to attract the reader. Selling newspapers was a business, far more than was mad medicine. Output was driven by an overriding need to gain and sustain readers’ attention and information was a raw product that could be processed into a form to be used to achieve this end. Therefore, stories were re-packaged into forms that were already familiar and were perceived as interesting to the printers and proprietors themselves and to the target audience.316
Other factors were also relevant to coverage of mental disorder in the media, including political concerns, commercial considerations, and a perceived requirement for drama:
The tendency towards sensationalism also worked against the local press discussing changes in the attitude to the insane and their care. Madness was often presented in the newspaper as a way of sensationalising deviant behaviour, all in the interest of generating sales. In reports of suicides, and less frequently of murders, the madness of the perpetrator was used to explain the action or as a mitigating circumstance. Both social class and the location of the incident determined the press attitude. Few details were given regarding local suicides or murders, especially those involving individuals of high social status.317
Ultimately, the position of the mentally ill in nineteenth-century Ireland, both in reality and in the eyes of the press, was rather bleakly defined by institutional care followed by either death in the asylum or a life of social exclusion:
What is certain is that once labelled as mad, an individual was not permitted to maintain any public identity of which the press approved. Therefore, though by the end of the period under discussion insanity was described in the Limerick press as misunderstood, the old stereotypes remained and even after discharge from an asylum the label of lunatic followed individuals into their everyday life and social dealings. Geographic, economic and class issues had clouded opportunities for balanced representations of the mad and madness, and the lunatic was still constructed and portrayed as a distant, deviant other.318
4
EARLY-TWENTIETH-CENTURY PSYCHIATRY
Good lunacy laws should make it possible to obtain care and treatment in asylums with ease, but they should make unnecessary detention difficult.
Committee on Lunacy
Administration (Ireland), Second Report
of the Committee Appointed by the
Lord Lieutenant of Ireland on Lunacy
Administration (Ireland) (1891)1
The early twentieth century was a time of extraordinary change in Ireland with the advents of the Easter Rising (1916), War of Independence (1919–21) and Civil War (1922–3), and establishment of the Irish Free State (Saorstát Éireann; 1922–37). This was also a time of considerable change in Irish psychiatry, as determined efforts were made to move from the asylum based system of the 1800s to a better, more humane model of service provision for the mentally ill.
The problems presented by the mentally ill were clearly acute: by 1900, the 11 pre-existing district asylums had increased to 22, housing a total of 16,404 patients.2 There were, in addition, 709 patients in 12 private asylums and 4 charitable hospitals; 162 patients in the Central Criminal Lunatic Asylum; 89 patients looked after as single patients in private residences; and some 3,805 patients in workhouses. That came to a total of 21,169 patients in these locations in 1900; the number outside these settings was unknown.
Nine years earlier, in 1891, the issue of patient numbers was considered (yet again) by the Committee on Lunacy Administration (Ireland), which comprised Sir Arthur Mitchell (Lunacy Commissioner for Scotland), R.W.A. Holmes (Treasury Remembrancer for Ireland) and Dr F.X.F. MacCabe (medical inspector with the Local Government Board).3 The Committee noted that many factors, other than mental disorder itself, contributed to rates of certification, especially among the poor:
It has been said that ‘human power cannot multiply the lunatics of a country,’ but this opinion is here treated as entirely erroneous, if by lunatics are meant those persons whom the State registers and treats as such; and it must be erroneous, unless the views here expressed are wrong. In point of fact, the lunacy of a country is far from being a fixed amount, which can neither be increased nor diminished. There is no uniform standard of mental soundness or unsoundness which is accepted by all medical men when considering whether a certificate of insanity shall or shall not be granted, nor indeed by any one medical man in all circumstances. The ease or difficulty of getting certificates of insanity may depend, and does often depend, on the object in view, or the results which will follow certification. Circumstances apart altogether from the mental condition necessarily influence the granting of these certificates – the source, for instance, from which any expenditure consequent on the granting of the certificates is to be obtained, cannot fail to have an influence.
If all this is true of lunacy generally, it is of necessity still truer of pauper lunacy, because, in addition to the lunacy, there is then the pauperism, about the determination of which it is clear there may be uncertainty. A lunatic, for example, will become a pauper lunatic in one locality who will almost certainly remain a private lunatic in another. A rich parish will admit a lunatic as a pauper, whom a poor parish would refuse to admit, and of course, a poor parish will admit him, if the consequent expenditure by the parish is to be small more readily than it will if the consequent expenditure is to be considerable.4
One of the key variables in this context was the parlous state of Ireland’s lunacy legislation. By the end of the 1800s mental health law had become impossibly complex, frequently contradictory and ultimately impenetrable. In 1886, a definitive tome on the topic was published, impressively titled The Law and Practice of Lunacy in Ireland as Administered by the Lord Chancellor under the Sign Manual Together with a Compendium of the Law Relating to Establishments for the Care of the Insane.5 Written by George Whitley Abraham, Barrister-at-Law and Registrar in Lunacy, the book ran to a total of 752 densely written, convoluted pages, and the indefatigable author did not even live to see his masterwork published: he died when it was with the printer. Nonetheless, Abraham’s impressive book presented useful, if lengthy, accounts of topics ranging from the ‘general policy of laws concerning the insane’ to ‘management of the lunatic’s estate’, from ‘civil contracts’ to ‘varieties of incapacity attaching upon lunacy’, and included a ‘compendium of the law relating to establishments for the care of the insane’. Ultimately, however, there was no hiding the fact that the legal position of the mentally ill was a desperate mess, albeit an exhaustively documented one.
The matter was stated even more directly in 1891 by the Committee on Lunacy Administration (Ireland) which concluded, with admirable brevity, that ‘fresh Lunacy legislation for Ireland is beyond question necessary’:
In regard to many matters it is extremely difficult, if not impossible, to know what is, or is not, statutory. For this reason alone, the codification or consolidation of the Statutes relating to Lunacy appears to us to have become necessary. But, apart from this, the provisions of the Statutes are in many respects of an undesirable character. They do not sufficiently guarantee the proper treatment of the insane, nor do they adequately safeguard the public against unnecessary detention in Asylums.6
In terms of service provision, the Committee suggested ‘that it be considered whether some of the empty Workhouses could not be acquired and converted into’ provincial asylums:
If this were done, the buildings would cease altogether to be Workhouses, and would be as unconnected with the Poor Law Authorities as District Asylums. In this way increased Asylum accommodation might be cheaply obtained in those cases in which extensive structural changes would not be necessary for the conversion of the Workhouse
