Those living in Armagh may have a cursory familiarity with the history of St Luke’s Hospital on the Loughgall Road as a former “insane asylum” for the confinement and treatment of those living with psychiatric conditions… otherwise known as the “insane poor”.
A commonly-used (perhaps unwittingly offensive) turn-of-phrase, heard spoken by exceptionally tired or stressed persons locally, “They will be sending me to St Luke’s”, derives from its former use.
But the building’s history is much more than just that. According to one scholar, Armagh’s asylum was, perhaps, much more industry-leading and forward-thinking than anyone gives it credit for.
Yes, by today’s standards, it was brutish in ways. But, in its infancy, it worked to the “moral management” principles of a man relatively modern in his thinking. It was both well-intentioned and progressive.
That man, was “Moral Manager” and Asylum Director, Thomas Jackson.
According to historian, Arthur P. Williamson’s journal article ‘Armagh District Lunatic Asylum: The First Phase’, Armagh was at one stage “distinguished in the field of social policy for the mentally ill”. It was a notion born out of the establishment of St Luke’s Psychiatric Hospital in 1825.
It was initially built to house 100 “lunatics” with a view to expand accommodations for 150. The asylum was divided, with males and females split. They had provision for those suffering from “acute mania” and a smaller number of convalescents.
Williamson explains that St Luke’s was the first in a “network” of lunatic asylums set up across Northern Ireland under legislation introduced when Robert Peel was Chief Secretary.
In its first years of operation under Jackson, Armagh District Asylum was at the forefront in terms of methodology, practice and procedure, preferring “moral management” systems as opposed to traditional medical practices.
Jackson’s aim was to return patients to the community after “as brief a stay as possible”. To that end, he saw “employment” as the most efficient means to recovery.
He believed “lunatics” must be “taught to restrain their evil habits and propensities, to correct their conduct and behaviour by giving them ideas of order, industry and decorum, to return them to society, better not alone in health but in their moral character.”
Coercion – or restraint – was only to be used when deemed necessary to protect the patient or others.
In terms of employment, male patients were put to work in the hospital’s gardens. They largely grew food to be used in the asylum kitchens to feed patients.
The women were given “spinning” and made clothes for patients. The clothes were also known as the “asylum uniform”.
When patients arrived at the facility, they were made to hand over their clothes and to redress in the uniform. They also had their hair cut short and were made to bathe.
Their diet largely consisted of potatoes, grown by the gardening males. They were also, on occasion, given soup and bread and on Sundays “one pound of raw beef and one pint of beer per patient”.
Thanks to Jackson’s benevolent practices, patients were also given small ‘luxuries’, albeit, with the view of making them more agreeable. Said Jackson: “Avoiding all compulsion, I mostly find a small premium, such as a little tea on Sunday to the female worker and tobacco to the male, has the desired effect, the withholding of which for any misconduct often tends to check and produce obedience in the offending party.”
The asylum soon gained a solid reputation locally. But, it came with a drawback. By 1826 – just one year after admitting its first patients – the facility was already overcrowded.
In 1827, six patients were denied admission due to the “quota having been met” in Armagh. Just a year later, the number awaiting admission had grown to 19.
Jackson reluctantly had to be choosy when it came to admitting patients. He soon found himself classifying some as “incurable” and denying their entry to the centre.
In 1826, the Moral Manager commenced a “tour” of Ireland’s gaols – where many ‘insane’ were kept owing to the lack of asylums – on the search for lunatics within their walls.
Sadly, he wrote in his subsequent report: “I would beg to observe that from the length of time which most of the patients have been confined and other causes, no reasonable hope can be entertained of their recovery with the exception of five or six cases.”
The Board for the asylum deemed them all “probably incurable” and determined that, should they be admitted to the asylum, they would occupy beds more suitable to those deemed curable and rejected their admission.
The asylum also regularly rejected applications from epileptics and those with “long standing” conditions, for the same reason.
There are instances were Jackson referred to specific patients successfully admitted to the asylum and how they came to arrive.
Of one such nameless patient, he said he arrived “with as much rope coiled around him as would have secured a wild beast. The horse drawn cart on which he was tied was surrounded by six relatives, all of whom were afraid, on arrival at the asylum, to untie him.”
This same patient he said, in three months, was “perfectly recovered and expressed often and, feelingly his gratitude for the kindness he received, being fully aware of his former treatment.”
In 1841, a school was opened on the grounds for the education of women and girls with mental illness.
Matilda Jackson – unsure of familial connection to Thomas Jackson – was its Matron. She – like Thomas with employment – was convinced of its connection to rehabilitation.
Of one girl who had been in the asylum for four years and was considered incurable, Ms Jackson said: “When she began to attend the asylum school her mental disease declined and in six months she went home recovered, a good reader and writing tolerably.”
The curriculum, according to Williamson consisted of counting, poetry reading, reading the New Testament, history, “tales and interesting stories.”
There were also those who sadly died in asylum care. Though details of their deaths are not known, between 1826 and 1834 out of a total of 652 patients, 88 passed away.
Later, Jackson became engaged in a “running battle” with members of the medical profession over the procedures and practices used to treat the patients.
In the end, the medical professionals won out and gained control of the asylums. Their methods, according to Williamson, were “demonstrably less effective”.
