‘Out of sight and out of mind’ was certainly the approach taken to mental health before the late 20th century. There are six psychiatric hospitals in Northern Ireland, St. Luke’s, Armagh (1825); Purdysburn/KHCP Belfast (1829); Gransha, Derry (1829); T&F, Omagh (1853); Downshire, Downpatrick (1869); and Holywell, Antrim (1898), all still open and operating psychiatric hospitals. Mental health policy has developed comprehensively since the 19th century and change is still ongoing however it is still clear that mental health services in Northern Ireland fall considerably behind those in the United Kingdom.
This essay will discuss how and most importantly, why mental health policy has developed in Northern Ireland throughout the 19th and 20th century. It will first illustrate life inside the asylums, the policies that supported institutionalisation, and why change was needed. Next it will establish the progression in policy to support community and integrated care; it will examine this change and its effectiveness throughout society. Moving onto the 21st century, it will focus on a few of the main policies established throughout this period. Finally a conclusion will be made, assessing the current policy in Northern Ireland and how far we have to go to enhance the quality of life of those struggling with mental illness.
First off, it is important to understand the political and social whereabouts of Northern Ireland from 1898 to gage the changes that have been made in policy. Before 1921, the North and South of Ireland were under British rule. When the government of Ireland Act 1920 partitioned the island of Ireland into two separate states, Northern Ireland and Southern Ireland, the North of Ireland remained under British rule while the South of Ireland was ruled a free state. It was not until 1998 under the Northern Ireland Agreement, that Northern Ireland was gained the right to its own assembly. The Department of Health, Social Services and Public Safety is one of 12 Northern Ireland Departments created in 1999 as part of the Northern Ireland Executive by the Northern Ireland Act 1998 and the Departments (Northern Ireland) Order 1999. (DHSSPSNI).
Individuals with mental health problems have been segregated from communities for centuries; they were contained for care in frightening psychiatric hospitals, referred to as asylums in the 19th century. These asylums were far from pleasant, with long daunting corridors, padded cells, straightjackets, poor nutrition, and harsh treatments.
The treatments were primitive, yet traumatising, usually involving sedative drugs like laudanum, which were administered orally, and treatments such as lobotines banished in the 1950’s ,insulin induced coma therapy, and electroconvulsive therapy ongoing today. (Bewely, 2008)
In the 19th century Northern Ireland was put under the Lunacy and County Asylums Act in 1821- 1890. This legislation took away patient’s rights and gave them no voice to their own...