Madness and Society

At six o’clock each morning, the alcoholics, addicts, and mentally ill residents of San Donato Val di Comino, Italy, emerge from their homes and congregate—sometimes together, but mostly alone—in the cafés around the town’s main square. Some of the hardened alcoholics order an espresso with a shot of liquor, then climb into work trucks and head out to farms and construction sites. The mentally ill—who suffer predominantly from depression, bipolar disorder, and schizophrenia—order cups of coffee or sit at the patio tables emptyhanded, an indication that they have run out of cash for the month.

My father was born in this village, where I’ve observed this early-morning ritual during family vacations over the past two decades, but this time it struck me in a new way. For the past 18 months, I’ve reported on homelessness, addiction, and mental illness in American cities and spent many hours with America’s most vulnerable residents, who, on the surface, struggle with the same afflictions as the residents here in San Donato.