Sandrine Josso Photography

 

“We need to imagine a mental health service without the institution as a starting point,

or a reference point.” Damien Brennan

 

Saint Brigid's psychiatric hospital, also known as the Connaught District Lunatic Asylum, or bluntly called "Ballinasloe", a euphemism for mental hospitals, was built in 1833 due to an "apparently" growing population of mentally ill people. In fact, the nineteeth century is commonly described as the century of Asylums all around the world.

 

St Brigid's Ballinaslloe closed its door in 2013 when psychiatric services were consolidated in Galway city and Roscommon. A certain portion of the numerous buildings are still in use (maintenance) but the site is very large and lot of buildings are left unused. Designed by William Murray, the X shape form was influenced by the "panoptic" prison concept. The principle behind this layout was to allow a governor, his family  to occupy a central structure, with radiating wings from which they could monitor and administrate life within the institute. The arrangement allowed the wings to be viewed from the centre, while access was only possible from one wing to the other by passing through the centre.

 

In the case of Ireland, the rapid growth of its Asylums, the always increasing number of admission, lead us toward the conclusion that by the end of the nineteeth century, the country had locked up more of its population as “mentally ill” than anywhere else in the world. In the book  Irish Insanity 1800-2010 , Damien Brennan* drew a statistical table. It shows the number of psychiatric beds per 100,000 people in 1955. A simplified version reads like this: Ireland  710; Soviet Union  617; United States  511; Northern Ireland  440; Scotland  436; Sweden  422; England and Wales  357; Australia 332. But in Ireland, there was no epidemic of mental illness claims Damien Brennan throughout his book. The institutional confinement occured in response to the social context, traditions and family dynamic: the famine of 1845 was a social, health and economic cause of a high level of committals.The fact that land was not subdivided led to a lot of people having no income or status. A very conservative code of behaviour was applied. Land issues seem to have been a cause of "dangerous lunacy". Mary Raftery*, Irish journalist in her documentary Behind the walls, 1999:

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"There was one woman who wanted her brother out of the way, because her fiancé said he wouldn’t marry her unless she had clear title to the farm. So she had him committed".The facility to carried out the act of committal : "All you had to do was go to court and claim that your relative was a dangerous lunatic, and the judge would say ‘Fine.’ Mary Raftery, Behind the walls.

 

The diagnostic criteria for admission changed over time and were loosely applied. One report for 1879 sets out reasons for admission under four headings: 'Moral Causes, Physical Causes, Hereditary and Not Known'. Moral causes included 'poverty, reverse of fortune', 'grief, fear and anxiety', 'religious excitement', 'domestic quarrels', 'ill-treatment', 'pride', 'anger' and 'love, jealousy and seduction'.

The 21,000 people who were incarcerated in Irish mental hospitals when the system was at its largest, perhaps half were not mentally ill even by the standards of the period. At any given time, for most of the history of the State, thousands of people who should not have been in asylums were locked away in extreme conditions and subjected to appalling “treatments” that had no medical justification.

 

Unlike others church-run institutions (mother-baby homes, Magdalen laundries...) where acts of abuse, cruelty where reported and shocked the public, Irish mental asylums  didn't spark the same outrage. Although it's fair to say that the church is not blameless in that it created the social and moral norms that allowed for this kind of systematic cruelty. But the mental hospital system was overwhelmingly run by the State and local authorities.

 

Mental hospitals throughout the developed world were terrible places. People who were defined as mentally ill lost their human rights and were subjected to misery, indignity and, at times, vicious cruelty. They were guinea pigs for “treatments” from uncontrolled electroconvulsive therapy to the deliberate induction of comas with insulin.

Ireland was certainly not unique in any of this.

 

How will our present vision of mental health services be judged in a century ?   

 

*Dr Damien Brennan trained and worked as a psychiatric nurse in Ireland. He undertook his PhD at the Department of Sociology Trinity College Dublin, which detailed and critiqued mental hospital use in Ireland.  He is Assistant Professor at the School of Nursing and Midwifery, Trinity College Dublin where his teaching and research are focused on the Sociology of Health and Illness, particularly Mental Health.

His book: Irish Insanity 1800-2000, Routledge 

By the 1950s Ireland had the dubious honour of having the world’s highest rate of mental hospital residency. This book demonstrates that there was no epidemic of ‘insanity’ in Ireland, rather this institutional confinement occurred in response to social forces, along with the actions of the individuals, families and professional groups who directly carried out the act of committal. The state-run mental hospitals were the largest institutions of confinement in Ireland, however unlike institutions that were church/state partnerships, mental hospitals have not undergone extensive public scrutiny to date. This book offers an empirically based analysis of the social, cultural, economic and political dynamics that have underpinned the excessive confinement of Irish people in mental hospitals.

 

*Behind the Walls documentary produced and written by Mary Raftery  unfold the history of Ireland's psychiatric hospitals. During the middle decades of the 20th century, Ireland led the world in locking up more of its people per capita in mental hospitals, ahead even of the old Soviet Union.

This documentary reveals damning evidence of appalling conditions within the hospitals, information which was kept secret by the State. It also tells the remarkable story of Hanna Greally, locked up for almost 20 years, but who emerged to write about her experiences in the 1970s, becoming one of the very few to chronicle her experiences behind the walls.