The following has been written by Bernie Deasy of the Delaney Archive (
www.delanyarchive.ie), located in Carlow, Republic of Ireland.
The Health Service Executive has donated the archive of St Dympna’s Hospital, Carlow, to the Delany Archive, based at Carlow College. St Dympna’s, originally known as Carlow District Lunatic Asylum, opened in May 1832 and originally catered for mentally ill patients from counties Kildare, Wexford, Carlow and Kilkenny, and the city of Kilkenny.
During the early years, patient care was shared by the Asylum’s manager and visiting physician. Patients were primarily treated using an approach known as ‘moral management,’ rather than one based on medical principles. Moral management was based on kindness and understanding and it encouraged recreation, religious observance, work and a good quality diet as aids to recovery. The types of work assigned to male patients included agricultural work and gardening, trades and housework, while females participated in sewing, knitting, quilting and housework. The ordinary diet was heavily based on carbohydrates and changed little during the nineteenth century after the Famine, when potatoes were substituted by other foods. An 1861 report gives the ordinary diet as: breakfast – 8 ounces of oatmeal in stirabout, with ⅓ quart of new milk; dinner – males, 11 ounces of bread, with a quart of good soup, or a pint of mixed milk; females – 8 ounces of bread; same soup or milk; supper – 8 ounces of bread with a pint of cocoa. While moral management marked a huge step forward in the treatment of the mentally ill, it was difficult to operate due to the large numbers in asylums.
An 1862 report provides a useful profile of patients then in the Asylum and the types of illness that led to admission. Of 205 patients, 79 are described as belonging to the agricultural class; 29 to the servant classes; 12 are clerks and shop assistants; six are soldiers; and three are members of the Royal Irish Constabulary. Illnesses are described as mania, monomania, melancholia, dementia, and epilepsy complicated with mania. Many writers on the history of mental illness have found it problematic to reconcile nineteenth-century diagnoses with the terminology used today. Some of the causes of mental illness given in the report are grief, love, fright, jealousy, loss of property, religious fervour and excess of study. Between 1832-1922, there were 5,517 admissions to the Asylum and men accounted for 55% of this number. While there were some long-stay patients, most spent less than 6½ months in the Asylum. The archive contains various registers of patients, containing biographical and medical information, and these records are expected to be of great interest to family, medical and social historians. Due to the sensitive nature of these records, some access conditions apply. Generally, patient records become available 100 years after date of admission.
The Asylum was designed by government architect, William Murray, to accommodate 104 patients but Ireland had high levels of asylum admission and almost from the beginning accommodation was not adequate to meet applications for admission. By 1871, The Asylum could cater for 178 patients, and for 426 patients by 1896. In 1911, it was reported that the asylum had housed more than 500 patients for some years. Overcrowding exacerbated illness and there are references in the records of outbreaks of influenza, cholera and dysentery. Due to pressure of numbers, the asylum district was divided twice. Asylums to cater for Wexford and Kilkenny patients were opened in 1852 and 1868 respectively. In 1870, Kildare Grand Jury made an abortive attempt to have an asylum opened in the county. They were frustrated by the fact that local taxes supported the Asylum but they had difficulty having patients admitted. Until 1874, day-to-day running costs were funded solely by the county cess, a tax payable to the local grand jury, when a grant-in-aid of 4 shillings per patient per week was introduced. Originally asylums were to accommodate paupers only; there was no provision for paying patients who were accommodated in a small network of privately run asylums.
Between 1821-1899, district asylums were in the general control of the Lord Lieutenant and bodies whom he appointed. Locally, each asylum was managed by a Board of Governors which met monthly. Board members were typically landed gentry, magistrates, merchants and traders, and clergy. The minute books of the Board of Governors are an important part of the archive. Typically, they refer to patients and staff; finance; building works and improvement; and the awarding of contracts for goods and services. The management system changed in 1899 with the establishment of County Councils, and their powers were exercises by a Committee of Management. The number of Governors from each of Kildare and Carlow was determined by the number of patients they contributed. Thus, in 1905, Kildare named 14 members and Carlow named nine, as they accounted for an average of 243 and 151 patients respectively over the previous three years.
The archive is available for research, by appointment, at the Delany Archive, Carlow College, and a catalogue of the content of the archive has been published at www.delanyarchive.ie. Further information about the archive is available from Bernie Deasy, Archivist.
Dr Catherine Cox, Lecturer in History, UCD, and author of Negotiating Insanity in the Southeast of Ireland 1820-1900 will give a lecture entitled ‘The Care of the Mentally-Ill in Nineteenth-Century Carlow’ at Carlow College on Monday, 15 December 2014, at 1.45pm. Admission is free of charge and all are warmly welcome.
(With thanks to Bernie)
Chris
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