To find the origins of why this is the case, we need to look to our past and, in particular, a piece of legislation from 1838, writes Helen Doyle, PhD candidate with the Department of History
     

    Please note the language and terminology used around mental health in 19th-century Ireland would clearly not be appropriate or acceptable today. Such terms are used here for historical accuracy and to denote the historical context.

    It is worth stating that the language and terminology used around this issue in 19th-century Ireland would not be appropriate or acceptable today. While I am using those terms here for historical accuracy, I am aware and sensitive of the fact that I am writing about real people and their experiences.

    Every year, mental health stigma charity See Change embarks on a Green Ribbon campaign. The aim of the campaign, which has been running for 10 years, is to raise awareness of the ongoing stigma associated with mental illness in Ireland today.

    While the benefits of such a campaign are obvious, it is difficult not to wonder why there is still a need for this. Sadly, stigma and shame are still associated with mental illness, and it may be why so many who experience this type of difficulty feel they must conceal it from family, friends, and colleagues.

    See Change have worryingly found that people suffering from mental illness are frequently stereotyped as 'dangerous’ and ‘violent’, although this is rarely the case. The myth that the mentally ill should be feared still exists, leading to discrimination and isolation for many. While there is still clearly stigma associated with mental illness in Ireland today, it is perhaps less clear why this is still the case.

    It is possible that we can find the origins of this by looking to our past, in particular to a piece of legislation that was passed back in 1838. It was in this year that the Criminal Lunatic (Ireland) Act, which soon became more commonly known as the 'dangerous' lunatic act, was passed into law. As a result, mental illness for the first time became associated with danger, crime and threat to society.

    Within a very short space of time, the majority of admission to district asylums were under this legislation, making it the most common route of entry to all Irish district lunatic asylums. Unprecedented numbers were soon being committed, leading to overcrowding and a deterioration in the care and treatment that patients received.


    By 1958, Ireland with a population of less than three million had a shocking 21,000 people incarcerated in district asylums, giving Ireland the highest number per capita in the world of people confined in asylums. While these are distressing statistics, it would be unfair to view Ireland's entire history of mental illness in a negative light, as Ireland would have been seen as a world leader in the early 19th century in terms of its provision for the mentally ill.

    From the end of the 18th century, there was a growing awareness that some type of provision needed to be made for the lunatic pauper population of the country. Those concerned with the plight of the mentally ill campaigned tirelessly for the establishment of a system of district lunatic asylums to accommodate those who could not afford to pay for private care.

    In 1817, legislation was passed for the construction of nine district asylums across the country to house the lunatic pauper population of the country. The original nine asylums, together with the already existing Richmond Asylum in Dublin, formed the early Irish district asylum system.

    But the failure to define who exactly a 'lunatic pauper' was, other than someone who could not afford to pay for care in a private asylum, led to the majority of committals coming from the working classes. The regime of care in all new Irish asylums was 'moral therapy' treatment. This new system of care, which had originated in England and France, dictated that all patients should be treated with kindness and humanity. There was, at this time, an overriding and optimistic belief that all lunatics could be cured. From the establishment of the district asylum system until the late 1830s, Ireland was offering the mentally ill the highest possible level of accommodation and care.

    Unfortunately, Ireland’s early progressive lead was to be extremely short lived. The Criminal Lunatic (Ireland) Act drastically changed both the level of care and treatment in asylums, and the way in which the mentally ill were perceived by the rest of society. The terms and conditions of the act were seriously flawed and open to widespread abuse. Any person could be committed on the unsworn testimony of another. In many cases, it was the old, infirm or destitute who found themselves in the asylum as ‘dangerous’ lunatics.

    While this aspect of the legislation was concerning, even more worrying was that mental illness became associated with 'danger', ‘crime’, and ‘threat to society’ for the first time. From that time onward, stigma and shame became intrinsically linked to those who suffered from mental health issues. The perception that the mentally ill were dangerous became prevalent, giving rise to the notion that they should be feared by the rest of society.

    In response, the idea took hold that it was safer to lock the mentally ill away behind the high walls of an asylum to protect the local community from danger. As a result, the numbers in asylums soared. In response, existing asylums were extended and new asylums built until there were 22 district asylums in Ireland by the 1860s. The majority of committals into these asylums were under ‘dangerous’ lunatic legislation.

    Although there was an almost immediate awareness that the act was flawed, and calls were made to amend it, nothing really changed until the mid-20th century when the entire asylum system was reformed. It would seem that these reforms did little to remove the pre-existing stigma that had become so inherently linked with mental illness, one that has remained with us to the present day.

    This article originally appeared on RTÉ Brainstorm