Following the launch of the paper back copy of Hearing Voices: The History of Psychiatry in Ireland, RTÉ Presenter John Bowman explored (Sunday 18th Aug 2019) short excerpts of recorded interviews with experts on the asylums and mental institutions in Ireland. Archive interviews with Prof Brendan Kelly, author of the book, also feature. This excellent and interesting short programme reminds us of how far our society has come in how we deal with those who vulnerable.
You can listen to the full episode here from RTÉ. The relevant section begins around 0:09:30.
Read some excerpts from the interviews below:
Prof Brendan Kelly, author of Hearing Voices: The History of Psychiatry in Ireland
On the book title Hearing Voices
‘It has multiple meanings. Hearing voices is commonly a symptom or something people report when they’re mentally ill. The book is also about hearing the voices of patients and staff from our asylums that had been forgotten in the past. But most importantly, in recent times it’s been realised that many people hear voices that aren’t necessarily there, and that they can live with these voices as part of their inner life. Some such people are indeed mentally ill, but some are not. This is one of the ways that psychiatry and mental health and our understanding of ourselves has evolved.’
On the conditions of people with mental illness before asylums were introduced
‘[In a 1817 committee] it was reported that “there is nothing as shocking as madness in the cabin of a peasant when a strong young man gets a complaint. The way they manage it is making a hole in the floor of the cabin, not high enough for the person to stand up in, with a crib preventing him from getting up. The hole is five feet deep. They give the wretched being his food there, and there he generally dies. Of all of human calamity, I know of none equal to this.” And this was back in 1817, before the era of the asylums. So before we even built the large institutions, people with mental illness ended up detained in prisons, in private residences as we see there, or indeed wandering the streets and the fields.’
On the difficulties of returning people with mental illnesses to their families
‘The asylums and the psychiatric services were often asked to do things, particularly take people in – people who were mentally ill, people who were intellectually disabled, people who didn’t fit in for one reason or another. But the system had great difficulty discharging them back to their families. So, for example, in the book [Hearing Voices] I quote a letter from the 1800s to Omagh Asylum where the doctor says, “Please take your relative home.” The family write in and say, “We can’t take him home, we’re too poor. We can’t have him in our home. Please do not write to us again about him. Simply keep him in the asylum and write to us again when he dies.”’
Dr. Hanora Henry, Our Lady’s Psychiatric Hospital, Cork:
On the conditions of asylums and the social repercussions of having a person with mental illness in the family
‘[The patients] were in prisons mainly. They were kept in outhouses. They were kept in holes in the walls, so to speak. They were kept in pits under the ground with a bit or grate over top of them, that is recorded in some of the earlier areas. Actually, there was very little about the care of the mentally ill until the treatment of George III. This created a need and a concern, especially among the English, for the care of the mentally ill. […] During the 19th century, the public were frequently invited into the hospitals to participate in recreational activities in the mental hospital. But prior to that they were neglected, chained, confined to outhouses, taken out at night for fresh air. Usually the families were told nothing about them. Any family with a mentally ill person was barred from being in the church, for example, entering the convent, going into nursing, teaching or anything like that. And of course you also then had the practice of matchmaking, where if there was a mentally ill person in the family and if was known, well then the other family wasn’t inclined to join those with a mental illness. They were really barred from quite a lot of activities, from most normal social activities.’
Joseph Robins, author of Fools and Mad: A History of the Insane in Ireland:
On early treatment methods and the evolving attitudes toward treatment for mental illness
Moral treatment approach
‘If one goes back a bit earlier into the last century, there was greater optimism then. There was a belief that by being kind to patients, by treating them according to what was called at that time the moral treatment methods, simply being kind to them and feeding them well and lodging them in comfort, that they would get better. It was an over-optimistic assumption which didn’t work out. By the end of the last century there were huge crowds in all the asylums which were built to cater to many instances which were, perhaps, one-third of the population which were in them by the end of the century. You would have had a mental hospital with 1,500 which was intended for 500.’
Custodial maintenance approach
‘By the beginning of the present century there was an air of pessimism descended over the whole service and people going into mental hospitals were faced with a long period of care there. It was custodial care, really, with little treatment. The result was that discharges tended to be few. For instance, in the first decade of the present century there were more people dying in a mental hospital than were being discharged.’