between 1811 and 1815, some 754 of its 1,179 admissions came from outside Dublin.31 The investigation ordered by Robert Peel in 1816 recommended that more extensive provision be provided in Cork and Belfast.32 Several decades later, the Commission of Inquiry in the State of Lunatic Asylums in Ireland (1858)33 looked into the matter again and found that the ‘wretched inmates’ in the Hardwicke Cells, connected with the Dublin House of Industry, were ‘in a most unsatisfactory state’. In 1857, these inmates were removed from this ‘disgracefully conducted’ establishment to a ‘new establishment at Lucan’ which was ‘commodious, airy, and cheerful, and every care and attention appeared to be paid to the wants of the inmates, of whom there were ninety-eight at the period of our visit’.
As the 1800s progressed, the Poor Law Act (1838) was introduced to relieve the distress of ‘deserving’ poor in Ireland.34 The system initially consisted of 130 Poor Law Unions, aimed at providing accommodation, food and medical care to the poor of the area. Despite the establishment of several new asylums for the mentally ill during this period,35 many persons with mental disorder or intellectual disability still had to enter the workhouses,36 which generated even greater fear than the asylums did.37 The food was reportedly better in the asylums, compared to workhouses.38
By 1844, there were 957 ‘mentally ill’ persons in workhouses or poorhouses on the island of Ireland and by 1851, towards the end of the Famine, this had increased to 2,393.39 The number continued to rise throughout the remainder of the 1800s, reaching a peak in 1892, when there were 4,198 ‘mentally ill’ persons in workhouses. The previous year, there were some 1,170 ‘idiots’ in workhouses.40 Interestingly, while males tended to outnumber females in public asylums throughout the 1800s,41 ‘mentally ill’ females outnumbered ‘mentally ill’ males in workhouses.42
It is difficult to gain a systematic picture of the specific experiences of the mentally ill in workhouses throughout the 1800s, although conditions were generally very poor and designed to repel,43 as was vividly outlined in the 1817 Report from the Select Committee on the Lunatic Poor in Ireland.44 Efforts were, however, made to improve matters in at least some establishments, albeit with limited success. Ballinrobe Poor Law Union in County Mayo, for example, was located in one of the areas worst affected by the Famine and commonly received persons with mental disorder. In August 1846, a man ‘who was confined to the workhouse as a cured patient from the Castlebar Lunatic Asylum took his discharge and went to his home’; there is no record of his mental state on departure or any attempt at follow up.45 In October 1896, the Ballinrobe workhouse employed ‘a woman at a shilling a day to mind … a woman who is insane’.
Conditions in workhouses were very difficult, not least owing to illnesses such as cholera, typhus and dysentery.46 As a result, there was significant public and official concern about the plight of the mentally ill in the workhouses,47 and it is notable that, unlike the English commissioners in lunacy, Irish inspectors did not approve particular workhouses as suitable for the mentally ill.48 Nonetheless, workhouses rapidly became de facto elements of the system of ‘care’ for the mentally ill during the 1800s,49 as patients were routinely admitted from workhouses to asylums50 and discharged from asylums back to workhouses.51 Relations between the institutions were commonly strained: in 1881, there were 148 persons with intellectual disability or mental illness huddled together in grossly unhealthy conditions in Cork workhouse, and they suffered further during a bitter dispute between the workhouse and the asylum over who was responsible for them.52
Against the background of this close, conflicted relationship between asylums and workhouses, the problem of the mentally ill in workhouses persisted well after the Famine had eased. In 1895, at a meeting of the Irish Division of the MPA in the Royal College of Physicians, Kildare Street, Dr Oscar Woods (secretary of the division) ‘introduced the question of dealing with lunatics in workhouses, and after some discussion, in which the following – Drs Drapes, Finegan, Lawless, John Eustace and the president – joined, the following resolution was unanimously adopted: “That the time has arrived when provision should be made for the large number of lunatics in the workhouses of the country at present uncertified for, not properly cared for, and treated not as lunatics, but merely as paupers, and that a copy of this resolution be sent to the Inspectors of Lunatics”.’53
The concerns of the MPA were strongly supported by admission statistics: Walsh, in an especially valuable study of the Ennis District Lunatic Asylum, County Clare, and the Clare Workhouse Lunatic Asylums in 1901, notes that there were eight workhouse asylums in Clare, housing a total of 263 residents.54 From a diagnostic perspective, 41 per cent had ‘dementia’; 30 per cent were ‘idiots’ or ‘imbeciles’; 20 per cent had ‘mania’; 6 per cent had ‘melancholia’; and 2 per cent suffered from epilepsy. There is also evidence that persons with other conditions, such as delirium tremens (from alcohol withdrawal), were admitted during the 1890s.55
In 1907, at a meeting of the Richmond District Asylum Joint Committee (in Grangegorman, Dublin), the chairman highlighted the magnitude of the issue at the Richmond:
A large number of our admissions come here direct from workhouses. I have looked up the exact numbers and find they average about 30% of total admissions. During the last four financial years 709 patients came from workhouses. I do not think I would be very much in error in estimating that 50% of these 709 admissions would come under the head of Chronic and Harmless Lunatics, and probably at the present time there are not far short of 700 or 800 cases in the whole institution who could be so classified. The 76th section of the Local Government Act of 1898 provides for the establishment of auxiliary asylums for such cases.56
The Richmond Joint Committee dutifully appointed a ‘special committee’ to look into the matter, and the committee visited asylums at Youghal,57 Cork and Downpatrick, and inspected Union Workhouses in North and South Dublin.58 The committee examined patient numbers, clinical conditions and financial arrangements and reported back to the Richmond Joint Committee on 19 December 1907.
Downpatrick Asylum was of particular interest because ‘Down County Council in 1901, after the fullest examination into the fiscal aspect of the question, decided to enlarge the Downpatrick Asylum for the reception of the insane then located in the workhouses’.59 The committee presented details of the accommodation provided at Downpatrick and agreed with the Inspector of Lunatics who, on 16 November 1906, concluded that ‘this county is amongst the few in Ireland which has made full provision for all the insane chargeable to it […]. Nowhere are the insane better housed in bright, cheerful, well-furnished and well-heated wards, where they are properly cared for, well fed, and well clothed’.60
The committee also visited North Dublin workhouse, where they found ‘that the provision for the inmates of the lunatic departments is truly deplorable. The overcrowding is very marked, and calls for prompt relief’.61 The female ward for ‘healthy lunatics’ is ‘little more than a dungeon, ventilation is inadequate, and the beds are laid upon wooden trestles. The patients are obliged to take their meals in this repellent place’.62 The male wards ‘are much overcrowded […]. Forty-two of the patients are confined to bed, 20 of them being of the dirty class. Ten patients have to be spoonfed’. The committee concluded that ‘all buildings occupied by the lunatic patients are deficient in light and air’ and ‘all lunatic inmates of the North Dublin Union Workhouse ought to be removed as speedily as possible’.63 Dr Fottrell at the workhouse ‘supplied us with a list of 60 patients, 20 males and 40 females, with an urgent request that these be provided for without delay’.64 The committee also visited South Dublin Union Workhouse where their ‘experiences were much more agreeable’.65
In the end, the committee made four recommendations to the Richmond District Asylum Joint Committee. First, they urged the Joint Committee ‘to assume the full responsibility imposed upon them by the Local Government Act of 1898 with respect to pauper lunatics within the district’.66 Second, they recommended ‘that provision for the 600 patients should be made by the erection of suitable buildings at Portrane, where ample space for that purpose is available’.67 Third, they concluded that ‘a thorough classification and segregation of
