Asistencia psiquiátrica hospitalaria en Bizkaia. Del Hospital de Nuestra Señora de Gracia (Zaragoza) y la cárcel galera de Bilbao, al Instituto Neuropsiquiátrico Nicolás Achúcarro (actual Hospital Zamudio)

Historical tour of the origins and vicissitudes of hospital psychiatric care in Bizkaia, taking as a starting point the beginning of the 19th century and the terrible healthcare conditions of the time. At first, the acutely alienated were barred from entering the then Achuri General Hospital, being sent to one of the prisons in Bilbao, along with beggars, criminals, and prostitutes. If their state of illness maintained, the absence of an institution for "insane" in the territory, forced the hospitalization in other provinces, far away from their family and friends, from which, sooner or later, they were totally uprooted given the long stays, even for decades. A provincial madhouse was a long-standing aspiration, which finally never came to completion in its entirety, with partial responses such as the Bermeo hospital in 1900, or later the old spa of Zaldibar, “provisionally” dedicated to hospital purposes from 1923. Since then, there have been several attempts to take up the matter of the provincial madhouse, with some scandals and complaints even from outside, forming a surprising succession of multiple proposals and failed projects until the last third of the 20th century. Among many others, the most ambitious project was the one promoted in the early 1930s, where a macro hospital complex was planned to welcome 1,300-1,500 patients and was finally transferred in 1951 to the Bishopric of Bilbao, for seminar purposes. It was in the late 1960s that a new psychiatric clinic project materialized, the current Zamudio Hospital of the Bizkaia Mental Health Network, Osakidetza.