Chapters in the History of the Insane in the British Isles

by Daniel Hack Tuke

Lord O'Hagan's measure had for its object to protect the interests of lunatics possessed of small properties, beyond the control of Chancery on account of the expense incurred thereby. There were in Ireland under the jurisdiction of the Lord Chancellor, committed to him by the Queen's sign manual, 229. By the operation of the Act of 1871, introduced by Lord O'Hagan, the guardianship then provided had worked admirably. But there remained those who had very small property. Of the 642 persons then in private asylums, 143 only were under the guardianship of the Lord Chancellor, and the remainder might be presumed to have small properties. In the district asylums there were 55 paying patients, 20 of whom were under the Court of Chancery. Those on whose behalf Lord O'Hagan addressed the House of Lords were estimated at 724. The property of most of these "was left to the mercy of relations or strangers, who did with these unhappy people what they would." While in the previous year 1276 patients had been sent to district, and 141 to private asylums, only 24 had been brought within the protection of the Lord Chancellor. As much as £3189 was received from patients in the district asylums in a year. The Bill now introduced gave protection to the class in question by vesting in the County Court judges a new jurisdiction, viz. in lunacy within the areas of the various courts, in cases in which the property of the lunatic should not exceed the sum of £700 in money value, or £50 a year—sums taken from the Lunacy Regulation Act of 1871, which provided that the Lord Chancellor might be at liberty not to impose upon lunatics having property of that value, the same fees and obligations that were insisted upon in the case of more wealthy persons. Lord O'Hagan regarded his Bill as only part of a larger measure to which he looked forward.[283]

A Bill was introduced into the House of Commons, but without passing into an Act, by Mr. Litton, member for Tyrone, entitled "The Lunacy Law Assimilation (Ireland) Bill," on the 6th of April, 1881,[284] and it may be worth while to observe what, according to so comparatively recent a speaker on the subject, is now wanted to improve the condition of Irish lunatics. After pointing out that, according to the Report of the Commission of 1879, there were on January 1, 1878, about 11,000 lunatics provided for, the number at large, inadequately cared for, was 6709, of whom more than 3000 were actually neglected, as against 1583 in the year 1857; and after reviewing the legislation of 1 and 2 Geo. IV., by which district asylums were established; the 1 and 2 Vict., c. 47, by which dangerous lunatics may be committed to jails; the 8 and 9 Vict., by which they might be transferred to Dundrum; the 30 and 31 Vict., c. 118 (1867), by which the first provision for sending this class of lunatics to jail was repealed; the 38 and 39 Vict. c. 67 (1875), by which it was provided that chronic lunatics not being dangerous might be consigned to the poor-houses—Mr. Litton showed that there was no attempt at classification in poor-houses, and that they only accommodated 3365 persons, and further that, in spite of the last Act, the asylums were crowded with chronic and incurable cases, and had but little room for recent cases. He deplored the want of supervision of the neglected lunatics referred to, many of whom were subjected to cruel treatment. He therefore preferred to extend to Ireland the provisions of ss. 66 to 68, 70 to 72, and 78 to 81 of the English Act, 16 and 17 Vict., c. 97, subject to certain changes which were explained in the Bill. He doubted whether powers to enlarge the existing asylums would meet the difficulty, and it would be very costly and lengthy. It was proposed to adopt the system of boarding out which had been in operation in Scotland; due provision was made for their inspection. It was also needful to give to poor-law guardians power to afford relief to the head of a family one of whose members was insane (as in England), which was now impossible, unless the head of the family was so afflicted.

The fact that all committals of dangerous lunatics on the warrant of two magistrates must be cases in which the latter are satisfied that a lunatic had shown an intent to commit an indictable crime leads, it is stated, to many persons who, although dangerous, have not shown the above intent, being kept out of asylums until they have passed into a chronic state. However this may be, the number committed in Ireland as dangerous lunatics is enormous, being in one year (1877) 1204 out of 1343 admissions, the truth being that numbers are classified as dangerous who are not so.

Mr. Litton's Bill provided (1) for the supervision of neglected lunatics; (2) the boarding out in suitable places, under the direction of the governors of district asylums, of such patients as they might select for that purpose; (3) an alteration in the law of committal, so as to allow of patients being admitted before they became incurable; and (4) power to the poor-law guardians to give outdoor relief under the circumstances stated.[285]

The Bill had the approval of the Social Science Congress committee, and of Lord O'Hagan, but on account of the pressure of other business never reached the House of Lords.[286] It should be added that the Government, in the person of the Solicitor-General, expressed a hope that they would be able to bring in a Bill of larger scope, one more fully covering the ground traversed by the Royal Commission of 1879.

The sketch now made, slight as it is, will serve to show that Ireland formed no exception to the neglect to which the insane were subjected, especially in the poor-houses and jails; that when attention was strongly drawn to the better treatment of the insane in England, partly by the publication of a work describing how this was to be carried out, and partly by the evidence given before the Select Committee of the House of Commons in 1815, the Irish Government took up the question of reform, and resolutely set about putting their own house in order. Select Committees collected valuable evidence which bore fruit in efficient legislative enactments, and there seems to have been singularly little opposition to the introduction of improved methods of treatment and new buildings in place of the old. The Richmond Asylum from the first led the way in enlightened modes of treatment, and at the present time this institution, under the long and able management of Dr. Lalor, is a credit to Ireland; the more so that here, more efficiently than in any asylum I have visited in the British Isles, the employment of the patients in school work has been introduced and prosecuted to a successful issue.[287]

One other feature of the history of this movement in Ireland has already been alluded to, but merits attention again, and that is the additional proof afforded of the inevitable tendency to the accumulation of cases, instead of their recovery on a large scale, as was at first hoped and expected, not in Ireland alone, but in England. The frequency of relapse was, in the outburst of delight accompanying the recovery of some cases hopelessly incurable under the old system, not suspected, and the bitter disappointment which this fact involves had yet to be experienced, and is, indeed, scarcely realised at this moment. In one of the Irish Reports, the circumstance is alluded to that, taking all the discharges of patients on account of recovery, the cures amounted to the gratifying number of seventy per cent. Had this proportion been sustained, and had these patients retained their mental health, there would have been little need of additional asylums. Patients from all quarters, their homes, poor-houses, and even jails, might have been drafted for a season into these temples of health, and, having passed the charmed threshold, been restored in a few months to the outer world, never to return.

If this pleasant illusion is dispelled by the course of events in Ireland, how much more strikingly must it be so in England? for the former country is almost altogether free from that most hopeless of all mental affections, the general paralysis of the insane—the plague of all other civilized countries—and has fewer epileptics.

There are now in Ireland 43 district and private asylums, with a population of insane persons amounting to 9289. There are 163 poor-houses in which there are insane and idiotic persons.