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Introduction
Introduction
I spent a week in Dublin exploring and depicting previous institutions like the Magdalene Laundries, current psychiatric hospitals and services like St. Patrick's and community based supports for people going through socio-emotional stressors like Jigsaw for the youth and Anew for homeless women who are pregnant. Finally we went to Dublin City University to learn about the educational support in higher education as well as met a Forensic occupational therapist.
Mental Health History in Ireland Overview
Mental Health History in Ireland Overview
Ireland being highly influenced by Catholicism has neglected their sense of duty to serve the people who are in need because of their history of oppressing individuals with mental health challenges. Families would admit their "crazy aunt" to be locked away for being vocal of her opinions and saying no to her husband. At the time, society trusted authorities like doctors, church and the government. Psychiatric institutions were known as the "dumping grounds" for "dangerous and damaged people" according the a documentary Ireland's Mental Health history: Behind the Walls.
This changed when people with lived experience expressed what truly happened behind the institutions' walls.
France--> World influence to de- institutionalize
Philippe Pinel a French physician is the founder of the Moral Treatment Movement in the 1960's leading towards de-institutionalization of mental hospitals. After these locations becoming tourist attractions and high class entertainment he found it unethical to treat humans this way.
USA --> Lived experience opens eyes on what truly is happening
In the United States, Nellie Bly, a journalist, spent 10 days in an institution in New York as an experiment. She reported she "heard voices" and then acted as she usually would when admitted. It took 10 days for her release and she discussed the issues inside with the other women she met and shed light on what truly occurred inside the institution.
Ireland--> Lived Experience opens eyes on what truly is happening...
Hanna Greally was only 19 when raped and impregnated and admitted into an institution in Cork, Ireland. Since women pay life for being raped she did not know if she'd ever get out of the horrific and continuous traumas she experienced behind closed doors. It took 20 years for her to be released and a lifetime to recover. She was given little to no freedom and labored all day. Though she had faith and a good relationship with her mother, once her mother passed away she was left alone. In order to be released she had to have a male in her family "liberate her" but no one wanted her. Finally she was randomly chosen to partake in a rehabilitation program and transition out of the institution and was freed.
Ireland's mental health milestones
Institutions like St. Patrick's in Dublin took in a majority of the population it was overcrowded and under managed. Since it is a private institution and funded by the government they are more strict with their treatments.
Though some natural remedies did appear like a river with high lithium content - the current treatment for some mental health challenges- was found and named "The Well". Often times treatments were physical restrains or chemical restraints with medication to make someone drugged.
Dangerous Lunatic Act was to criminalize individuals with mental health challenges who have committed a crime and no evidence was needed to prove their "wrongful acts".
Ellis Island, NY, USA: People who tried immigrating to the United States who did not pass the immigration tests were for reasons of being "insane" were sent back to Cork and admitted into an asylum.
Modern Ireland
Due to the religious oppression, Ireland has been slow to come to terms to "not in my backyard" notion of having "danger" in their neighborhood by accepting supported housing for people with mental health challenges near them. Though Ireland's society is still sanist and have many family ties to people who have lived experience there are more support systems put into place.
Mad Pride Movement founded by John McCarthy and held an event at the Fitzgerald Park across form University College Cork to celebrate neurodiversity and reclaim the word "Mad" with a capital M.
Site Visits
Site Visits
St. Patrick's Mental Health Services
St. Patrick's Mental Health Services
This private institution funded by the government to provide services, for people with mental illnesses. They have 234 beds with access to accommodation, food, leisure and medical services. Some medical services offered are mental health assessment, psychotherapy, Cognitive Behavioral Therapy (CBT), General Practitioner (GP), Occupational Therapy (OT), Social Work (SW). It was founded by Mr. Swift in 1746. At the linked St. Patrick's Hospital they serve service users for 34 days with follow up care. They are a medical model facility and are a training hospital for OT and Psychology. They do chemical restraints but no longer do physical restraints. They do not provide services to individuals with heroin addictions. Some programs they offer include CBT, Dialect behavioral therapy (DBT), and the Wellness Recovery Assessment Plan (WRAP).
Case Studies:
- The Case Books dating from 1899 included subjective comments regarding patients behavior which indicated their "insanity" such as: "sitting alone", "talks to self", or "hysteria". Phrases like these were often cited as reasons for continued institutionalization.
- behaviors today's society would categorize as being stressed or vocal about one's emotions especially women against their husbands would lead to institutionalization
- The lecturer discussed that at one point in Ireland's history a majority of the population was institutionalized and it affected everyone's lives.
- There's a misalignment in the system when the majority of the whole population is in the "wrong".
Reflection on St. Patrick's Mental Health Services:
- Though we walked in the corridors of the facility, I didn't see or hear anyone worker or patient. I do not remember seeing or hearing any occupations being offers to patients. The staff seemed aware of their language such as replacing "patient" with "service user" but sometimes the services provided at St. Patrick's has not been a voluntary choice and thus the use of this new term is a misleading.
- The staff also over medicated and the hospital was overcrowded.
St. Patrick's University Hospital
St. Patrick's University Hospital
Hospital overview_May2019.pdfReflection of St. Patrick's Hospital:
Reflection of St. Patrick's Hospital:
Strength: This private hospital has personal services and rooms for occupations like a ceramic room, painting room, OT Kitchen and a room to encourage clients to invite their family and their children to come play.Weakness: Sanist Language like "Service User", based on diagnosis for interventions, over medication and overcrowded, historic case studies were made by white doctors and would label "hysteria, sitting alone, doesn't talk much" as a diagnose criteria of admittance into an asylum. They also said "we no longer do physical restraints, only chemical restraints". Shocking! Chemical restraints are still unhealthy, Mary Maddock under the Cork button discussed the impacts of medication and ECT on her well being.
Overall: they have good intentions but they could work on being more personable and truly caring about individuals' life and recovery.
Mental Health Services Scavenger Hunt around Dublin!
Mental Health Services Scavenger Hunt around Dublin!
Anew Support Services is established to provide a safe space for homeless pregnant women or new mothers to be educated on how to parent. Specifically in Ireland, it is common that young pregnant women that are homeless were recently kicked out of their parents home due to their pregnancy and thus left on their own. (Their youngest at the moment is 17 years old!) They provide peri and post natal care in 4 different houses around Dublin. Free counseling is offered as well as peer-led groups and one on one parenting work. The focus of knowledge is for self-development, attachment, expectation for parenthood and creating a welcoming community for these women. Their focus is on independent living and providing a space for the mother to be supported during this difficult transition. Some of the work the counselors work on is a women's CV, postpartum depression or independent living skills like cooking.
Jigsaw
Jigsaw
This community based mental health support system has 13 service locations around the Republic of Ireland.
Person driven and primary care for individuals with mental health difficulties.
OT in Jigsaw - by Michelle Lowry - May 2019.pdfRebecca Murphy and Michelle Lowry welcomed us from Jigsaw and Michelle gave us this presentation
Reflection from Jigsaw
Reflection from Jigsaw
- talking about addressing diagnoses: "What does it mean to you?"
- trans disciplinary teams
- This is a step up from what I've been exposed to so far. The community feel and opportunity for people to support each other that are about the same age is important and truly valuable in my experience.
Women and Madness / Magdalene Laundries
Women and Madness / Magdalene Laundries
Film for Context: Philomena
This film based on a true story of a woman who lost her son to a forced adoption by the sisters in the laundries. When freed, she spent her life searching for her son but it was too late as he had passed away but you learn that he also looked for her.
Last Laundry closed in 1990.
That's about 30 years ago. How terrifying that this was still occurring when Karen was a child
There is a global oppression against women and power. In Ireland women only recently got the right to vote and have an abortion. If modern time women were to live in those days, all of us would be in the laundries.
Dublin City University OT services
Dublin City University OT services
Dublin City University (DCU) Susan Madigan, Roisin- forensic OT, Fiona- geriatric OT
DCU Dominican Group 30 May 2019.pptxReflection from DCU:
- The intellectual disability office talk resonated with me because I was diagnosed with mild dyslexia 5 years ago and I never had accommodations for it until junior year of college. I always stuck through my challenges in life. Check out the critical reflection for a comparison on getting accommodations for dyslexia between Dominican and DCU.
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