Hearing Voices. Brendan Kelly
Чтение книги онлайн.
Читать онлайн книгу Hearing Voices - Brendan Kelly страница 27
![Hearing Voices - Brendan Kelly Hearing Voices - Brendan Kelly](/cover_pre670155.jpg)
In more recent centuries, defences based on insanity were presented in the Irish courts with varying degrees of success.171 One of the most celebrated was that of Captain William Stewart, whose ship, the Mary Russell, sailed into Cork Harbour from the West Indies on 25 June 1828. On board, seven crew members had been brutally killed by the Captain, who appeared insane.172 The Reverend William Scoresby, a fellow of the Royal Societies of London and Edinburgh and Member of the Institute of France, was one of the first eyewitnesses on the vessel, and described it as ‘a scene of carnage so appalling … as to render, by sympathy, association and memory combined, the impression indelible’.173
At Captain Stewart’s trial, medical evidence of insanity was compelling and the jury returned a guilty verdict but added that they believed Stewart to have been insane at the time.174 The Chief Baron at the trial rejected this verdict; it was argued that the law did not recognise this as guilt because the act was committed while the person did not know right from wrong. The jury promptly altered its verdict to ‘not guilty’ owing to Stewart’s insanity. This change of verdict in the early 1800s prefigured the verdict of ‘not guilty by reason of insanity’ outlined much later in Ireland’s Criminal Law (Insanity) Act 2006 (Chapter 7).175
Internationally, the field of forensic psychiatry took significant steps forward in the mid-1800s with the publication of Dr Isaac Ray’s ‘Treatise on the Medical Jurisprudence of Insanity’ in 1838176 and the emergence of the McNaughton Rules which proved hugely influential as the insanity defence became more widely used in the courtrooms of Great Britain, Ireland, the US and elsewhere in the latter part of the 1800s.177 Against this background, the Central Criminal Lunatic Asylum (Ireland) Act 1845178 was introduced to establish ‘a central asylum for insane persons charged with offences in Ireland’. More specifically:
Whenever and as soon as the said central asylum shall be erected, and fit for the reception of criminal lunatics, it shall be lawful for the lord lieutenant [chief administrator of government in Ireland] to order and direct that all criminal lunatics then in custody in any lunatic asylum or gaol, or who shall thereafter be in custody, shall be removed without delay to such central asylum, and shall be kept therein so long as such criminal lunatics respectively shall be detained in custody.179
The 1845 Act also permitted the Lord Lieutenant to direct ‘that any person who might be detained in custody in any gaol by virtue of any such warrant as aforesaid should be removed to the [local] lunatic asylum [and] remain under confinement … until it should be duly certified to the said lord lieutenant, by two physicians or surgeons, or a surgeon and physician, that such person had become of sound mind’.180 Convicts who were certified insane could also be removed to the new asylum and then returned to prison or discharged (as appropriate) if medically certified as now being of sound mind.181
The 1845 Act was also notable for making provision for one or two suitably qualified persons to act as Inspectors of Lunatics in Ireland, to take over relevant duties from the Inspectors General of Prisons.182 In 1846, the first person appointed to this position was Dr Francis White (1787–1859), a remarkable physician who had opened a hospital and anatomical school on Ormond Quay earlier in his career and had been an Inspector General of Prisons since 1841.183 A second inspector, Dr John Nugent, was appointed in 1846, having previously served as travelling physician to Daniel O’Connell (1775–1847), an Irish political leader.184 Nugent had no experience managing the mentally ill and there were various complaints about his performance.185 The inspectors’ first report appeared in July 1846 and Nugent was later knighted by the Lord Lieutenant.186
The other historic outcome from the 1845 Act was the establishment of the Central Criminal Lunatic Asylum in Dundrum, Dublin, which was erected relatively swiftly at a cost of £19,547.187 Individuals were admitted if they were charged with an offence in court and deemed insane at trial or developed symptoms of mental illness while in prison. The asylum opened for admissions in 1850 and by 1853 there were 69 male and 40 female inpatients.
Patients admitted to the Central Criminal Lunatic Asylum generally presented complex combinations of psychiatric, medical and social need, often including poverty.188 For example, 70 women were admitted between 1868 and 1908, most of whom were Roman Catholic and single, with an average age of 33 years.189 Over half were charged with or convicted of killing, mostly child killing.190 Almost one woman in 10 was declared ‘sane’ on admission, but might have seemed mentally ill at the time of offence or trial. Among the others, ‘mania’ and ‘melancholia’ were the most common diagnoses. Approximately 15 per cent of these women died at the asylum; almost 50 per cent were eventually transferred to local asylums; 12 per cent were transferred to prison; and others were released to family or friends.
Between 1910 and 1948, a further 42 women were admitted, a majority of whom were detained ‘at the Lord Lieutenant’s pleasure’ (i.e. indefinitely).191 The most common diagnoses were ‘mania’ or ‘delusional insanity’ (38 per cent) and ‘melancholia’ (24 per cent); 7 per cent were ‘sane’. The average duration of detention was almost six years, after which 28 per cent were transferred to district asylums and the remainder released under various different circumstances.192 Overall, the average length of stay for women charged with infanticide or the murder of their child between 1850 and 2000 was 9.3 years, although it ranged from three months to 38 years.193
There was a complex mix of social, psychiatric and medical problems in evidence among both male and female patients, including mental disorders ranging from ‘mania’ to folie à plusieurs (when several people share delusions or fixed, false beliefs),194 various issues relating to intellectual disability,195 and physical illnesses such as syphilis196 and tuberculosis.197 Given this complicated combination of factors, it is unsurprising that there were substantial changes in admission practices over time as rates of admission fluctuated, and the use of ‘fitness to plead’ procedures in the courts varied significantly, peaking during the period from 1910 to 1920.198
Recurring issues at the Central Criminal Lunatic Asylum included the overcrowding that was so widespread throughout the asylum system during the 1800s and early 1900s;199 the tangled relationship between gender and the insanity defence;200 and the troubling matter of persons who were committed to the asylum but appeared sane by the time they actually arrived there.201 These issues – and many others – were readily apparent throughout the asylum system in general as early as the mid-1850s, when they elicited a by now familiar response from the authorities: the establishment of yet another commission of inquiry and the production of yet another report. But first, however, in 1854, the 1851 Census of Ireland led to the emergence of a fascinating Report on the Status of Disease which presented important, formative information about the mentally ill and intellectually disabled in Ireland.
The 1851 Census of Ireland and
a ‘Report on the Status of Disease’
The Census of Ireland performed in 1851 provided a wealth of fascinating data and reasons for continued concern regarding mental disorder in Ireland. A Report on the Status of Disease, based on the census and co-authored by Dr William Wilde, who was knighted in 1864 owing in large part to his work on the census, was published in 1854.202 Wilde’s biographer, Dr T.G. Wilson, wrote that he was especially fascinated by the statistical side of the census, which complemented Wilde’s work with individual patients and gave him a broader view of population health.203
The Report concluded that there were 5,074 ‘Lunatics’ and 4,906 ‘Idiots’ in Ireland, and that ‘many individuals in both these classes were also affected with epilepsy’.204 This meant that ‘there was 1 Lunatic in every 1,201 inhabitants,