The background of the Killarney District Lunatic Asylum runs in parallel with the national setting. Subject to the 1845 Lunacy Act, each district authority had a duty to provide and maintain proper and sufficient accommodation for treating insane or lunatic patients entitled to use their service. The district authorities were bound by the 1845 Lunacy Act to build a district lunatic asylum for its population. After this act, Ireland’s number of asylums expanded from eleven to seventeen over the next few decades (Prior, 2012: 224). The Killarney District Lunatic Asylum, presently known as St Finan’s Hospital opened its doors in December 1852 on a 30 acre site in Ballydribbeen, Killarney. The asylum was built to house 250 beds, and for the first few months, the numbers were small (Dwyer, 2002). Of the 135 patients that initially populated the asylum, a significant portion were females transferred from the lunatic section of Tralee jail.
Figure 1: St Finan’s Hospital 1852-2012
In the latter half of the 19th century, the Killarney asylum continued to expand both in numbers and premises, predominantly due to chronic overcrowding. Inspector reports in the first half of the twentieth century often referred to the Killarney asylums marked overcrowding, with gloomy rooms, crowded corridors in the daytime and inadequate ventilation (Annual report). Statistics produced by the Lunacy Commissioners of Ireland (Finnane, 1981:135), indicated that the Killarney asylum had an increase of 270%, of first admissions from 1871 to 1911. This was the second highest increase in Ireland (Finnane, 1981:135) with only the sizable Ballinasloe district asylum having larger admissions. Various factor was marked as contributing to the asylums increase in number. A report by The Congested Districts Board on Social Conditions (1914) attributed the high numbers in the Killarney asylum to the easy availability of premises that sold alcohol and whiskey throughout the county. Hereditary factors were considered to be a significant factor both in Killarney and nationally.
The 1915 Annual Report found that the some of the Killarney male patients were found to be untidy and worn with significant overcrowding and insufficient number of staff. On one occasion, a male patient attacked another patient, resulting in the rupturing of the small intestine, and subsequently peritonitis set in, which proved, fatal. The patient was found insane on arraignment and incapable of pleading. He was detained during the Lord Lieutenant’s pleasure, and served the rest of his life in Dundrum Criminal Lunatic Asylum. Though Dundrum was the institute for the criminal insane, violence was still a contributing factor in being admitted and remaining in district asylums.
By 1925, the inspector reported that the numbers of admissions continue to increase and that overall the patients seemed in good health. Female patients needed more variety in their clothing with a suggestive theme that poverty and lack of basic resources were a factor for some of the residents. Due to the large county area of Kerry, patients were allowed visitors daily, which the inspector disapproved of. Meals were satisfactory with lots of vegetables from the farm and it could be speculated that some of the residents were receiving more nourishment in the asylum than in their homes. Staff training was generally insufficient which questions the level of medical expertise in rationalising and categorising the patients’ symptoms, diagnosis and underlying causes.
Again in 1915, national average statistics from the Inspectorate claimed that 33% of male patients recovered, and 48% of females, the rest are presumed relieved, not improved, died or in rare cases, escaped. 8.7% of males died and 7.4% of females in 1915. In comparison to 1910, there was no significant changes of the total deaths in the asylums with 8.5% of patients dying in 1910 and similar amount of 8.1% in 1915.
Death rates were attributed to many health-related causes rather than mental illness. Phthisis (TB) and respiratory conditions were frequent factors in the overcrowded institutes and according to the inspectorate, KDLA was particularly unpleasant in the 1920s.
Figure 2: Phthisis (TB) was frequent in KDLA and was cited as a frequent cause of death
Following the Report of the Commission on the Relief of the Sick and Destitute Poor including the Insane Poor in 1927, mental hospitals were beatified by the Saorstát and the Killarney institute became St Finan’s Hospital. Comparable to national figures, the Killarney patient numbers continued to grow until its peak in the mid twentieth century when over 1,100 patients resided in the institute. Gradually Irish mental health policy began to change and in the latter half of the 20th century, there was a significant decline in patient admissions.
There was also popular belief that if you were admitted into a psychiatric hospital or a lunatic asylum as it was known over 100 years ago, that it was unlikely that you would get out alive. In the early part of the century, this was not always the case. For example, if you were admitted to the Killarney asylum in 1920, you were slightly more likely to be discharged than serve the rest of your years there. While discharge usually meant that the medical professionals regarded you as recovered from the mental illness, sometimes, people were discharged if the symptoms were simply relieved or on rare occasions without improvement (these cases may have been discharged into the care of another asylum or institution). Though there were cases of patients who escaped from the Killarney asylum, there were no recorded escapes in 1920. If however, you were admitted to the KDLA in 1920, the average length of stay for individuals was over five years.
Additionally, in the early part of the 20th century, there were many routes to admissions. The most common route was via a family member, friend or employer who suspected an individual of insanity. They could do this via signatures from the Justice of Peace or general practitioner. The psychiatrists would usually not contest the admission. This admission route had the potential for abuse and there are many stories of individuals with no signs or symptoms of mental illness who have been committed into asylums throughout Ireland. The reasons were varied, from disputes about family land or conflicts or moral disapproval of the individuals viewpoints or lifestyle. The next most common route was via the Dangerous Lunatic Act, where an individual was involved in a physical assault, threats, or a similar aggressive offence and deemed at risk to the public or self. Admissions from the workhouses of County Kerry, were the third most common route of admissions. Workhouses historically had units devoted to individuals with forms of mental illness but during the 20th century, the workhouse role changed to a County Home for the elderly. This resulted in a regular transfer of patients presenting with varied signs of mental illness, to local district institutions which specialised in the treatment of mental illness. On a minor scale, there were patients referred from the army, often as a result of shell shock from their experiences in Great War. The police and prison service (under his majesty’s pleasure) could also transfer patients (the courts could also instruct the asylum to transfer patients to prison depending on criminal sentences).
Admission to KDLA did not change significantly in the immediate aftermath of Irish independence. Initially, after the The Report of the Commission on the Relief of the Sick and Destitute Poor including the Insane Poor in 1927, mental hospitals were beatified by the Saorstát and the Killarney institute became St Finan’s Hospital. After the Irish Department of Health took over the running of St Finans, the number of admissions and residents continued to grow at an alarming rate. This growth is not unique to the Killarney psychiatric hospital and does correlate with growing national figures of the time. By the mid twentieth century, St Finan’s hospital had over 1,100 patients resided in the institute. While there has been some interesting accounts of the workings of Dr Eamon O Sullivan as a promoter of occupational therapy in St Finan’s in the 1930s and some informative accounts of the staff experience and sporting activities by Weeshie Foley and Dermot Dwyer, there is minimum information on the lives of patients in the densely populated institution in the mid 20th century. Further research on this era is one of the aims of this digital artefact.
In 1999, Dermot Walsh, the Inspector of Mental Hospitals, recommended that the Southern Health Board facilitated an accelerated closure of St Finan’s Hospital. He found that the conditions for some long-stay patients were far from satisfactory. By 2003, he writes: “Conditions in St Finan’s Hospital were quite unacceptable. This was particularly true of the male wards, St Peter’s, St Paul’s and St Joseph’s. Conditions in Our Lady’s ward, where staff were coping valiantly with unsatisfactory conditions also exemplified the unsuitability of this old building to modern practice”.
By 2011, the Mental Health Commission also recommended the closure of St Finan’s. A critical report by the Inspector of Mental Health Services found numerous areas of concern in St Finan’s Hospital. Factors such as the lack of privacy for female residents in cell like rooms to communal underclothing, lack of a varied menu and drinking water for patients were mentioned. St Finan’s was described as “drab, bare, institutionalised and smelly” with evidence of disintegrating plaster, “peeling paint” and ” mould” in some of the wards. The report praised the cleaning staff who had the difficult job of maintaining clean wards despite the decaying and underfunded environment. However, while moving away from the old asylum method of mental health care was supported by the Psychiatric Nurses’ Association, there was a genuine concern by the organisation that “cutbacks, retirements and the recession were more of a factor in the closure of St Finan’s rather that any meaningful movement to a comprehensive community-based mental health service”.
In September, 2012, after 160 years of mental health care in County Kerry, the architecturally magnificence building which towered over Killarney and the mental health services of County Kerry, finally closed its doors. Doors which thousands of patients have passed through, and with them, thousands of raw stories of people who were locked away, often hidden from our sights. Over time, this site, hopes to give a voice to some of these stories.
For a timeline overview of the history of St Finan’s Hospital, view 160 years of St Finan’s Hospital, Killarney