Keys (male and female)

P A U L   G U C K I A N

Growing up in the 1960s I was strongly influenced by the changing world around me – the Civil Rights movement in the US and especially the role played by Martin Luther King. Europe was not immune to the blowing winds of change of the 1960s including civil rights movements in Ireland (North and South) and addressing the rights of minorities and vulnerable people. Included in the drive for human and civil rights was the process of deinstitutionalisation of the mental health services, eventually leading to the adoption of the current Recovery approach.

This atmosphere of change led me to study social sciences in the University of Ulster, Coleraine, Northern Ireland and then on to a professional social work course in UCD, Dublin. Working now as I do in the mental health field, I now have the privilege of lecturing on the MSW course in the National University of Ireland, Galway.

I was appointed as sole social worker to Our Lady’s Psychiatric Hospital, Ennis, Co Clare, Republic of Ireland, in October 1989.  Our Lady’s was opened as the Lunatic Asylum for County Clare in 1868 and closed in 2002.  My appointment coincided with the phased closure of psychiatric hospitals and the development of a community based multidisciplinary service under the then national mental health policy, Planning for the Future (1984).

On appointment I sought and eventually was given a pair of the infamous keys.

I chose these Keys (male and female) because …

I soon discovered that there was a certain status attached to the ownership of these keys as not all staff were allowed to possess them.

The first battle was to convince the powers that be that a social worker was suitable to hold a pair. The access to and from all the wards, including the separate male and female acute admission wards, was dependent on the decision of the key holder.  Many of the service users who used the first floor acute units talked of their generally very negative experiences of approaching the units for admission and knocking on the big doors and waiting for a key holder to let them in. Equally, they found the sound of the door closing and being locked behind them quite distressing.

During this time the mental health legislation in the Republic of Ireland was the Mental Treatment Act 1945, which was found to have been in breach of the European Convention of Human Rights under many headings, including not having a definition of mental disorder in the Act, no built-in independent reviews, and the possibility of service users being detained without review indefinitely.

We have moved on since then. The Hospital was closed in 2002 with the Acute Unit now based in the local General Hospital and the emphasis on a recovery-based model in the community. The Mental Health Act 2001 has brought with it a whole new rights-based approach, unimaginable even in 1989. I am no longer a sole social worker but head up a team of seven.

To this day I carry these keys on me at all times as a reminder of times past and a warning that even in our modern approach, issues of power and control are not forgotten and in vigilance that key pads and swipe cards do not become the keys of the modern era.