From Bedlam to Bedpans The institutionalisation of

MSc in Mental HealthMental Health & Social Policy: 

MSc in Mental Health Mental Health & Social Policy Lecture 2: Mental health in Ireland: An historical introduction

From Bedlam to Bedpans:The institutionalisation of mental health care in Ireland 1750-1900: 

From Bedlam to Bedpans: The institutionalisation of mental health care in Ireland 1750-1900

Historical Context: Ireland in the 18th Century: 

Historical Context: Ireland in the 18th Century Rapid population growth Change from subsistence to paid labour Increase in numbers of ‘labouring poor’ Modernization and the rise of the rural bourgeoisie Unstable economy Agrarian dissent and millenarianism

Institutional care in Ireland in the 18th Century: 

Institutional care in Ireland in the 18th Century Increasing ‘visibility’ but sporadic concern (Walsh & Daly 2004) 1745 Swift endows St Patrick’s Hospital, Dublin 1772 Houses of Industry established in Dublin, Clonmel, Cork, Waterford & Limerick 1787 Prisons Act establishes lunatic wards in Dublin, Cork, Waterford, & Limerick workhouses 1799 Hallaran ‘the first Irish psychiatrist’ founds Citadella Hospital, Cork

The Hallaran Swing: 

The Hallaran Swing

Institutionalisation & the social order in the 19th Century: 

Institutionalisation & the social order in the 19th Century It is generally caused by poor heredity, or by drink, or possibly starvation. …Special authorities should be set up for the running of asylums under a strong central control. Patients have to be treated under compulsion and they must be locked in… The only way in which they can be detained without infringing the liberty of the subject is to delay certification until the patient is obviously, and perhaps incurably, insane. Early treatment might mean wrongful detention….and our first duty is to protect the sane Jones (1960, cited in Walsh & Daly 2004)

Beginning the ‘Great Confinement’ 1800-1850: 

Beginning the ‘Great Confinement’ 1800-1850 1804 House of Commons select committee recommends the building of 4 Asylums; only 1 actually built (Richmond Hospital, Dublin) 1817 Commissioners for the Erection of Lunatic Asylums 1821 Enabling legislation passed to provide for the building of asylums for the lunatic poor. 1826 Inspector General of Prisons empowered to visit ‘madhouses’ 1831 5 Asylums constructed in Armagh, Belfast, Derry, Limerick & Dublin (791 beds)

Managing the mad in the 19th Century: 

Managing the mad in the 19th Century Either by fair means or force, a complete ascendancy should be gained over the patient. Anger and violent passions to be restrained by the strait waistcoat. To be kept in silence and darkness, and as much as possible in an erect posture……Head to be shaved and cloths moistened with the coldest water or pounded ice, gently wrung and applied constantly to the head, until there is a sense of cold and chilliness ; to be renewed as soon as they acquire any heat; and again to be employed when necessary…...

Consolidating confinement and care: 

Consolidating confinement and care 1830-40 Asylums built in Ballinasloe, Carlow, Clonmel, Portlaoise & Waterford, Richmond Asylum extended (1205 Beds) 1838 Criminal Lunatics (Ireland) Act 1842 Post of Inspector of Lunatic Asylums established 1844 First Lunacy Report published 1845-50 Dundrum & Eglington Hospital Cork 1846 Inspectorate of Lunacy established

Controlling the ‘crisis’ after the famine: 

Controlling the ‘crisis’ after the famine 1859 Board of Control established to oversee asylum building programme 2 Commissioners of Public Works 2 Inspectors of Lunacy RIC conduct ‘community prevalence’ study of ‘lunatics at large’

Slide11: 

‘They were eminently successful as curative establishments …..’ ‘a wondrous immunity… from accidents and deeds of violence, considering the excitability of our race.’ Dr Nugent ‘Observations on the Report of the Commisioners of Inquiry into Lunatic Asylums (Ireland)’ 1858

Changes in the Irish Lunatic Population 1851-1891: 

Changes in the Irish Lunatic Population 1851-1891

Consolidating control at the end of the 19th Century: 

Consolidating control at the end of the 19th Century St Ita’s Auxiliary asylum at constructed at Portrane 1890 Largest capital project undertaken by colonial administration in Ireland 21,000 or 0.5 % of Irish population resident in asylums

Explanations of lunacy in 19th Century Ireland: 

Explanations of lunacy in 19th Century Ireland Emigration Low rate of discharge Preference for the asylum over the workhouse Lower tolerance of insane in the community Low mortality amongst inmates Low rate of syphillis in general population Moral heredity & tea

Further reading: 

Further reading Finnane M. Insanity and the Insane in Post-Famine Ireland. London: Croom Helm, 1981 Malcolm, E. Swift’s Hospital: A History of St Patrick’s Hospital, Dublin 1746-1989. Dublin: Gill and Macmillan 1989. Robins, J. Fools and Mad: A History of the Insane in Ireland. Ireland: Institute of Public Administration, 1986. Saris, A J. The Asylum In Ireland: A Brief Institutional History and Some Local Effects in The Sociology of Health and Illness in Ireland A Cleary and M P Treacy (eds). Dublin: University College Dublin Press, 1997. Scull A T. Museums of Madness: The Social Organisation of Insanity in Nineteenth-Century England. London: Allen Lane,1979. Walsh D Daly A Mental Illness in Ireland 1750-2002: Reflections on the decline of institutional care Dublin: Health Research Board 2004