- 03 Oct 18
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.
“Let us not talk falsely now / The hour is getting late.” – Bob Dylan (‘All Along The Watchtower’)
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 saints 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.
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.
No one thought about 'mental health' then. 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 sub-humans. 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, 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 about Mental Health have delivered extraordinary results.
Now wouldn’t that, in time, be a marvellous legacy for us all to celebrate.