of both therapeutic enthusiasm and efforts to reform and expand Ireland’s emerging asylum system. This initiative built on progress elsewhere, especially the humanitarian approach of Pinel in Paris, who pioneered less custodial approaches to asylum care, and Tuke’s York Retreat, based on policies of care and gentleness, as well as medical supervision.10
From its establishment, the Richmond pioneered ‘moral management’ in Ireland. Esquirol, in France, had defined moral management as ‘the application of the faculty of intelligence and of emotions in the treatment of mental alienation’.11 The moral management approach represented a significant break from the past which had emphasised custodial care rather than engagement with each patient as an individual. In more recent decades, the moral management approach might well be compared with ‘milieu therapy’ involving a group-based approach to recovery and establishment of therapeutic communities,12 or occupational therapy.
Although its precise meaning was, at times, rather vague, moral management had the key benefit of representing a significant (although by no means complete) move away from traditional treatments such as bloodletting, routine confinement and restraint. Elsewhere in Ireland, mechanical restraint was an especially disturbing feature of asylums, initially involving manacles, hoops, chains and body-straps, with the emphasis moving to straitjackets in the early 1800s.13 Physical or bodily restraint was also used, as was chemical restraint, involving bromides, paraldehyde and chloral, among other substances. The moral management approach sought to reduce or end such practices, and strongly emphasised having a good diet, exercise and occupation, as well as reason and human interaction.14
The moral approach significantly influenced asylum design during this period15 and, to emphasise its commitment to the new model, the Richmond was run chiefly by moral governors during the first half of the nineteenth century; these included Richard Grace (1815–30) and Samuel Wrigley (1831–57), separated by a brief interlude during which Dr William Heisse (1830–1) ran the asylum. Heisse was removed from his post rather dramatically in June 1831, apparently owing to the poor condition of the institution.16
Notwithstanding the emergence, growth and relatively enlightened approach of the Richmond in the early 1800s, however, it was soon apparent that further, systematic provision was needed across Ireland for the care of the destitute mentally ill. In what would become a recurring paradigm in Irish mental health care, a committee was established to produce a report about the problem and, presumably, try to advance provision.
Select Committee on the Lunatic Poor in Ireland (1817):
‘Totally Inadequate for the Reception of the Lunatic Poor’
In March 1817, the indefatigable Robert Peel, Chief Secretary, persuaded the House of Commons to set up a select committee to look into the need for greater provision for ‘the lunatic poor in Ireland’.17 This followed on from the work of Sir John Newport (1756–1843) examining the plight of the ‘aged and infirm poor of Ireland’, including the mentally ill,18 but the 1817 initiative focused more specifically and emphatically on the ‘lunatic poor’. The committee heard a broad range of evidence, relating to many institutions, and the evidence that Mr James Cleghorn presented to the committee regarding St Patrick’s Hospital has already been explored in Chapter 1. The first paragraph of its final report stated the committee’s central finding bluntly:
Your Committee have enquired, as to the extent of the accommodation which may be afforded by the present establishments in the several counties of Ireland, and are of opinion, that those establishments are totally inadequate for the reception of the lunatic poor. An hospital attached to the House of Industry in Dublin, was originally the only receptacle in that city for persons of the lower class, who were afflicted with mental derangement; and the cells attached to the infirmaries or poor houses in some of the counties were by no means calculated for the restoration to sanity, or even for the safe custody and care of the unhappy persons who were suffering under so dreadful a malady.19
The committee noted that, in 1815, 170 persons with mental disorder were moved from the Dublin House of Industry into the newly established Richmond Asylum which, like the asylum established by Hallaran in Cork, appeared to be generally well run. The Richmond, however, was already full ‘and as the majority of patients are sent from the remoter parts of the country, it is in vain to hope to diminish it, unless by the establishment of other asylums’:
Your Committee beg leave to call the attention of the House to the detailed opinion expressed by the governors of the Richmond Asylum, that the only mode of effectual relief will be found in the formation of district asylums, exclusively appropriated to the reception of the insane. They can have no doubt that the successful treatment of patients depends more on the adoption of a regular system of moral treatment, than upon casual medical prescription … there should be four or five district asylums capable of containing each from one hundred and twenty to one hundred and fifty lunatics.20
The evidence presented to the committee about the desperate plight of the mentally ill outside asylums, which led to their call for more asylums, was, by any standards, compelling.21 John Leslie Foster, one of the governors of the Richmond, told the committee about conditions in the Dublin House of Industry which were, for many, ‘as defective as can possibly be imagined’.22 The committee asked if he thought ‘the accommodation in the House of Industry for lunatic patients is so defective that upon the whole it is a less evil to exclude them than to admit them?’ Foster responded:
I have seen three, I think, certainly two lunatics in one bed in the House of Industry. I have seen, I think, not fewer than fifty or sixty persons in one room, of which I believe the majority were insane, and the rest mere paupers not afflicted with insanity. I have seen in the same room a lunatic chained to a bed, the other half of which was occupied by a sane pauper, and the room so occupied by beds there was scarcely space to move in it …23
In other parts of the country, provision for the destitute mentally ill was simply non-existent: James Daly, another witness, was asked ‘what provision exists in the county of Galway for lunatic paupers?’ He responded: ‘None; any patients that I have known, it was necessary for them to be sent to Dublin’.24 The committee also heard there was no accommodation for ‘pauper lunatics’ in Cavan or Kerry, and that accommodation in Clare comprised ‘seven cells, adjoining to the House of Industry, together with a room for convalescent patients, which I deem totally inadequate’.
In a similar vein, Colonel Crosbie confirmed that there was a county infirmary in Kerry but when asked if there was ‘any separate accommodation for pauper lunatics’, he responded: ‘None that I am aware of’.25 Asked ‘would there be any difficulty in attaching a separate asylum to the present infirmary for lunatics’, Colonel Crosbie was emphatic: ‘None whatever; there is a large yard in which it could be erected’.
The 1817 committee also heard at some length from the illustrious Thomas Spring Rice (1790–1866), ‘life-governor, and member of the regulating committee for [Limerick] Lunatic Asylum for the last three years’, who, in 1815, ‘visited the asylums of Cork, Waterford, Clonmel and Limerick’.26 The asylum in Cork was ‘the best managed, not only that I had ever seen, but ever considered or heard of’.27 But Rice warned that the Cork establishment ‘derives everything, that can be derived from humanity and skill, from the physician who is at the head of it’28 (Hallaran, Chapter 1). The Cork arrangement was not, in Rice’s view, a solid basis for establishing a broader system of asylums; dedicated, systematic, legislative reform was needed at national level.
The situation in Cork contrasted sharply with that in Waterford, where Rice reported there were ‘a few miserable cells attached to the House of Industry, resembling an ill-constructed gaol rather than a retreat for lunatics’.29 In Clonmel, ‘so little understood was the management of the insane that they were unable even to keep them clothed, and some
