One Sunday evening in 1992, the telephone rang. It was a ward sister at the local psychiatric hospital, the Rector of the neighbouring parish who was Church of Ireland chaplain to the hospital could not be contacted and they were anxious that a patient receive a call.

The hospital was only four miles away and was reached in a few minutes. A lady from the ward had just returned from the district hospital where she had been diagnosed as having an aneurism. Her life was not necessarily in imminent danger, “she might live on another ten years, on the other hand, she might be gone in ten minutes”.

I sat at a table and talked to a woman in her eighties; sprightly, but with that slightly pale look that comes from being long years in an institution. She had come from a small coastal village back in the 1930s. Her family had not been large, she knew no-one from the village anymore. She seemed as sane as anyone I knew.

On leaving the ward, I went to sign the record of visitors that was kept in the ward office. Apart from the chaplains’ visits, the lady had received no visitors since 1982, some ten years previously.

The imminent danger remained no more than a danger; occasionally, I would take services at the hospital or do a chaplain’s round, if he were away on holidays, the lady would always greet me with a wave and a smile.

I never discovered why she had ever come to the huge 19th Century institution that older people in the community still referred to as “the Mental”. Had she become pregnant when she was young? Was she judged to be somehow “morally defective”? Sixty years seemed a long sentence for having offended the sensibilities of the upright in the community.

Memories of the lady returned in reading Sebastian Barry’s The Secret Scripture where Dr Grene, the senior psychiatrist writes,

. . . a task long avoided, which is to establish what circumstances brought in some of the patients, and whether indeed, as was tragically true in some cases, they were sectioned for social rather than medical reasons. Because I am not so great a fool as to think that all the ‘lunatics’ in here are mad, or ever were, or were before they came here and learned a sort of viral madness. These people are perceived by the all-knowing public at large, or let us say public opinion as it is mirrored in the newspapers, as deserv­ing of ‘freedom’ and ‘release’. Which may be very true, but crea­tures so long kennelled and confined find freedom and release very problematic attainments, like those eastern European countries after communism.

Our sins of omission are great.