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Conclusion

from the book 'St Mary's Hospital Castlebar' by Joe McDermott

There is, at the time of writing, a widespread aversion among people toward many of the institutions that existed in the name of service to the disadvantaged, the ill, and the oppressed. Behind many of the walls and doors of Irish institutions there are residues of shame, the remnants of tyrannies imposed on the less fortunate. Irish society is holding itself up to the light, and what it sees it does not like. In this story of St Mary's, no attempt was deliberately made to hide any truth that needed to be told, indeed this very story may elicit others of an unfavourable nature. However this account is offered in the spirit of truthfulness, which it set out to realise. In reality the majority of the stories that emerged during the research, indicate that the staff of St Mary's, were well meaning, caring, and kind to the patients in their charge.

In the life of a large institution there are many defining moments. Some of them are signalled with vigour, others just happen, nevertheless their consequence can leave a memorable signature. For St Mary's, those moments are many, new buildings in the nineteenth and twentieth centuries, the enlargement of the farm, the development of St Theresa's. Even the present scaling down of the hospital is of major significance.

During the 1960's, a paradigm shift took place in the treatment of mental illness. For St Mary's the invitation by the Minister of Health in 1961 to examine all aspects of hospital life coincided with the arrival of a group of staff members who were inspired to look at reality in the hospital and indeed in the county, and to set about managing change, in treatments, and in services offered inside and outside the hospital. Occupational therapy, was revamped, community nursing was put on a sound footing, a journal critiquing the entire institution was launched from within. A comprehensive host of new treatment techniques was introduced. These have already been instanced in the chapter on administration, because while they were treatments, it was by realigning the whole administration of treatment and care into a new seamless weave of services, they were successfully introduced. The whole ethos of the hospital was reformed in line with progress elsewhere in Ireland, England and Europe.

The symbolism of the high walls and locked gates is gone and the mental hospital turns to face it's public. Throughout the 1960's, 70's and 80's, major changes occurred in the way that the hospital was managed, the treatments it offered, the profile of the patients treated and the locations used as care centres. More and more patients were treated in their communities, at day care centres and in houses acquired by the health board and staffed in new ways. Greater emphasis has been put on old illnesses being treated in a new manner. Addiction illnesses especially alcohol are receiving greater attention, drug addictions are also part of the remit of the mental health services today. The emphasis is now on education, especially through the work of The Mayo Mental Health Association. This organisation was founded in the late 1960's. Dr Gilvarry, RMS, was instrumental in starting it, and it continues to provide excellent advice, guidance and expertise to the public. There are other organisations who also work voluntarily with the mentally ill, such as AWARE, founded by patients, relatives, and mental health proffessionals to assist those who are directly affected by depression. Schizophrenia Ireland is a self help group for relatives and friends of people who have the illness, Mayo has a branch which meets regularly. GROW is another self help organisation where people learn to overcome such problems as phobias, anxiety, depression, panic attacks and loneliness. It is open to all and meetings are held regularly in different parts of the county.

The future is bright for the treatment of mental illness. The future is different for the institution that is St Mary's. In as few as three years the hospital may cease to function as such. The measure of success will be the ending of the institution and the treating of patients locally in day care centres, at home or in the psychiatric units of general hospitals. The building that is St Mary's will be finally engulfed by the Galway Mayo Institute of Technology. It will use two thirds of the building. On the other side community care services are already refitting wards as administrative offices, mental health administration will be conducted from this third.

For some of the longer serving staff members and their patients there is a sense of grief, mourning the passing of an old friend. Corridors echo to old memories ghosts of long dead patients, matrons, nurses, keepers and attendants linger on. The scent of St Mary's, so hospital, so real, so distinguishing, remains, retreating to it's core from the invading worlds on either side. Many of the older patients, there are now just over 140, will be moved on to a more appropriate setting. It is near the fateful moment for an old institution, and while there will be some who will not mourn it's passing, they will be far fewer than those who do.

"And then a Plank in Reason, broke
And I dropped down, and down -
And hit a World, at every plunge,
And Finished knowing - then -"

(From: I felt a Funeral, on my Brain) Emily Dickinson

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