Treating the traumatised: Shell-shocked veterans in the Irish Free State

By Dr Eoin Kinsella

Given the momentous changes that occurred in Irish politics and society during the First World War, it’s easy to overlook the extraordinary ‘Home Front’ efforts across the island between 1914 and 1918, in support of the British army and war effort. 

Munitions were manufactured in Dublin, Cork, Waterford and Galway, providing workers with much needed wages. 

The National Shell Factory on Parkgate Street, Dublin employed up to 600 women and gave preference to soldiers’ wives or widows. 

Voluntary Aid Detachments (VADs) played a critical and often forgotten role in the Irish war effort, organising fund raisers, staffing military and auxiliary hospitals and manufacturing medical equipment.

Their efforts were crucial to the survival and recovery of wounded soldiers, who began pouring back into Ireland just weeks after the outbreak of hostilities. 

Between August 1914 and February 1919 at least 20,000 wounded men travelled through Dublin port.

These men returned to convalesce from their wounds before returning to the front, or to be permanently discharged as a result of disablement. 

There simply weren’t enough hospital beds available to cope, prompting organisations like the St John’s Ambulance Brigade and the British Red Cross Society to lead the voluntary sector in establishing auxiliary hospitals around the country. 

Often set up in private homes and varying in size, more than 100 sprang up around the island.
South County Dublin had its fair share of auxiliary hospitals – the first in Ireland opened in Monkstown House, the home of Harold Pim, in October 1914. 

Others followed at Linden Convalescent Home in Stillorgan, as well as Temple Hill in Blackrock. 

The War Office converted the Meath Industrial School, on Carysfort Avenue, into the Blackrock Military Orthopaedic Hospital in 1917. 

That same year, Leopardstown Park House was offered to the British Ministry of Pensions by its owner, Gertrude Dunning. 

Ms Dunning had inherited the property from her first husband, James Talbot Power (of Power’s Whiskey), who died in 1916. 

By 1920 the vast majority of homes that accommodated auxiliary hospitals had reverted to private ownership. 
Yet Leopardstown Park was different. 

Ms Dunning had gifted the house in trust to the Ministry of Pensions, to facilitate the treatment of wounded ex-servicemen, for however long it was needed. 

As things turned out, the hospital fulfilled that purpose for decades longer than expected.

For its first 14 years in operation, Leopardstown was also different in the type of patient it treated.

The image of the shell-shocked soldier is one of the most powerful and iconic legacies of the First World War in popular memory, an enduring symbol of the devastating effects of trench warfare and of new technologies for killing and destruction.

As it struggled to come to terms with the phenomenon, the Ministry of Pensions established several hospitals in Britain dedicated solely to the care of shell-shocked soldiers.

Craiglockhart Hydropathic in Edinburgh is perhaps the most well-known, having treated the war poets Siegfried Sassoon and Wilfred Owen.

With very few exceptions, military and auxiliary hospitals in Ireland lacked the expert staff and facilities to treat shell shock and other mental disorders. Specialist centres were opened at Dublin’s Richmond War Hospital between 1916 and 1919, and at Belfast War Hospital between 1917 and 1919.

In response to a request from the military authorities for assistance from VADs, Florence Barry established the Hermitage War Hospital at Lucan, County Dublin, in early 1917. It too specialised in the care of shell-shocked soldiers, but was closed by May 1919.

The number of beds that the Richmond, Belfast and Hermitage War Hospitals were able to provide for shell-shocked men between 1916 and 1919 was nowhere near adequate.

Gertrude Dunning’s decision to give her home to the Ministry of Pensions had come not a moment too soon.

Dunning’s gift also included Leopardstown Park’s grounds – some 100 acres of meadows, woods, formal gardens and an ornamental lake. Located at the foothills of the Dublin mountains, the house and grounds offered a peaceful retreat and the Ministry of Pensions quickly recognised its potential for treating shell shock.

After a quick programme of works to convert the house, thirty-two shell-shocked patients arrived in March 1918.

The British government’s wider plans to provide medical care for its veterans in Ireland were thrown into chaos during the War of Independence (1919–1921).

The situation was not eased following the establishment of the Irish Free State and the Civil War that followed. By the time the dust had settled, Leopardstown Park was one of just three hospitals in the Free State dedicated to the treatment of First World War veterans, even though more than 30,000 men in Ireland were in receipt of disability pensions.

The 32 beds available at Leopardstown fell pitifully short of what was required.

By 1921 the waiting list for admission was already at 762 men. Extensions of the hospital’s bed capacity and facilities in the 1920s were funded by the British government and a fundraising drive in the US, spearheaded by Lady Ethel, Countess Kingston.

Outpatient clinics for shell shock treatment opened in 1921 in Cork and Dublin, yet made slow progress reducing the waiting lists. Reporting in December 1923, the Irish Times offered a poignant description of the hospital’s occupants:

[They] are officially described as disabled ex-servicemen.

Their disablement is not, however, in limb. They are men whose nervous system was either disturbed by some sudden great shock, such as shell burst, or worn down almost beyond repair by prolonged strain in the war. It has been ascertained that the most important factors in recovery in such cases are rest, nourishment, and congenial occupation of mind.

The treatment methods employed at Leopardstown Park followed best practice. Termed ‘hardening’, patients deemed physically able were encouraged to spend at least six hours a day training in workshops, learning new skills such as brush making and basket-weaving.

Reports from Leopardstown suggested that the workshops were having a positive impact: ‘The interest which the [patients] have taken in the workshops has displaced proportionately their mental preoccupation with their health.

Two of the workshops, which taught carpentry and boot repairing to forty men, were constantly full. Even so, following discharge from hospital, outpatient treatment and employment opportunities for ex-servicemen were limited.

Thanks in no small part to the reluctance of the Irish government to supplement the work of the British government, training centres operated by the Ministry of Pensions for ex-servicemen lasted for just a few years during the 1920s.

With Leopardstown treating shell shock, the Ministry of Pensions also administered a general medical and surgical hospital at Blackrock, just a short distance away. The Military Orthopaedic Hospital on Carysfort Avenue treated patients between 1917 and 1931.

Its specialism was amputees, and the hospital fitted and supplied prosthetic limbs for ex-servicemen. At the height of its operations, Blackrock had beds for more than 500 patients.

The hospital was, however, closed in 1931 as a cost saving measure. This was a major blow to disabled ex-servicemen in the Free State, particularly those suffering from shell shock. Leopardstown was now the Ministry’s main hospital for ex-servicemen in Ireland, and had to adapt to cater for their general medical and surgical needs.

Admission registers for Leopardstown demonstrate the effect that the closure of Blackrock had on its patient profile. The first general medical patient was admitted to Leopardstown on 2 December 1931.

A 47-year-old former sergeant with the Royal Dublin Fusiliers, he remained at the hospital for 76 days.

Admission records show that shell shock was the primary complaint of 26 patients (10.3%) admitted to Leopardstown in 1932; 21 patients (8.4%) admitted in 1938; and just six patients (2.7%) admitted in 1944.

By way of contrast, 89 shell-shocked patients were admitted to the hospital between August 1930 and November 1931, which made up 90% of admissions.

The remaining 10% were almost certainly suffering from other forms of mental disability. The registers for the 1930s also show that virtually every patient admitted was Irish, and that 98% were Catholic.

With Leopardstown now converted to a general medical and surgical hospital, there was no specialist treatment centre for shell shock in Ireland.

Given the enormous waiting lists for admission to the hospital in the 1920s, the suspicion must be that very many of the shell-shocked ex-servicemen in Ireland never received the specialised help they needed.

Some of those lucky enough to be admitted required full-time, permanent care at the hospital.

Three of the shell-shocked men who arrived in 1930 and 1931 remained at the hospital for eleven, twelve and sixteen years respectively.

The medical superintendent’s annual report for 1941 noted that:

Many of the Old War cases of the chronic [shell shock] type require permanent institutional treatment; a few are constantly in and out and we have endeavoured to make their stay as short as possible.

The New War cases presented considerable interest: we have not, unfortunately, been able to see them in the immediate state but they have reacted well to treatment.

The report highlighted the case of one patient who had been at the hospital for almost seven years: ‘He discharged himself, against medical advice, and, I understand, is now in a mental hospital.

Men such as this were effectively abandoned to a life of chronic invalidity, most likely unable to maintain steady employment, supported only by a war pension and often destined for committal to an asylum.

Under the terms of the Gertrude Dunning’s gift to the Ministry of Pensions, Leopardstown Park House and its grounds were reserved solely for treating ex-servicemen of the British armed forces – for however long it was needed.

This was an extraordinary act of generosity, for Leopardstown Park Hospital continues to fulfil that role more than a century later. Falling patient numbers in the 1960s prompted an alteration in the hospital’s admission policy, and in the 1970s its doors were opened to the wider public.

In 1979, even as Anglo-Irish relations worsened in the face of the deteriorating situation in Northern Ireland, responsibility for the management of the hospital was successfully transferred from the British government to their Irish counterparts.

Though some of the original hospital infrastructure remains intact to this day, there is nothing on the grounds to indicate that, for more than a decade, Leopardstown Park Hospital was the only shell shock hospital in the Irish Free State.
 

On 17 June 2017 the hospital marked its centenary with a concert and the launch of Leopardstown Park Hospital, 1917–2017: A Home For Wounded Soldiers, written by Eoin Kinsella. It is available from branches of Dubray Books and all local bookstores, online or directly from the hospital.