Heart Forward Conversations from the Heart

This is the second time I’ve had the privilege to interview Professor John Foot (see  Season 3 Episode 5), and this time, it is upon the occasion of the much anticipated translation and publication of the book The Negated Institution:  Report from a Psychiatric Hospital edited by Franco Basaglia.   This book originally published in 1968 (as “L’ istitutzione negata”) sparked a revolution in thought throughout Italy and the non-English speaking world.

It is a collection of essays, conversations and interviews involving nurses, patients, psychiatrists and others associated with the psychiatric hospital in Gorizia, where Basaglia was assigned before he went to Trieste. 

The book is available in hard copy from Punctum Books and is also available as a free downloadable pdf.  

We’ll explore with Professor Foot some of the theories as to why a book that was so popular and influential in other parts of the world seemed to be shunned by the more traditional clinical “thought leaders” in the UK and the US.   We’ll also explore why, in this time of institutional protections and so little progress in the human-centered focus of our mental health system, reading this book might provide inspiration to spark new ways of thinking about system change.

 Professor Foot is the author of The Man Who Closed the Asylums:  Franco Basaglia and the Revolution in Mental Health Care. 

Some of the topics that surface in this conversation deserve follow up links:

Link to film by Raymond Depardon, San Clemente

Basaglia’s International Legacy by Tom Burns and John Foot, May 2020 

The Isaac Foot Collection at University of CA at Santa Barbara

With special recognition to our key sponsors:

·       Presenting Sponsor, Tony Hale

·       Community Impact Sponsor, Peter Lizotte

And a special thank you to those who have helped to make this season possible:

Sarah Dusseault, Brian Folb, Dave Pilon, Nick Halaris, Jae Lee and David Israelian.

For this episode, we handed the podcast studio over to one of our UCLA interns from the Luskin School of Public Affairs, Mei-Mei Barnhardt.  She interviews Marc Novick who brings a wealth of lived experience to his role as a case manager for Project 180, a program that is focused upon diversion and reentry programs for people involved in the criminal justice system.  

Since late last year, Heart Forward has been involved in a Hilton Foundation-funded project which involves taking a deeper look at the residential ecosystem that is connected to LA County’s Office of Diversion and Reentry (ODR).   This program, working in concert with Superior Court judges in the criminal and mental health courts, offers programs that divert individuals with serious mental, physical or behavioral health needs from jail into community-based care, housing and supportive services. 

The Heart Forward team, as part of this project, has been visiting various service providers who staff these residential placements, and when we visited Project 180’s Crescent House last fall, one enthusiastic member of the case management team captured our attention.  That was Marc.  Mei-Mei, in particular, was drawn to his positive energy and asked if she could meet with him to learn more about his life.  

As she relayed back to us the substance of their three-hour meeting – where he candidly shared his challenges with family trauma and addition, starting at a very young age, we thought he would be a great candidate for an interview.  And, in the spirit of promoting student learning, we offered Mei-Mei the opportunity to take the reins in the podcast studio. 

His journey out of addiction is inspirational, and undergirds the role he plays as a peer supporter with other men facing similar life challenges.  

With special recognition to our key sponsors:

• Presenting Sponsor, Tony Hale
• Community Impact Sponsor, Peter Lizotte

And a special thank you to those who have helped to make this season possible:

Sarah Dusseault, Brian Folb, Dave Pilon, Nick Halaris, Jae Lee and David Israelian.

This season starts off with a wonderful conversation with Dr. Gordon Flett, Professor Emeritus in Psychology at York University in Canada and the author of the 2018 book, The Psychology of Mattering:  Understanding the Human Need to be Significant.   Dr. Flett’s research into “mattering” – which he started in the 1980’s --  seems to be finding a contemporary relevance in the 21st century as our society trends toward social isolation and loneliness.  

His work resonates with Heart Forward because of our belief that the human posture of coming alongside people, and practicing radical hospitality in our relationships, can be transformative for all involved.    Flett, who is considered one of the global experts on this topic, believes that the experience of mattering is critical for human well-being and a sense of flourishing.  As you will hear, this is not the same as a sense of belonging or self-esteem.  People need to feel seen and heard and they yearn to know that they are making a difference or add value in some way. 

Dr. Flett has been busy in his so-called retirement from academic life and has appeared on several podcasts and interviews in the past year.  Here are some helpful links:

Hidden Brain podcast:  Do you Feel Invisible (Feb 2026)

Hidden Brain podcast:  A Secret Source of Connection (June 2026)  Dr. Flett responds to listener questions and comments sparked by the February podcast)

The Oprah Podcast:  How Mattering to Yourself & Others Can Change Your Life with Oprah, Jennifer Wallace & Ina Garten (January 2026)

Books and publications

The Psychology of Mattering:  Understanding the Human Need to be Significant.  Dr. Gordon Flett.  Published 2018.

 The Healing Power and Potential of Mattering.    APA PsycNet.  

Other resources

Mattering in Action | Making Schools More Human

Why ‘Mattering’ Is a Key Part of Mental Health - The New York Times

Ted Talk Des Moines Nov 2021 Angela Maiers – You Matter   Gordon L. Flett.  2026

With special recognition to our key sponsors:

• Presenting Sponsor, Tony Hale
• Community Impact Sponsor, Peter Lizotte

And a special thank you to those who have helped to make this season possible:

Sarah Dusseault, Brian Folb, Dave Pilon, Nick Halaris, Jae Lee and David Israelian.

Welcome to Season Six of Heart Forward Conversations from the Heart.  After dedicating all of Season Five to voices from Trieste, for the next 10 episodes we’ve returned home.  I am excited to share with you some amazing people and their work from which I know you will draw inspiration and hope.  

We will explore this simple question:  

What if the way we treat people is just as important as the services we provide? Or, perhaps, more important?

As you know, if you’ve been on this journey with us so far, we characterize this culture of coming alongside fellow human beings as Radical Hospitality.  

It is fundamentally simple:

We see you. We hear you. You are safe here. Your voice matters.

This season we'll explore what happens when those values move beyond philosophy and become everyday practice. We'll talk with researchers, practitioners, advocates, and people with lived experience who are challenging the way we think about recovery, belonging, addiction, community, and what it means to truly matter.

You'll hear conversations with Father Greg Boyle of Homeboy Industries, psychologist Dr. Gordon Flett, experts in diversion and recovery, and others who press for system change and ask us to reimagine how we care for one another.

If you believe there is a more humane way to approach mental health care, you’re in the right place.

If you are interested to partner with Heart Forward as one of our sponsors, which helps us to avoid monetization and the pop up of annoying ads mid-sentence, please explore our sponsorship package HERE.   A direct link to our Donor Portal is provided HERE. 

Subscribe now, and join us for Season Six of Conversations from the Heart. New episodes begin in August.

With appreciation always to our technical producer, Aaron Stern of Capstone Audio. 

Support this podcast with a contribution of any amount HERE

Meet Mario Colucci, a psychiatrist who has worked in a variety of roles in the Trieste system for over 30 years.  He is currently the director of the Psychiatric Diagnosis and Treatment Service , which is linked to the general emergency room of the civil hospital in Udine, in the same region of Trieste.   

I consider him “the psychiatrist’s philosopher” because of his keen intellect and how he effortlessly weaves philosophy into telling the story of Basaglia.   

In this interview, we explore four themes:

• Philosophy – and how it impacted the thinking of Franco Basaglia in the 1960’s
• Education of psychiatrists – then and now
• Power dynamics between clinician and patient – and power-sharing
• The “total institution”

 To provide some additional resource material to follow along in the conversation, the following links may be helpful.

General discussion of phenomenology.

Four influential books that coincidentally were published in 1961, the same year that Franco Basaglia was assigned to the asylum in Gorizia:

• Madness and Civilization:  A History of Insanity in the Age of Reason.  Michel Foucault (1961)
• Asylums.  Erving Goffman.  (1961)
• The Wretched of the Earth.  Frantz Fanon.  (1961)
• The Land of Remorse. Ernesto de Martino (1961)

 Additionally, Dr. Colucci provided additional resources from his own research. In  2001, he and Pierangelo Di Vittorio wrote the first monograph on Basaglia.  In 2024, they wrote a book and the links to the abstract and the book are provided below. 

Franco Basaglia. Thought, Practices, Politics  [abstract from a book written by Mario Colucci and Pierangelo Di Vittorio]  2001 by Edizioni Bruno Mondadori, Italy. 2005 by Éditions Érès, France; 2006 by Ediciones Nueva Visión, Argentina; 2020 by Edizioni Alpha Beta, Italy; 2024 by Meltemi Editore, Italy.

 Franco Basaglia. Pensiero, pratiche, politica.  Mario Colucci and Pierangelo Di Vittorio.  2024

 Here is a link to an article, “The Issue of Violence in Psychiatry,” written by Colucci in April, 2025.  

Foucault and Psychiatric Power after Madness and Civilization[Published in Alain Beaulieu and David Gabbard (eds.), Michel Foucault and Power Today:
International Multidisciplinary Studies in the History of the Present. Lanham, MD: Lexington Books, 2006.]

 Medicalisation.   Mario Colucci.  SISSA – International School for Advanced Studies Journal of Science Communication ISSN 1824 – 2049 http://jcom.sissa.it/   JCOM 5 (1), March 2006

Psychiatrie et santé mentale: une quer

Stefania Grimaldi works with the social cooperative La Collina in Trieste Italy.  This particular social cooperative was formed in 1988 and employees 200 people, 35 percent of which are considered “disadvantaged.”  

 In this episode, we briefly explore the origins of the social cooperative network in Trieste – starting with the first one called the Basaglia SC, which was features recently in a movie called 50 Years of CLU.

 We explore the two different types of social cooperatives – Type A and Type B.  In particular, we are interested in the Type B social cooperative because e they train and employ people who fall int the disadvantaged sector – which can involve physical and mental disability, substance use addiction and past experience with incarceration.

 What is interesting is how the social cooperative must operate like a business and coimpete in the market place to secure contracts to provide labor and services.  La Collina will be competing with other private entities – and therefore their workforce must be up to the job. We explore their pathway to work which involves mentoring and internship before full employment status is achieved.   The cost of the internship is underwritten by the health agency, ASUGI.  

The take-aways for an American audience are threefold:

·       Work is a human right, guaranteed by the UN Declaration of Human Rights and the Convention on Rights for Persons with Disabilities.  

·       So-called disadvantaged workers can achieve full employment and pursue their life aspirations

·       The proper supports must be in place to ensure people are trained and prepared to pursue their employment goals

Michele Sipala is a peer support worker at Recovery House, located in the heart of the city centre in Trieste.  Recovery House provides a six-month transitional residential environment for six young people, age 18 – 35, to help give a “kick start” into more independent living.   Recovery House was started in 2015 and over the past nine years, it has served 55 young people.

In this conversation, we discuss the unique needs of younger people in the mental health services in Trieste who are transitioning into the adult service sector – with changes to their clinical supports and all the stresses and challenges that can accompany an expectation of moving into adult life.  He reiterates the three pillars of their mental health system:  the importance of work, home and socialization.   

Resources and publications mentioned in this conversation:

The Recovery House in Trieste:  Rational, participants, intervention as the “work.”  APA Psyc Net 2018

The Recovery House of Trieste. Journal of Recovery in Mental Health.  2018

Full article here. 

Book that has had a great impact on Michele:

Tutto chiede salvezza  (Italian)

Everything Calls for Salvation (English version)

And it is a Netflix series – with two seasons. 

In this episode we sit down and talk with Caterina Vicentini in my hotel room in Trieste.  Caterina is a math and physics teacher at the secondary school level in a town – Monfalcone --  that is about 30 minutes from the city centre of Trieste.

She is a service user and takes advantage of opportunities like this to share her story to help destigmatize mental illness and to offer hope that one can have a full life --  education, career and family –-  even while encountering the challenges of a mental illness.  Of course, she lives and works in a region that is known for exemplary care.

Her first crisis in her 20’s happened when she was a graduate student.  At that time, she had been awarded an Erasmus Fellowship which allowed her to study in Belgium.  Then she was offered an opportunity as a PhD student to be a teaching assistant.

She recalls for us her first experience of being taken to the hospital, forcibly injected by someone she did not trust, and then placed in a padded room with four point restraints.  The shock of all that is beyond frightening and you will hear about her Houdini-like liberation that took all night long.

In 1991 she and her husband returned to Trieste and she shares the stories over the subsequent decades of a few more incidents that would set her back, and how she emerged stronger each time.  

Note:  when she talks about going to the “centro di salute mentale” or staying there in one of their beds, this is not a hospital.  This is the community mental health center, which is an unlocked place with crisis beds for those who might need to stay for a day, a week or longer.  

In this episode, we speak with Claudia Battison, a Psychiatric Rehabilitation Technician (PRT) in the mental health system in Trieste Italy.  I am joined in this interview by Dr. Joy Agner, Assistant  Professor at the USC Chan School of Occupational Therapy and Occupational Science at USC.  

 Heart Forward has become particularly interested in the potential role that occupational therapists --  if empowered to practice their profession to its full potential --  could play in mental health support settings in the U.S.  Unfortunately, the way that OT services are primarily funded (through short-term, medically oriented reimbursement systems) constrain their ability to come alongside people in their recovery journey over the long term.

 This topic was already approached in a Season Four podcast with Dr. Deborah Pitts from USC’s Chan School.

 In this conversation, we learn about the ways in which the PRT engages with the system users.  Three stark differences emerge:

•  Time.  There are no deadlines.  They are afforded the time necessary to get to know the user and tease out the life plans/goals (also referred to as a personal rehabilitation project) that are meaningful to the user.
• Friendship.  The relationship is described more like a friendship than what might be more typical in an American context.  This equates with the ethos of coming alongside people in horizontal relationships that eschew the power dynamics associated with “professional” more verticalized relationships.
• Team.  The PRT is part of a broader team – an équipe of other “operators” (their word for staff) – in the Community Mental Health Center.  The other team members can help to weigh in on how to support the system user; the PRT is not left to his or her own devices.

And, or course, all of this is grounded in the belief that a mental health system must support a person in all three pillars of one’s life:  casa, lavoro e socializazzione, or housing, work/purpose and community.  The PRT must pay attention to each of these pillars to provide support for recovery.

 As we have researched this further, it appears that this role if fairly unique to Italy and was created to augment the psycho-social support that is an underpinning to the Italian model.  As described in one of the articles linked below, “Psychiatric rehabilitation technicians are trained to perform multidisciplinary rehabilitation and education interventions for people and their carers.”  

 Here are two articles about the role of the Psychiatric Research Technician.

 Psychiatric Rehabilitation in Italy:  Cinderella No More – The Contributions of Psychiatric Rehabilitation Technicians.  Internation Journal of Mental Health.   2016

 Who cares for it?  How to provide psychosocial interventions in the community.  International Journal of Social Psychiatry.  2012

 Elena Cerkvenic recently published a book, Sono Schizofrenica e amo la mia follia, which translated  means:  I am schizophrenic and I love my madness.  This book ia part of a new series being published – La Collana 180:  Archivo Critico della Salute Mentale by Meltemi, a publisher in Milan.  

 Elena meets with us to share her story as a young woman, living in Trieste,  excited by her career studying and teaching languages and literature with a bright future ahead of her.  While on a study visit in Munich, at the age of 29, she experienced a psychiatric disruption that was sudden, scary and unexplainable.  

Her life now is bright and full and she describes herself as happy and empowered.  She credits the mental health services in Trieste for supporting her recovery and coming alongside her as a “family,” especially during about 20 years of suffering when she was quite isolated and somewhat abandoned by her family and friends.  

Elena was motivated to write this book as a source of hope for others who should not give up on their recovery and their future.  She provides a very first-person glimpse into the mental health services in Trieste and feels grateful for the kindness of the people she met along the way and their belief in her potential.

Bio from the official website for the book:

Elena Cerkvenič was born in Trieste into a Slovene minority family. A graduate in Languages, she has taught German in middle and high schools. She is currently involved in initiatives for the dissemination of Slovenian language and culture and is involved in associations of people who live or have lived the same experience as her. Her publications include the poetry collections Amore chissà se (2009) and Sapor di.vini (2012).

Links:

"Sono schizofrenica e amo la mia follia": presentato il libro di Elena Cerkvenič - RTV SLO

She speaks about the influence of philosopher Pier Aldo Rovatti.  

 If you want to reach out to Elena, please send an email to [email protected].