In these days of endless Church scandals, the role of the State in the abuse of the citizenry is often overlooked. Paul Reynolds opens the Pandora’s Box that is the history of Irish psychiatric healthcare.
Grangegorman, in Dublin’s North inner city is perhaps the most striking example of Ireland’s journey through psychiatric healthcare. Built 200 years ago to the plans of London’s Bethlehem (‘Bedlam’) Hospital, it was at the time a progressive leap and signified a willingness to deal with ‘idiots and lunatics’ rather than leave them to families, death or the church.
In October 1968, The Irish Times published an influential series of articles by Michael Viney highlighting a range of problems related to mental healthcare and, in particular, the large numbers in psychiatric hospitals. The following decades saw determined efforts by Government and health services to move psychiatric care away from institutions into the community. By 2003, there were fewer than 3,700 psychiatric inpatients – an 80 per cent decrease in four decades. Eighty Per Cent.
In 1960 there were 500 people in Irish prisons. In Irish ‘Lunatic Asylums’ the number exceeded 20,000. In many towns, the asylum single-handedly dominated the local economy: in 1951, Ballinasloe had a population of 5,596, of whom 2,078 were patients in the asylum. By 1961, one in every 70 Irish people above the age of 24 was in a psychiatric hospital.
It is something that we have cleansed from our conscience but, like the other skeletons in our closet, it will come back to shame us.
The mentally ill were seen as different from the poor and indigent; while we built poor houses for them, until the 1821 Lunatic Asylum for the Poor Act we had no concerted approach to dealing with the mentally ill.
Of course our definition of mental illness and that of our ancestors varies greatly. It must be noted that involuntary commitment could occur for a plethora of ‘ailments’ such as masturbation, atheism, homosexuality and even laziness. So wide-ranging were the ailments that by the 1940s all that was needed to lock someone away was a family member to claim they were insane. By the post-war years we had more people in asylums or mental hospitals per capita than anyplace on earth.
Naturally the conditions were appalling. Even in the early years Grangegorman accommodated 2,000 in-patients. While the local poorhouse was afflicted with filth, disease and relied on wheelbarrows of leftovers to feed the poor the state of Grangegorman was not very different. Tales from around the country, in the 20th century, explain that the number of in-patients exceeded the number of beds sometimes by as many as 3 or 4 to one so patients either slept in groups or on floors. A 1958 report on St Luke’s Hospital in Clonmel, described the patients all stripped at 6pm, then herded up to bed, naked, at half past six. Women with no sanitary towels, faeces all over the place, food ladled out with garden forks.
Grangegorman’s in-patient facilities began closing in the 1980’s and by this year the old premises had all closed with patients having been situated elsewhere in modern small care facilities. One small newer facility still operates in the grounds. The grounds will see the demolition of almost all the buildings this year as the new DIT campus rises from the rubble.