In the wake of the Mother and Baby Homes report, it is hardly surprising that campaigners have begun to call for a light to be shone on Ireland’s record in the field of mental care. And although the high walls, the locked gates and the enforced isolation of the mental hospitals have long gone, it remains true that the nation has as much to answer for in its past treatment of the mentally unwell.
That Ireland had one of the world’s highest mental-hospital admission rates, it is now acknowledged, had little to do with the true incidence of illness. It was because incarceration of the mentally ill became the accepted low-cost solution to society’s problems of dealing with those who didn’t fit in. The poor, the homeless, the destitute, the elderly, unmarried mothers, those who had fallen foul of their families or of the authorities – they were as likely to find themselves behind hospital walls as were the truly ill.
Leading psychiatrist Professor Brendan Kelly’s recent study, ‘Hearing Voices’ traces the use – and abuse – of the mental health system. He commented on the fact that 20,000 patients were confined behind hospital walls. But, he says, that did not mean that Irish people were more prone to mental illness than any other race – it was because such hospitals were answering to society’s demands that somewhere be found for those who did not ‘fit in’.
Hanna Greally was a young student nurse at Guy’s Hospital in London when she came home after the shattering experience of the wartime blitz, which had undermined her health. Her mother arranged for her to be admitted to St Loman’s hospital in Mullingar, known locally as The Big House, for a ‘rest’. The ‘rest’ was to last 20 years.
Repeated escape attempts and pleading letters to her family to secure her release were all in vain. Finally, by a stroke of good fortune, she secured her discharge and returned to England where she held down a job until her retirement.
She came back to Roscommon, where she wrote the best selling ‘Bird’s Nest Soup’, a searing, first-person account of how the system could deprive people of their human rights and condemn them to a lifetime as social outcasts, banished and unloved.
When the lid comes to be lifted on the history of Irish mental care – as it undoubtedly will – there will emerge a picture of coldhearted, callous neglect by families who choose to commit a parent or sibling to a mental institution as the easy option. Hospital files are replete with unanswered requests from hospital doctors to families asking that they reaccept a family member who was ready for discharge.
Even more egregious was the recognised practice of ‘wintering in’, when a family would commit a patient at the beginning of winter, and leave them there until they were needed back on the farm for the summer.
Even though mental patients were treated with great kindness and compassion by those who nursed them, hospitals were, all too often, places of containment rather than of treatment or recovery. For the majority, there was one road in, but no road out.
But if the clamour for disclosure is not yet as loud as it might be, Dr Kelly has a possible explanation.
“One of the most interesting aspects was that the Roman Catholic Church was not involved at all. The Church is far from blameless in other areas, but in this case, these were entirely secular, government-run institutions,” he observes, “and maybe that fact challenges some of the received narrative of Irish history.”