Adeline (Ada) English (1875-1944) was a psychiatrist who played an important role in the development of healthcare in Ireland in the first half of the 20th century. Female doctors were a rare breed at the times but many of these pioneering women went on to help shape healthcare in Ireland at a time of great political, social and scientific change.

Ada was also a staunch nationalist who was active during the campaign for Irish independence. She entered psychiatry in an era where the forbidding mental asylum system – essentially a ‘warehousing’ of the mentally ill and socially unwanted – flourished. Ada managed to pioneer significant improvements in the treatment of the mentally ill in her time at Ballinasloe District Asylum.

Ada devoted her career to making a better life for her patients. She promoted occupational therapy and convulsive therapy, encouraged sports, entertainment and greater levels of activity for patients, and campaigned with zeal for improved conditions.

Large asylums had been developed in Ireland in the 19th century. However, by the early 20th century, when Ada started her career, asylums like Ballinasloe had become severely overcrowded and this problem persisted throughout subsequent decades.

Author Brendan Kelly says key issues included the regulation of large numbers of patients within enclosed spaces, the spread of infectious diseases, and pressure on beds. Of necessity, the emphasis appears often to have been more on crowd control than on optimal treatment.

Ada ultimately enjoyed much success in improving the lives of patients. However, the asylum environment was far from ideal, with patients often living in very poor conditions. The Ballinasloe asylum was not free of the type of administrative difficulties, in-house political squabbling and ‘blame-gaming’ that are a feature of Irish healthcare provision today. There was a sworn public inquiry in 1940 into the running of the hospital.

Assessing Ada English’s medical career, Brendan Kelly, a consultant psychiatrist himself, says she had notable achievements, but had to cope with apparently intractable day-to-day problems common to asylums at the time, including chronic overcrowding, industrial disputes and interstaff conflict.

Kelly’s book is an impressive account of the career of one of the key women medical figures of the 20th century, and of healthcare, society and politics at a time of great change. It includes a section outlining the careers of other pioneering women doctors.

- Niall Hunter

Book review - Pioneering psychiatrist