- Asylums, Mental Health Care and the Irish, 1800–2010 ed. by Pauline M. Prior
As a place with a very long history of public provision of institutional care for the mentally ill, Ireland has by now received a good deal of attention by historians as well as psychiatrists, sociologists, and other researchers. This new collection, edited by Pauline Prior, well known for her original contributions on the history of criminal insanity, reflects a good deal of the breadth of research being conducted on the subject.
The editor has divided the collection into two chronological parts (nineteenth and twentieth centuries), with concluding chapters on macro-trends, institutional and legal. An alternative way of capturing the book’s coverage suggests itself, that is, thematically. One theme is that of public provision and policy and politics, a second is institutional, a third is sociohistorical.
Looming over all modern accounts of the subject is the rise and fall of the asylum. In seeking to explain the extraordinary growth in asylum use in Ireland, sociologist Damien Brennan offers a problem-based review of the subject that is sensitive to both institutional history and the social context of asylum provision in Ireland. Brennan sensibly opts for a “social conjuncture” model to explain the changing pattern of asylum residency. A question remains over such an analysis—namely, what kind of weight might be apportioned to the changing social conditions that drove admissions, as well as residency, the latter being the focus of his analysis. Another perspective, closer to the decision making of policy and provision, comes from Dermot Walsh, leading Irish psychiatrist and erstwhile inspector of mental hospitals. His chapter on the mental health service since 1959 traces both the momentum of change and the torpor of policy—a major review of 1966 was visionary but devoid of a mechanism of implementation. As so often with mental health provision, making do with what can be found is much of the story—Walsh’s documentation of the “sectorisation” of provision (delivering services more locally) highlights the reuse of institutions (e.g., sanatoria) that had outlived their original purpose. He also addresses the conditions that have now finally brought into view the sale of the old nineteenth-century asylums to fund new facilities, but as he notes (p. 99), in the conditions of deep recession, will there be any buyers? Together with Prior’s concluding overview of long-term changes in mental health law, these chapters are productive accounts of long-term change as well as stasis in health and social policy in a setting encompassing two jurisdictions.
Institutional histories are addressed in a great variety of contributions by the editor and others. Prior herself contributes chapters on the Irish inspectorate of lunatic asylums, a subject that deserves a more analytical and perhaps comparative treatment than given here, and also (with David V. Griffiths) a study of the conflict over provision of chaplains at the Belfast Asylum. In this conflict between local and central government, the authors consider the struggles over medical versus lay authority, but is there missing here another story, about local denominational politics, one that perhaps divided the Board of Governors itself? A different kind of intersection with life outside the asylum is offered in Anton McCabe and Ciaran [End Page 289] Mulholland’s study of the Monaghan Asylum Soviet of 1919—an event spawned by war-time hardship, labor and socialist politics, and even gender consciousness, in the demand for equal wages for female attendants. Life and death within the asylum are examined in two contributions, one (Margaret Crawford) dealing with an alleged beriberi epidemic in the Richmond Hospital in the 1890s, the other with tuberculosis at the Dundrum criminal asylum (Brendan Kelly). Each ponders the problems of diagnosis as well as the institutional and social context for pathology and mortality; but Crawford’s careful inquiry into the course of the controversy over the epidemic takes us into a lucid account of nutrition in asylum diet that makes this one of the...