Behind the Walls

Behind the Walls is a two part documentary made by journalist Mary Raftery for RTE  which covered the historic treatment and abuse of patients in Irish psychiatric institutions or asylums. The documentary gives an insightful and sad account of the stories of pain, abuse, neglect and dis-empowerment experienced by patients in Irish Mental Hospitals. These institutes often became dumping grounds for Ireland’s unwanted. People who were outcast, the unwanted, the different, people that did not confirm, spirited people and people who questioned authorities. There was too, people who struggled with life and its demands, people who had clear mental illnesses, were trying to cope with abuse or were suicidal and melancholic (what we would called depression today). There is no doubt that the admission criterion, definition and diagnosis for insanity was very broad and appears to be easily manipulated. The documentary highlighted that one causative reason was ‘husband in California’. Certainty with my research on the St

Finan’s archives, I have come across an equally broad criterion for admission (See Figure 1 below) and saw a similar rationale, such as ‘resident in the USA’,  ‘husband in England’ as well as ‘seduction‘, ‘married life‘ as well as physical illness like ‘influenza‘ or ‘anaemia‘.

The archival case books and other material from different old psychiatric institutions are regarded as damning documents that give an unique insight into the human condition. Indeed, from the first day that I gained access to the archives of St Finan’s, I was aware of the enormity of responsibility in both reading and telling the stories of the thousands of people who have passed through its doors.

Over the next while, I will be compiling some of the case stories (whilst maintaining confidentiality) and am going to share the insights that I have come across. Already I think of a young 19 year old woman, who had to go to the Killarney Workhouse to give birth to her child. She was unmarried, without income, and apparently without family or family support. Soon after giving birth, she returned to the lane-way where she had previously been living and came across another young woman, who it appears, was a source of rivalry.  In a fit of jealousy, she approached the girl and threatened her with a knife. Subsequently, she was apprehended and taken to the asylum.  Another case involved a young spirited girl in her mid- twenties, who tried to get away from her overbearing mother. She was found at the railway station, with her bags packed, ready to leave. When confronted at the station, she resisted returning with her mother. Again, she attempted to get away and her mother, beckoned people to help. The young woman fought three or four people, including the police, that tried to to hold her down. Instead of getting away, she was gathered by the group and forcibly brought to the asylum. After being admitted, both females, explained their predicament; the former, acted in a fit of jealousy (possibly in relation to the father of her child starting up a new relationship, the latter, wanted to get away and lead her own life). In the case books for both patients, behavior was described as normal with no signs of mental illness. However both stayed inside the asylum walls for a length of time.

Going back to the documentary, the decades of individuals forgotten in institutions is a story that needs to be told. A lot of the programme focuses on the institutions in the 50s and 60s when Ireland’s huge institutional system was operating at a never ending expanding size and scale. Some of the leading experts on the history of Irish psychiatric institutions discuss its legacy but its the stories of its patients and survivors that give insight and give the human connection. One wonders about the size and scale of admissions and why as a society we felt the need to collaborate in locking away so many of our people.



A Few Short Words on Jail, Asylum and Psychiatric Care

Early asylums developed from prison system. Jails and workhouses would have lunatic sections and when the Killarney District Lunatic Asylum first opened in 1852, the majority of the initial patients were from the Tralee jail or the Tralee and Killarney workhouses. According to Professor Kelly in his book Hearing Voices: The History of Psychiatry in Ireland, some of the procedures in the asylums came from prisons system rather than a healthcare standpoint. This resulted in some patients being chained up, while others were restrained in straitjackets. According to the Inspector of Lunacy in the mid 1800s, some asylums were particularly bad. In Limerick asylum, patients were chained with their hands placed under their knees so that they were unable to stand up resulting in a permanent disability and an inability to stand up straight.

The history of mental healthcare has shown that how we treat the mentally ill in our society is far more to do with how society treats the vulnerable than any other area of social care or medicine. In 1907 at the Richmond asylum, one third of all admissions were directly from the workhouse across the road. Brendan Kelly points to his time working in the Mater in the last decade, noting that one third of psychiatric assessments in the emergency department were homeless people. Ireland has a significant problem with suicide and some sources state that mental health issues have risen over the last twenty years. A warning that the fast changing pace of the 21st century may be a new challenge to mental healthcare.