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Hearing Voices. Brendan Kelly
Читать онлайн.Название Hearing Voices
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isbn 9781911024446
Автор произведения Brendan Kelly
Издательство Ingram
These results, although interesting, need to be interpreted with an awareness of various limitations of the census methodology, not least of which is the (likely) inconsistent use of the terms ‘imbecile’, ‘idiot’ and ‘lunatic’, despite definitions being provided. A ‘lunatic’, for example, was ‘a mentally ill person with periods of lucidity’. This definition is similar, although not identical, to the definition of a person of ‘unsound mind’ in the Fourth Census of Canada in 1901, which stated that ‘it is not necessary that the degree of infirmity should be absolute or total, but that it should be so sufficiently marked in any one of the classes as to have reached the stage of incapacity’.26 The Irish definition is quite similar, at least to the extent that it defines lunacy as involving a lesser degree of impairment than ‘imbecile’ or ‘idiot’.
It is difficult, if not impossible, to clarify just how conscientiously these definitions were used by various enumerators in 1901. It seems likely that, at the very least, the terms ‘imbecile’ and ‘idiot’ were used interchangeably. The Mental Deficiency Act of 1913 later defined an ‘imbecile’ as an individual unable to take care of himself or herself, and an ‘idiot’ as a person unable to protect himself or herself from common dangers.27 The 1901 census, however, preceded the Mental Deficiency Act of 1913 by more than a decade, and the 1913 Act was not, in any case, applied in Ireland. As a result, the terms ‘imbecile’ and ‘idiot’ were likely used interchangeably in the 1901 census. In this context, it also appears likely that the low prevalence of ‘lunatics’ in the census is explained, at least in part, by the way in which the definition of ‘lunatic’ was used.
Notwithstanding these complexities, it is interesting that a majority (60 per cent) of ‘lunatics’ outside the institutions in 1901 were female and the average age of females (47 years) was higher than that of males (44 years). By way of comparison, there were, on 1 January 1901, 21,169 mentally ill people in Irish institutions, of whom 48 per cent were female.28 This difference in gender distribution inside and outside the institutions might reflect an increased likelihood for women, possibly especially slightly older women, to remain in the home, despite showing signs of mental disorder. This is consistent with the fact that women generally tended to be admitted to asylums at a later stage in their illness than men, and were more likely to be discharged.29
From the 1901 census, the most common relationship outside the institutions between a ‘lunatic’ and the ‘head of household’ was child (33 per cent), suggesting that children with mental disorder may have remained in the home in order to be cared for by their families, or, alternatively, in order to care for their parents, attend to household tasks or work on farms.
It is interesting that certain counties with large asylums (e.g. Kerry) had a relatively high prevalence of ‘lunatics’ outside the asylums and workhouses. This might reflect the fact that many Irish asylums demonstrated significant rates of both admission and discharge,30 possibly resulting in relatively larger numbers of persons with diagnosed mental disorder living in counties with asylums. Local geography was also important, as people living near asylums were more likely to be admitted than those living far distances away, at least in the 1800s.31
On the other hand, the prevalence in Dublin was relatively low, despite the presence of a number of asylums, suggesting that this explanation was not universal, or that other factors were at play, especially in Dublin. It is also notable that some of the ‘lunatics’ outside the institutions who were ‘boarders’ were unrelated to the ‘head of household’ suggesting the possibility that these households may have represented early or informal de facto ‘boarding out’ initiatives, as championed tirelessly by Norman at the Richmond.32
While no ‘occupation’ was provided for 38 per cent of ‘lunatics’ in the 1901 census, farming was the most common occupation recorded (41 per cent).33 Also consistent with the broader population, majorities were Roman Catholic (82 per cent); could ‘read and write’ (65 per cent); and, among those for whom ability to speak Irish was recorded, 74 per cent spoke both Irish and English. This, too, is consistent with broader trends in Ireland, as illiteracy had fallen rapidly in preceding decades from 53 per cent in 1841 to 18 per cent in 1891.34
In these important respects (occupation, religion, literacy), ‘lunatics’ living outside the Irish institutions in 1901 bore significant similarities to the broader population, although it remained the case that the lives they led differed significantly from the lives of those who were not labelled as ‘lunatics’. This situation was largely attributable to the twin processes of continual legislative change and inexorable expansion of institutions for the mentally ill during the late nineteenth and early twentieth centuries. These matters were of enormous concern to asylum doctors in the early 1900s and predictably dominated the Conference of the Irish Asylum Committees in 1903.
Conference of the Irish Asylum Committees (1903):
Degeneration, Politics and Tea
Issues relating to overcrowding were strongly to the fore of the agenda at the Conference of the Irish Asylums Committee convened at the Richmond Asylum in 1903.35 By that time, it was felt that the increase in admissions was related in large part to ‘heredity’ rather than poverty, adversity, religion or mental anxiety – a conclusion which contrasted in certain respects with that of Hallaran a century earlier, who had emphasised physical illness, alcohol, political disturbance and ‘terror from religious enthusiasm’ as causes of mental disorder.36 This was not a universally agreed position, however, with some commentators, such as Dr M.J. Nolan, then RMS in Downpatrick (having previously worked in Dublin and Limerick), citing ‘stress’ as a key contributor, and appealing passionately that the needs of the mentally ill should not be ignored.37
With palpable alarm, the 1903 conference noted that there were 22,139 ‘registered lunatics’ in Ireland and this number was increasing.38 Dr Edward D. O’Neill, medical superintendent of Limerick District Lunatic Asylum, read a paper titled Increase of Lunacy and Special Reasons Applicable to Ireland and noted, at the outset, the difficulties with accurate data collection:
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