‘Magnificent in architecture but often scandalous in governance’ the vast hospital optimistically named Bethlehem rose in palatial self-confidence in 1676 from the ashes of the Great Fire of London. It was the largest civil building in the city and quickly one of the most despised, colloquially known as Bedlam and thus, as Patrick Quinlan writes, ‘a synonym for chaos’.
Possibly surprised by the speed at which the public imagination can operate, Dean Jonathan Swift was an early governor of the Bethlehem foundation and, in St Patrick’s Hospital, Dublin, funded, along reduced but similar lines, an institution for the care of ‘fools and mad’ in 1757. In other words for the mentally ill, the insane, eccentric, homeless and abandoned men and women cast on city streets or housed reluctantly in prisons, reformatories, and workhouses.
It was from impulses of sympathy, from the requirements of public hygiene and social order and even from economic necessity that these new buildings were provided. The intention was that they would be imitated around Britain as the most suitable environment for their inmates.
Quinlan’s utterly fascinating study of the following centuries of what until very recently was, indeed, containment begins with the early history of what might kindly be called asylum.
His first chapter, fittingly entitled ‘The Lunatic at Large’, looks back through the years to 1814, after which developed the concept of Moral Management, a huge obligation for right-thinking Georgian politicians and, for want of better words, medical scientists and enthusiasts of social reform. The ensuing complexities of regulations and legalities are explored cleverly through the many examinations of the Irish buildings required to enact the laws.
The architecture of insanity in Ireland is now re-purposed, although there are many of us who today still shudder at the legends of our childhood.
The Magdalen Laundries and the mother-and-baby homes are not the only institutions Irish society has used for hiding its embarrassments.
Madness was as socially unacceptable as badness; confinement, often involuntary and just as often without any hope of release, could solve a problem of inheritance, of marriage, of alcoholism, even, according to a ledger in one Irish institution, of masturbation. This is a fact rarely admitted let alone discussed, and one to which Sebastian Barry’s novel The Secret Scripture (2008) has given powerful witness. It is no great surprise to discover from Quinlan’s intensely detailed book that ‘the otherworld of corridors’ at Portrane was used for the subsequent film.
Our legacy of incarceration as therapy should not be a secret one; although the Dangerous Lunatics Act of 1838 created, as Quinlan explains, ‘a permissive system of judicial admission — easy to obtain committal orders for involuntary commitment of a patient, difficult for management to refuse, and next to impossible for that individual to resist’, operating as a one-way valve without time-limits. This also resulted in a continuing increase in patients which meant that the hospitals were enormous structures, immensely long and scenically dominant.
The architect William Atkins was forced to amend his picturesque design for Eglinton Asylum at Shanakiel in Cork (since then Our Lady’s Hospital, now Atkin’s Hall) to include the 295 metre-long corridor linking the hospital blocks, the very element he had tried to avoid in his scheme of 1851.
With this book, Patrick Quinlan has provided a deeply questioning survey of Irish management of pauperism, homelessness, eccentricity, and mental illness since the late 17th century.
Where history falters fashion can dull the realities of the lived experience. Language is only a tool and can be invaded by anodyne terminology. Time and theory can sometimes work together; influencing the significant re-thinking on symptoms, treatment, pharmacology, and social attitudes through the last two-and-a-half centuries.
With much of the early compassionate changes led by the Quakers, initial enlightened legislation allowed for improved architectural standards. Several county jails in Ireland condemned as unfit for prisoners were adapted for the accommodation of lunatics — a very broad term in itself.
Kilkenny’s House of Correction ‘for the enraged and convalescent’ included a generous allotment of lavatories, under-floor flues for heating, and good lighting and ventilation.
Examples of this kind of technological advance might have allowed the spread of a framework of institutional architecture across Ireland but was interpreted so variously as to offer what Quinlan describes as ‘a standard of accommodation somewhere between punitive and primitive’.
There is more of this, more good intentions leading inexorably to mismanagement and misery and to the distinctly disgraceful, as when the authorities not only failed to rectify the appalling conditions exposed in an Inspector’s scathing report on Clonmel’s District Mental Hospital in 1959 but also kept the report itself secret even from the responsible local committee.
Thankfully, there is the other hand, and on it lies St Conal’s Hospital in Letterkenny (1865-2010) which lives on as an example of how such places can re-invent themselves so that ‘the Inspector’s recommendation to locate it here, over 160 years before, continues to resonate to the benefit of the Letterkenny community’.
That other hand is a capacious hand, for it also contains further examples of places of containment distinguished by an architect’s or a builder’s determination to evince in stone the best guiding principles of humanitarian empathy, even before their time.
Quinlan’s use of maps, diagrams, and images, his meticulous notes, and the crisp design of these many pages interrogate the relationship between housing and human frailty and encourages a new understanding of these monuments to asylum, as at St Davnet’s Hospital (1869 – 2020) in Monaghan.
Here the local committee and the architect John McCurdy aimed at the best international precedents ‘and then strove to do better’. Much of McCurdy’s plan has been outlived and demolished, but surviving pavilion sections function now as a modern healthcare system and the grounds are home to many voluntary and sporting organisations.
Against all the odds, writes Quinlan, McCurdy’s ‘visionary Victorian asylum lives on’.
- Walls Of Containment: The Architecture and Landscapes of Lunacy by Patrick Quinlan
- UCD Press, pb €40/hb €55.99