The Secret History of Mental Health in Ireland

Nowadays we speak freely of mental health. This is a very good thing. It wasn’t always so. For perhaps seven or eight generations, we were expected to keep a lid on inner turmoils and disturbances; take them on the chin, keep your upper-lip stiff and your back straight.

Much was left unsaid, unexpressed, unrecognised. And there was so much that needed airing and acknowledgement. There still is.

Of course, these things aren’t absolute. Families and communities have found ways to comfort and shelter those in difficulties. But the overarching impression from those eight generations is of numbness, intolerance and repression of both the issue of mental illness and the mentally ill themselves. As the late, great Irish playwright Brian Friel told Peter Lennon in 1964, the “Irish mind has many windows and the blinds are often down.”

That said, we must avoid the trap of romanticising earlier times, of thinking that the Irish of medieval and early modern times were more accepting, humane and understanding when it came to mental health - and that the denial and repression of those eight generations were a result of being colonised, co-opted and suppressed by both a rapidly expanding British empire and economy, and militant Roman Catholic Church.

While there is no doubt that this overarching political and clerical conquest deeply influenced Irish attitudes, and the peculiarly institutional responses to mental health and ill-health that resulted, as they also did with sexuality and poverty (there is, after all, little to choose between asylums, laundries and workhouses), it is a very dubious assumption indeed to think that the centuries leading up to the Act of Union were all sweetness and light.

Little is known of those times, though we can glean bits and pieces. For example, the depiction of mad figures in early medieval Irish and Scottish sources was studied by University of Rennes academic Anna Matheson for her doctorate (2011). She shows that “an association between madness and vagrancy is widespread in medieval Irish texts” - and that the wanderlust of the madman takes on a spiritual significance. Indeed, it’s presented as a form of penance, thereby aligning the madman with the ailithir or “pilgrim exile” of insular penitential tradition.
Dr Matheson also notes that, “The breadth of terminology believed to denote variant forms of illness in the legal, historical and literary texts has long been recognised as extensive and sophisticated…”

So mental health issues have always been with us, and they have been recognised as well. Of course, the population was much smaller, and modern drivers of stress and alienation didn’t exist. But there were others. Wars and disturbances may have provided safety valves, and itinerant traditions of music, drama and carnival may have grafted a more tolerant, even protective, situation.

There are downsides to this, of course. While mental illness may have been more accepted, treatment was likewise scant. St Patrick’s Hospital was established with funds from the will of the great satirist, patriot and Dean of St Patrick’s Cathedral, Jonathan Swift, who died in 1745.
Having been a former governor of the notorious Bedlam asylum in London, he understood that the membrane separating mental health and mental illness is fragile. He recognised that those suffering from mental health difficulties needed a specialist service to provide care and treatment. This was very progressive for its time and indeed still rings true to many campaigners in 2017. But developments in the 19th century drove everything in a different direction, in particular the establishment of an extensive system of public asylums that followed the 1817 report of the Committee on the Lunatic Poor. What a name.

Of course, the 19th century gave plenty of challenges to mental health, including the wars and rebellions; the return of soldiers from the Napoleonic wars; economic stagnation following the Act of Union; crop failures (of which the Great Famine was, of course, the deadliest); and the agricultural and industrial revolutions, and consequent dislocation, migration and emigration. Not to mention increased intrusion into private lives by an increasingly assertive and invasive ultra-conservative clergy…

It’s no surprise that the mental health resources of families, communities and institutions were often overwhelmed. And so, in a land of squinting windows, the blinds came down.

Well, in the 21st century, there’s even more to worry about than the 19th, by a long shot, including the prospect of nuclear annihilation and vast global climate change. But now, at least, in Ireland we recognise the need to open those blinds, to think of mental health as a continuum spanning positive mental health, mental distress and mental ill health and to try to engender a general culture of mental well-being.

It’s a sea-change, helped hugely by courageous individuals - writers, musicians, sportsmen and women, entrepreneurs - who have spoken of their own troubles with depression and the importance of finding ways to foster mental health.

We get it. And yet there’s a paradox: many people spend a lot of time and effort being physically fit but don’t care for their minds and mental health. There is truth in the old maxim mens sana in corpore sano, but it’s not an absolute. We need to maintain mind and body alike.

In doing so, we must be watchful not to replace old repressions and dogmas with new ones. Recognise and ignore scare stories and self-serving hysterias in the media and social media. Be wary of the huge wellness industry. Avoid gurus and charlatans.

Just do the simple things: stay fit and stay connected. Don’t be tyrannised - by expectations or prejudices (others’ or your own), by social media, by convention or by fear. Don’t be afraid to ask those you trust for help. And if those you trust tell you that you need help, don’t be afraid to accept.

And if there’s just one thing you’ll do, learn to breathe. That way, what needs air will get it.