place. It is indescribably fascinating and they survived the war today in terms of they never became the focus specifically of a kind of a you know a Nazi sweep or they went on sheltering people it went on being a hotbed of resistance and no one ever came knocking. As far as I'm aware, they got away with it. I've not come across anything that suggested they were ever specifically targeted. So they obviously did a really good job of keeping it hush-hush. And, you know, Paul Éloard stayed for a winter and then left and he was fine. He survived the war, carried on working.

So they were really effective. Is it reasonably well known about in France? Because it's just not a story told in the English speaking world. Yeah, it has much more of a legacy in France. So someone who interned after the war, Jean Aurie, he went on to open a hospital in Saint-Alban's image, which is still running today. And the principles that these people developed at Saint-Alban and at Aurie's hospital, some of the basic principles were rolled out across France in the sort of latter part of the 20th century under the name of sector psychiatry. This kind of broad humanistic principle was nationalised. Bits of it went on to kind of influence French intellectual culture really until the present day. This is what surprised me. When I came across it, I had never heard of it. It just hadn't touched my radar.

I'd been working in community building and, you know, working with people with psychiatric problems and disability for 16 years. No one had ever mentioned it. It's astonishing. And I don't know, is that the French-English cultural divide? I don't know. What is that? I don't know, because it's such an extraordinary story.

And it was so relevant, particularly for my work, for what I was attempting, this kind of co-produced, community-based solution to the problems. It was a bit late. I'd left by then. So sadly, I'd left my work. Well, I wouldn't be surprised if some Hollywood producer comes knocking on your door, buddy, because it's an extraordinary story, isn't it? And it deserves to be very, very widely known.

Right. I agree well thank you very much for coming on the podcast and starting that process off tell everyone the name of that documentary again because it does sound really remarkable

you can search for it in English the English title is Our Lucky Hours and the director is Martin Deres and that's what first put you on to it

really terrific film highly highly recommend it thanks so much for coming on the pod pleasure, thank you This is History's Heroes people with purpose brave ideas and the courage to stand alone.

Including a pioneering surgeon who rebuilt the shattered faces of soldiers in the First World War. You know, he would look at these men and he would say, don't worry, Sonny, you'll have as good a face as any of us when I'm done with you. Join me, Alex von Tunzelman, for History's Heroes. Subscribe to History's Heroes wherever you get your podcasts.