Ireland’s mental hospitals: the last gap in our history of 'coercive confinement'?

By Carl O'brien
Irish Times
June 16, 2014

http://www.irishtimes.com/news/social-affairs/ireland-s-mental-hospitals-the-last-gap-in-our-history-of-coercive-confinement-1.1833379

Some of the artefacts and records on view at Grangegorman Community Museum. Grangegorman was home to Ireland’s first psychiatric hospital founded in 1814.

At the age of 19, Hanna Greally was admitted to St Loman’s Psychiatric Hospital in Mullingar. It was the mid-1940s and she had just returned home from London, where she had witnessed the horrors of the blitz.

She thought she was being admitted to the hospital for “a rest”.

Despite several escape attempts and pleading letters to relatives to sign her out, she remained there for the best part of 20 years.

Bird’s Nest Soup, her book published in the 1970s, captured in haunting detail the lives of others stripped of their human rights – social outcasts, the unloved, the incurably embittered and the dispirited.

“The patients inside, expectant, waited for the letters and the visits, until finally, one day, they would find themselves rejects, outcasts, and no explanation given. Sometimes a crushed spirit breaks, from mental agony and anguish, when she understands at last she is captive in a free society.”

At the time there were more than 20,000 patients confined behind mental hospital walls across the State, or 0.7 per cent of the general population.

In fact, Ireland led the world locking people up in institutions, with inpatient admission rates that were multiples of other countries – even ahead of the old Soviet Union.

“The high rate had nothing to do with mental illness,” says Dr Eoin O’Sullivan, associate professor in social policy at Trinity College Dublin. “They were used to dispose of people who society didn’t want . . . They were the single biggest part of our system of coercive confinement.”

As the Government prepares to establish a commission of inquiry into the operation of mother and baby homes, some mental health campaigners now say it is also time to shine a light on another gap in our social history – what happened behind the high walls of our mental hospitals.

These institutions share – at least on the face of it – many issues that have been flagged in mother and baby homes.

Mortality rates were high, with more than 11,000 deaths every decade between the 1920s and 1960s.

Discredited procedures

Experimental but now discredited medical procedures were also commonplace, including lobotomies – which involved removing parts of the brain – and insulin coma therapy, where patients were repeatedly injected with insulin to induce a coma.

There is also evidence of controversial burial practices – such as mass, unmarked graves – and the wrongful incarceration of people who had fallen foul of families or authorities.

But there are also some crucial differences.

These were institutions operated by the State, which were subject to inspection and, in some case, were closely integrated in the community.

“They were asylums in the old meaning of the world,” says Dick Bennett, a former staff nurse who worked in St Brendan’s Hospital in Dublin from the 1970s. “There was a sense of community there. The standard of care was excellent. You had people who lived into their 80s or 90s.”

But the number of deaths was considerable earlier in the century. Eoin O’Sullivan and Ian O’Donnell’s Coercive Confinement in Ireland found that one in 20 patients died annually between 1927 and 1963 – or 40,000 people – mostly from tuberculosis and other diseases, with a very small number taking their own lives or killing others,” according to the book.