From Institutions to Inclusion: What Ireland’s 1926 Census Tells Us About Stigma, Mental Illness and How Far We Have Come

An article published last week by The Journal highlighted one of the most striking findings from Ireland’s 1926 Census (Link to Journal article: Census data reveals almost 9,000 people were confined to mental institutions in 1926). It offered more than names and numbers. It opened a window into a young State and into the lives of people who were often hidden from public view.

The Journal reported that, of the 16,086 people recorded as living in institutions on census night, 8,973 were in mental hospitals. In other words, more than half of those detained in institutions were living in psychiatric settings. In Dublin alone, 2,052 people were recorded in Grangegorman Mental Hospital. That statistic should give us pause. It tells us something profound about how society once responded to mental illness: not with support, rights or recovery, but with separation.

The Ireland of 1926 was emerging from revolution, civil war and economic hardship. Life was difficult for many families, and communities were shaped by loss, emigration and poverty. In that environment, mental illness was poorly understood and heavily stigmatised. Families often had little access to treatment, community supports or compassionate language to describe distress. Institutionalisation became the common response. Mental hospitals, known at the time by terms we would rightly reject today, were not simply healthcare settings. They were part of a wider social system that often removed people seen as troubled or inconvenient. Some people needed significant care. Others may have needed housing, trauma support, family assistance, income security or dignity but too often, they received walls.

Stigma is sometimes mistaken for rude language or prejudice alone. It runs deeper than that. Stigma happens when society views a group as lesser, dangerous or shameful. It then builds attitudes, systems and barriers around those beliefs. In 1926, stigma often meant exclusion from ordinary life. It meant that a person experiencing psychosis, depression, trauma or severe distress might lose liberty, status and voice. Their identity could be reduced to a label rather than recognised as a full human being with hopes, relationships and rights. To be hidden away and excluded from society is one of the harshest forms of stigma.

Much has changed in 100 years, and it is important to recognise that progress. Mental illness is discussed more openly than at any point in our history. Many people access counselling, peer support, psychotherapy, medication and recovery-focused supports while living in their communities. Human rights protections are stronger and the voices of people with lived experience of mental illness increasingly shape policy, research and services. Younger generations are often more willing to speak honestly about mental health. There has been a significant shift from containment to recovery, from silence to conversation, and from exclusion to greater inclusion.

That progress did not happen by accident. It was driven by people with lived experience of mental illness, families, advocates, clinicians, charities and communities who challenged shame and demanded better.

We should also be honest: stigma has not disappeared. Today it may look like:

• long waits for support  
• fear of disclosure in the workplace  
• poor housing or homelessness  
• outdated portrayals or misunderstandings in public discussion and media coverage  
• loneliness and exclusion  
• families carrying heavy burdens without enough support  
• people delaying seeking support because they fear judgement  

The locked gates of institutions are less visible now, but barriers still remain.

As The Journal’s coverage reminds us, historical records can still speak powerfully to present-day Ireland. The most important lesson from these figures is this: stigma is never just an attitude. It becomes policy, structures and everyday behaviour. When a society fears mental illness, people are hidden. When a society understands mental illness, people are included. Ireland in 2026 has an opportunity not simply to look back, but to move forward with confidence and purpose.  

The future does not need to take another century to improve. Change is already happening, and it can happen faster when there is leadership, investment and collective will. That means:

• timely access to mental health supports  
• community-based recovery services  
• family inclusion  
• secure housing  
• employment opportunity  
• zero tolerance for discrimination  
• responsible and informed media coverage  
• leadership shaped by lived experience  

These are not distant ambitions. They are practical choices we can make now.

Nearly 9,000 people in mental institutions in 1926 is not just a historical fact. It is a reminder of what happens when fear and stigma shape society. But it is also a reminder of how much can change. The Ireland of today is not the Ireland of 1926. And the Ireland of tomorrow can be fairer, kinder and more inclusive still. The task before us is not to wait for history to change. It is to shape it now.