How we treated the mentally ill says a lot about us
THE recent inquiry into the mother and baby homes in this country has generated significant questioning, disbelief and anger among those directly affected by these institutions. The children of mothers placed there are seeking answers as to how these establishments came about in the first place.
They also want to know how could they become such toxic environments.
The authors of an inquiry into the homes suggested that the nature of society in Ireland at the time was a major contributor to the tragic outcomes.
The study of another group of institutions might also be illuminating.
The psychiatric institutions, or lunatic asylums as they were then called, played a huge social and economic role in the local communities and beyond. Like the mother and baby homes, here too people were kept locked away from the world, in many cases until their death.
Until the middle of the 18th century those with mental illnesses were looked after by their families. This was the case across Europe and the United States. But with no treatments available, widespread poverty and abounding atavistic fears of the mentally ill, victims did not fare well. The book Mental Illness in Ireland by Brendan Kelly, Professor of Psychiatry at Trinity College, describes the plight of this group; it was starkly illustrated by the Right Honourable Denis Browne, an MP for Mayo, when he gave evidence to the Select Committee on the Lunatic Poor of Ireland, established by Robert Peel in 1817.
He reported that “when a strong young man or woman gets the complaint, the only way they [the family] have to manage is by making a hole in the floor of the cabin not high enough for the person to stand up in, with a crib over it to prevent his getting up, the hole is about five feet deep, and they give the wretched being his food there, and there he generally dies”.
Against that powerfully distressing image the building of psychiatric hospitals for the impoverished mentally ill flourished in Ireland and seems to have been driven by philanthropy, as it was in Britain, Europe and the USA.
Figures tell the story. The number of residents in psychiatric institutions in Ireland in the 1800s rapidly exceeded their capacity. In 1851 there were 3,234 people in psychiatric institutions and by 1914 it was 16,941. A 1966 Commission of Inquiry into psychiatric institutions found that it had the highest rate of psychiatric hospitalisation in the world and that more men than women were incarcerated.
The possibility that abuses took place in these asylums cannot be ruled out. Even in 20th century Sweden women in asylums were forcibly sterilised to ensure the genetic health of the nation. Similar practices were prevalent in the US until the 1940s.
In Soviet Russia psychiatrists became puppets of the government in the 1960s when the diagnosis of “sluggish schizophrenia” was invented, allowing dissidents to be detained in psychiatric institutions simply because they disagreed with the political zeitgeist.
In detention, they were administered electrical treatment without anaesthetic, high doses of the recently synthesised antipsychotic chlorpromazine and given insulin comas. In 1989 the Greek island Leros housed mental ill people who were treated with degradation and cruelty to the astonishment of the whole world.
Hopefully no practices of the magnitude and depravity of Leros or Russia took place in Irish psychiatric institutions but a review of these institutions is necessary to establish this.
What would be the purpose of such a review – what is retrospection likely to achieve? All of our institutional reviews so far, into mother and baby homes, laundries and the industrial schools have focused on those run by the Church.
Psychiatric institutions, on the other hand, were exclusively the responsibility of the State. Yet Church and State seem to intersect in their recourse to incarceration and both have shown callous disrespect for the humanity and dignity of their inmates.
What drives this? What is it about the Irish psyche or Irish society that has such a propensity to lock people up, away from public view? Was the State acting on its own or in consort with the wishes of the populace? A formal review of Irish psychiatric institutions would assist in answering these questions.
A review would also provide a more broadly based appreciation of the society in which these practices flourished. This was touched upon in the report on the mother and baby homes.
The expansion of the review process to include psychiatric institutions would enrich our sociological understanding of incarceration as tool of the state against the vulnerable.
To date the blame for the conditions in the institutions that have been studied has, in the public mind, focused on a harsh, punitive Church. But the activities of psychiatric institutions in this country, with the highest rates of incarceration in the world until they started to close in the 1970s, is surely a study in social history and begging to be explored.
We can only know who we now are by understanding our history, murky though it may be.
Even in 20th century Sweden women in asylums were forcibly sterilised