41.8 per cent of male and 31.8 per cent of female admissions to district lunatic asylums; by 1890–2, these proportions had risen to 75.7 per cent for men and 67.3 per cent for women, with some regional variation.78 To make matters worse, approximately 17.1 per cent of all male patients and 18.2 per cent of female patients were discharged from district lunatic asylums in 1851, and these annual proportions fell steadily to 7.7 per cent for men and 7.4 per cent for women in 1911.79 In that year, readmissions accounted for 21.9 per cent of male and 21.0 per cent of female admissions, while 5.9 per cent of male and 6.2 per cent of female patients died in the asylums (down slightly since 1851, when the proportions dying were 7.6 per cent for men and 6.4 per cent for women).80 By 1914, Ireland’s population had declined by a third since the Great Irish Famine (1845–52, Chapter 3) but the number of ‘insane’ persons in public asylums had increased sevenfold.81
If there was one single, standout event among the many factors that set Ireland on a course towards mass institutionalisation of the mentally ill, it was the 1838 Act.82 Asylum doctors, including Woods in Killarney and Garner in Clonmel, objected vociferously, to little avail.83 The legislation was ill conceived, poorly implemented and grossly unjust,84 and, even after it was revised later in the 1800s, its echoes reverberated through the asylum system for much longer, setting the tone for the dominance of asylum care for the mentally ill and intellectually disabled well into the twentieth century.
Lord Naas attempted to enact reforms with the Lunacy Law Amendment Bill 1859, following the commissions of enquiry of 1858. He was, however, unsuccessful at that point, so it was not until 1867 that the 1838 Act was finally amended, with the effect of ending confinement in gaols prior to asylums and requiring magistrates to call a dispensary medical officer to examine the patient and sign the certificate.85 Many decades later, when introducing the 1944 Mental Treatment Bill for a second reading in Dáil Éireann (part of the Irish parliament), the Parliamentary Secretary to the Minister for Local Government and Public Health, Dr Conn Ward, summarised the revised process, post-1867:
The committal order was made by two peace commissioners or a district justice after the person concerned had been certified as a dangerous lunatic by a dispensary medical officer. The expenses connected with the committal, including the payment to the medical officer for his services, were defrayed by the local public assistance authority […]. The procedure under the Act of 1867 is that the Gárda apprehend the person and bring him before two peace commissioners before whom evidence is given that the person is dangerous and likely to commit an indictable crime. When it is proved to the satisfaction of the peace commissioners that the person was discovered and apprehended under circumstances denoting derangement of mind and a purpose of committing an indictable offence the peace commissioners call to their assistance the dispensary medical officer and if he certifies that the person is a dangerous lunatic or a dangerous idiot the peace commissioners, by warrant, direct the person to be taken to the district mental hospital for the district in which he was apprehended. This procedure has much in common with that followed in a criminal case. The patient is dealt with as if he were suspected of being guilty of a crime.86
While the 1867 amendment excluded doctors in private practice, it meant that local dispensary medical officers were required to sign certificates, even if asylum staff had provided evidence during petty session hearings. These measures, along with further amendments in the Lunatic Asylums (Ireland) Act 1875, improved the certification process but certainly did not eliminate errors or misuse. The fundamentally flawed and deeply unjust Dangerous Lunatic Act remained in place until the advent of the Mental Treatment Act 1945. Therefore, while the 1838 Act did not represent the only admission pathway during this period – and Cox devotes much needed attention to the ‘ordinary’ certification procedure and its increased medicalisation in 1862 – it was the Dangerous Lunatic Act that firmly set the tone for asylum care in nineteenth-century Ireland and accounted for the majority of admission in the early twentieth century.87
Against this distinctly dispiriting legislative background, there were three identifiable waves of asylum building in Ireland. The first wave saw, in addition to the Richmond, the construction of four district asylums during the 1820s and five more by 1835.88 Legislation in 1845 made provision for the Central Criminal Lunatic Asylum in Dundrum, Dublin89 and a large, 500 bed establishment in Cork, the Eglinton Asylum, which opened in the early 1850s. Originally in three blocks, which were later joined together, the Eglinton Asylum formed the longest façade of any building in Ireland.90 Various other asylums were also opened during this, the second phase of asylum building, including establishments in Mullingar (1855) as well as Letterkenny (1866) and Castlebar (1866), both of which were designed by George Wilkinson (1814–1890), known for designing workhouses. There was considerable controversy about various aspects of the asylum building process in the 1850s, resulting in a highly critical report by London architect T.L Donaldson and James Wilkes, medical officer at Stafford Lunatic Asylum, supporting local concerns about how the building work was being directed from Dublin.91 Problems persisted, and delays with progressing the asylum in Castlebar, for example, were publicly reported and lamented.92 The Castlebar asylum was predated by ‘the Chatterhouse’, a bridewell on Station Road (‘Mad House Hill’) where patients were held before the Royal Irish Constabulary (RIC) transported them to Ballinasloe for admission.93 Eventually, ‘the Chatterhouse’ was replaced by the Castlebar asylum proper, which opened on 5 March 1866, at a cost of £34,906.
The growth of the asylums was unstoppable. The third phase of asylum building involved a range of individual architects and included the asylum in Ennis (with its Florentine palazzo, in 1868), the Monaghan asylum (the first to adopt a villa or pavilion format, in 1869) and the auxiliary asylum to the Richmond, in Portrane, County Dublin.94 In 1900, the Building News and Engineering Journal reported that Portrane was ‘constructed to accommodate 1,200 patients which [sic] are divided up into four classes – viz., chronics, melancholic and suicidal, recent and acute, the epileptic and infirm […]. The total cost, when completed, will probably be about £250,000’.95 The building contract for Portrane was the largest ever awarded to a single contractor in Ireland (the Collen brothers of Portadown). A further asylum was opened in Antrim in 1899, and, as Walsh and Daly point out, by 1900 approximately 21,000 people, 0.5 per cent of the population of the 32 counties of Ireland, were accommodated in the district asylums, with a small number of the mentally ill still in workhouses.96
Private Asylums in Ireland:
‘Sent by an All-Bounteous Providence’?
In parallel with the steady and genuinely alarming expansion of Ireland’s public asylum system, a limited, although by no means insignificant, network of private asylums also emerged and carved out a role for itself in Irish medicine and society. In 1799, Hallaran opened a private establishment, Citadella, near Cork, and further private asylums were established in Carlow, Downpatrick and Portobello in Dublin (Dr Boate’s asylum).
One of the more dramatic episodes in the history of private asylums in Ireland concerns Dr Philip Parry Price Middleton who blew up Carlow Castle in 1814, when attempting to remodel the imposing, historic thirteenth-century building near the River Barrow. Middleton had earlier cofounded ‘Hanover Park Asylum for the Recovery of Persons labouring under Mental Derangement’ in Carlow town, with two surgeons, Dr Clay and Charles Delahoyd.97 An 1815 pamphlet about the establishment emphasised that the ‘humane means’ used at Hanover Park had the ‘safe and positive powers of readily tranquilising the most furious maniac’:98
The unequivocal results arising from the humane means employed by the Conductors of this Institution, for regenerating Reason and Health, in that once wretched portion of our fellow-creatures, who had long been deemed incurable; and consequently doomed to rigid confinement, constant coercion, and hopeless misery, in this life as though Insanity were a Crime, instead of a Calamity, naturally excited the most lively Interest in the minds of all ranks of the Community in the Metropolis of the British Empire: it was there hailed as a celestial meteor, sent by an all-bounteous Providence, to illumine the dark and dreary destiny of the unhappy sufferers, by restoring them to the long-lost
