Images In Psychiatry: St. Patrick’s Hospital

On Oct. 19, 1745, Jonathan Swift, Dean of St. Patrick’s Cathedral in Dublin and author of Gulliver’s Travels, died. In his will, he bequeathed his entire estate to found a hospital for “fools and mad” (1). On Aug. 8, 1746, a Royal Charter was granted to the hospital by George II. St. Patrick’s Hospital was the first psychiatric hospital to be built in Ireland and is one of the oldest in the world. Its life spans two and a half centuries of tumultuous social and political change in Ireland—the 1798 rebellion being commemorated this year (Dr. Robert Emmet, father of the patriot executed in nearby Thomas Street, was the first State Physician to the Hospital), the Great Famine, home rule agitation, the 1916 Easter Rising, the War of Independence, the Civil War, and the birth of a new Ireland. Throughout these times, the hospital continued to fulfill its founder’s aspirations: providing psychiatric care for many thousands of men and women from all over Ireland, helping to foster positive attitudes toward the mentally ill, and contributing to the development of better diagnostic and treatment approaches to psychiatric disorders.

Swift’s interest in the plight of the mentally ill dates back to the period in England when he had himself elected as one of the Governors of Bethlem Hospital (“Bedlam”) in 1714. Shortly after becoming Dean of St. Patrick’s Cathedral, he became acutely aware of the appalling conditions in which the mentally ill of Dublin languished; he conceived of a hospital specially designed and built for such patients. He insisted that it should be run by an independent board of governors in such a way that all the monies accruing from the operation of the hospital should be put back into it for its further modernization and development. Such is the situation at the present day. The hospital flourishes and is now the largest and most comprehensive psychiatric hospital in the country. As the affiliated university hospital for the teaching of psychiatry to medical students at Trinity College in Dublin, St. Patrick’s organizes the most extensive psychiatric residency program in the country, possesses one of the oldest psychiatric nurse training schools, and has developed clinical programs in all the major areas of modern clinical psychiatry.