Where men­tal health is con­cerned, we may be in at the dawn of a new era. The old stigma as­so­ci­ated with ex­pe­ri­enc­ing men­tal health is­sues is be­ing ex­tir­pated. Peo­ple are step­ping for­ward to dis­cuss what ails them psy­cho­log­i­cally and emo­tion­ally. And grad­u­ally, a deeper truth has be­gun to emerge: that to one de­gree or an­other we are all vul­ner­a­ble. This re­al­i­sa­tion doesn’t make life easy for those who reg­u­larly feel as if they are be­ing plunged to­wards the abyss. But it does open up the pos­si­bil­ity that, to­gether, we can pro­vide the nec­es­sary help and sup­port.

There are those out there who seek to ped­dle the lie that things were bet­ter in the past here in Ire­land. They be­moan the ef­fects of progress. They claim that spir­i­tual val­ues were stronger in the years af­ter the es­tab­lish­ment of the Free State, and on up to the 1950s and ‘60s. That fam­ily val­ues have since been lost. That we are less moral as a na­tion and as a so­ci­ety than we were. That we are, in all prob­a­bil­ity, col­lec­tively bound for hell in a hand­cart. They de­pict a kind of lost Eden, in which Ir­ish peo­ple lived no­bler lives. Faith. Fam­ily. Com­mu­nity. Virtue. Ab­sti­nence. Sim­plic­ity. These were the things that mat­tered. God smiled down on us. And we smiled sheep­ishly back. We were the is­land of saint and schol­ars, re-es­tab­lished af­ter cen­turies of British rule, bend­ing the knee to Rome. We knew our place too. We con­fessed our sins and did what our bet­ters told us.

If it were a dis­ease, we’d be well ad­vised to treat nos­tal­gia of that kind, for the way things were, as highly toxic. In the UK, a few bad cases of it in­fected the body politic and de­liv­ered Brexit. If peo­ple suf­fer­ing from the dis­ease of ex­ces­sive nos­tal­gia had been put into quar­an­tine, imag­ine how much bet­ter things would be in Bri­tain right now. In­stead, what ul­ti­mately proved to be a vir­u­lent con­ta­gion was al­lowed to spread. The ex­tent of the en­su­ing dis­as­ter is only be­gin­ning to un­fold. We may see dead bod­ies yet. Well, it is vi­tal not to al­low any­thing sim­i­lar to gain trac­tion here.

So let’s not fudge it. The truth is that Ire­land was a sor­did pit of hyp­o­crit­i­cal piety, which saw the great masses troop to the al­tar ev­ery Sun­day, while the most ap­palling abuses of hu­man rights took place as a mat­ter of rou­tine all around them, the length and breadth of the coun­try.

Nowhere is the stark re­al­ity of this more ev­i­dent than in the way the State dealt with men­tal health is­sues. What was done here in Ire­land, un­der the in­flu­ence of the Ro­man Catholic ethos that dom­i­nated at ev­ery level of Ir­ish so­ci­ety, was un­con­scionable.

“Let us not talk falsely now / The hour is get­ting late.” – Bob Dy­lan (‘All Along The Watch­tower’)


Re­cent years have made the ex­tent of col­lu­sion be­tween Church and State in the use of in­dus­trial schools, mother and baby homes and Mag­da­lene Laun­dries as a way of main­tain­ing so­cial order, and ad­her­ence to a nar­row Catholic view of so called sex­ual moral­ity, abun­dantly clear. But the same ap­plied in the area of men­tal health too – ex­cept most of these in­sti­tu­tions were en­tirely State-run.

If the in­dus­trial schools and the mother and baby homes were gu­lags, in some re­spects they were put in the halfpenny place by Ire­land’s psy­chi­atric hos­pi­tals. In her book Bird’s Nest Soup (1971), Hanna Gre­ally evoked the ap­palling plight of peo­ple, like her, who were locked up in what were

then called “men­tal hos­pi­tals” or “asy­lums”. Many were dumped in these piti­less places just to get them off the pitch. It hap­pened to women who had con­ceived and lost chil­dren. Or had abor­tions. It hap­pened to those who acted dif­fer­ently. Who looked strange or odd. Or who were dis­senters, peo­ple who didn’t con­form to the rigid dic­tats of a bru­tally au­thor­i­tar­ian so­ci­ety.

In those days, an as­ton­ish­ing 20,000 ci­ti­zens were more or less per­ma­nently in­car­cer­ated in psy­chi­atric hos­pi­tals around Ire­land. That was not far off one per cent of the pop­u­la­tion of the Repub­lic. Bizarrely, and yet tellingly, Ire­land was the No.1 coun­try in the world for lock­ing peo­ple up – and in a huge num­ber of cases the keys were sim­ply thrown away. Peo­ple were al­lowed to rot.

There is gen­eral agree­ment now among his­to­ri­ans that the net­work of men­tal hos­pi­tals was used as a way of dis­pos­ing of peo­ple that didn’t fit in. Peo­ple who had fallen out with their fam­i­lies were often com­mit­ted.

And within the hos­pi­tals, in­di­vid­ual pa­tients were fre­quently treated with the bru­tal­ity, and the ut­ter blind­ness to hu­man rights, which were also a hall­mark of the mother and baby homes and the Mag­da­lene laun­dries.

Con­tro­ver­sial med­i­cal prac­tices, in­clud­ing ECT and lobotomies, were car­ried out with­out any­thing like due dili­gence or over­sight. Huge num­bers died while in the care of the State, with an as­ton­ish­ing 11,000 deaths ev­ery decade be­tween the 1920 and the 1970s. It is ru­moured that there were mass buri­als in un­marked graves.

No one knows the ex­tent of this. But what is not in doubt is that these were fear­ful places. As my sis­ter Mary Stokes men­tions in her piece in our spe­cial 100 Voices For Men­tal Health fea­ture in this is­sue, within the fam­ily, we had to deal with a series of bru­tally dam­ag­ing, chaotic erup­tions from the late 1960s right up to the sec­ond half of the 1980s. Dur­ing that time, I got to know St. Bren­dan’s Hos­pi­tal in Grange­gor­man far too in­ti­mately, and I can com­fort­ably say that it was a rot­ten, stink­ing, hell-hole in which pa­tients were mired in the most ap­palling man­ner.

To say that it was un­suit­able for hu­man habi­ta­tion is to un­der­state it.

And yet, it was where a sig­nif­i­cant num­ber of Ir­ish ci­ti­zens were locked up (lit­er­ally), paci­fied with drugs and forced to en­dure liv­ing in des­per­ate squalor.

I re­mem­ber the feel­ing of hor­ror that gripped me when I vis­ited my brother Colm, when he was held there. The place was dark and filthy. I never saw ver­min but I am sure they were lurk­ing. To my young eyes it seemed that the in-pa­tients were treated like an­other species, of sub­hu­mans. They were se­dated up to their eye­balls. They were packed into wards that should have ac­com­mo­dated half the num­ber at most, and shuf­fled around like lost souls.

I ex­pe­ri­enced a ter­ri­ble feel­ing of im­po­tence too. There was noth­ing I could do to help Colm. I re­mem­ber speak­ing to Pro­fes­sor Ivor Browne, who had taken over as the Med­i­cal Su­per­in­ten­dent of the hos­pi­tal in

1966. He agreed that the place was a dis­grace to the na­tion, but there was lit­tle or noth­ing he could do ei­ther. Politi­cians didn’t give a damn. It was im­pos­si­ble to se­cure the kind of fund­ing re­quired to change things. Psy­chi­atric pa­tients were about as far down the totem pole as it was pos­si­ble to get…

And of course, this was symp­to­matic of the way Ire­land was then. Things were swept un­der the car­pet. Doors were locked and bolted. Peo­ple were im­pris­oned. Turned into slaves. At least psy­chi­atric pa­tients were saved from that grisly form of ex­ploita­tion. It didn’t mat­ter how well mo­ti­vated in­di­vid­u­als doc­tors or staff might have been: our won­der­ful, hum­ble, pi­ous, re­li­giously ob­sessed es­tab­lish­ment treated those con­fined to the pub­lic hos­pi­tals abom­inably.


All of that is a long time ago. Nowa­days, I go to what was St. Bren­dan’s Hos­pi­tal twice a week to play foot­ball. Cur­rently hous­ing cer­tain DIT de­part­ments, it is the cen­tral cam­pus of what, in 2019, will be­come a first of its kind in Ire­land, the Tech­no­log­i­cal Uni­ver­sity, Dublin.

It is mar­vel­lous to see the ex­tent of the trans­for­ma­tion on this sprawl­ing acreage, just over a mile from the city cen­tre. Those op­pres­sive old build­ings have been cleared out. The filth and grime has been sand­blasted away. It is a work in progress, but there is an open­ness and feel­ing of light­ness in the air which couldn’t con­trast more com­pletely with the sense of dark­ness and dread that I felt in this same place back in the 1970s.

It is bet­ter, far bet­ter, that the old St. Bren­dan’s should be no more.

That the tide of his­tory can wash away all of the an­cient con­fu­sion, pain, suf­fer­ing and heart­break. That we can smell the fresh air around the uni­ver­sity-to-be and en­joy the at­mos­phere of autumn as the leaves turn bronze and yel­low on the trees and scat­ter to the earth when the wind blows, there to be­come part of the great re­newal that will come fully good when the first shoots of spring come burst­ing through again.

What used to be St. Pa­trick’s Men­tal Hos­pi­tal, across the river in Kil­main­ham, is now styled as St. Pa­trick’s Men­tal Health Ser­vices. I haven’t been there for a long time now – that there has been no one for me to visit is a good thing – but the last time I called by, the place had been fresh­ened up and made to feel like any other de­cent mod­ern hos­pi­tal.

There is a dif­fer­ent at­ti­tude ap­par­ent now, among those work­ing in hos­pi­tals that of­fer psy­chi­atric and ther­a­peu­tic care. Many years ago, the push be­gan to change peo­ple’s at­ti­tudes to men­tal health. Grad­u­ally, our un­der­stand­ing of the whole ter­rain has shifted. The old stigma as­so­ci­ated with ill­nesses of the mind has been chipped at least par­tially away.

We are far more aware now of the fact that the old bi­nary model – you are ei­ther fit for the mad­house or you are not – is to­tally in­ad­e­quate as a way of look­ing at men­tal health is­sues. We un­der­stand that there are spec­trums in­volved. That none of us is im­mune. That life cir­cum­stances and traumatic ex­pe­ri­ences can, and do, play a part. That we all need healing to one de­gree or an­other.

And know­ing all of this, we are bet­ter placed to em­brace the open­ness and hon­esty of peo­ple when they do say, whether pri­vately or in pub­lic: “I have a prob­lem.” That med­i­cal in­ter­ven­tion can be es­sen­tial. But that open­ing up is also hugely valu­able. Which is why Hot Press has joined with Lyons Tea and Pi­eta House in cham­pi­oning the Now We’re Talk­ing ini­tia­tive, and the event which we have an­nounced to­day, to take place on World Men­tal Health Day.


Of all the things that we might take from that his­toric Ir­ish past, the cup of tea, drunk to­gether, is per­haps one of the few that is re­ally worth hold­ing onto. The ti­tle of Sally Rooney’s beau­ti­fully writ­ten, ac­claimed de­but novel is rel­e­vant here: we all ben­e­fit from hav­ing con­ver­sa­tions with friends, and the op­por­tu­nity to share and con­fide that these con­ver­sa­tions en­tail. Talk­ing is good for us. Be­ing with friends is good for us. Know­ing that we are not alone is very good for us.

There is one other thing I want to say here. When the Govern­ment be­gan to clear out the old ‘men­tal hos­pi­tals’, it was a fine and nec­es­sary thing.

But the way it was done, and the con­se­quences for fam­i­lies were not. What has hap­pened in prac­tice, is that peo­ple are, far too often, in a po­si­tion of be­ing forced to cope with the im­pos­si­ble. I know what it is like. Two of my broth­ers were di­ag­nosed as para­noid schiz­o­phrenic. And this des­per­ately un­for­tu­nate roll of the dice turned life in the fam­ily home in Rath­farn­ham


into a kind of liv­ing hell, much of the time, for my par­ents and for the rest of the fam­ily.

My par­ents’ love for those who have since been lost never di­min­ished. Nor did mine. But along the way, there were the equiv­a­lent of reg­u­lar car smash-ups to be dealt with, and all of the pain and suf­fer­ing that sur­rounded them, along with the cer­tainty, af­ter ev­ery one that there would be an­other – and it might be next week or even to­mor­row.

Fam­i­lies should not and can­not be left to live with and man­age these more ex­treme cases of men­tal ill­ness all on their own. The fo­cus, first of all, has to be on the in­di­vid­ual who is ill. But in ex­treme cases, moth­ers, fathers, broth­ers, sis­ters, hus­bands, wives and chil­dren can all take a ter­ri­ble bat­ter­ing over a pe­riod of years en route to a des­ti­na­tion no one can ever even be­gin to iden­tify. They des­per­ately need sup­port too – from so­ci­ety, and from the State.

That can mean only one thing: that more re­sources need to be ded­i­cated to Men­tal Health Ser­vices. Pre­ven­tion is far bet­ter than cure. But if, and when, those demons do strike, then it is im­per­a­tive that ev­ery­one knows that there is some­where to turn. And that the per­son who is wrestling with the dark cloud knows that he or she will be minded, looked af­ter, taken care of and helped wher­ever that is.

Those who are most vul­ner­a­ble need this sense of se­cu­rity most of all. I hope that in ten years’ time, we will all be able to look back and say: the con­ver­sa­tions that were started back then have de­liv­ered ex­tra­or­di­nary re­sults.

Now wouldn’t that, in time, be a mar­vel­lous legacy for us all to cel­e­brate.

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