Chapter 11 — Current circumstances

Accommodation

Homelessness was a reported feature in the earlier years following discharge of 22 of the male witnesses and 40 of the female witnesses who spoke to the Committee. A small number of male witnesses reported ongoing periodic homelessness in recent years. I slept in down and out places where it was really cheap. ... I was thinking would I come back ...(to Ireland)... but you can’t come back, you know nobody. I slept rough because I had nowhere to stay, I used to sleep in the park. I met ...named ex co-resident.... I got a job in ...named establishment... where all the boys used go. But, I had nowhere to stay and I used to be standing up nearly falling asleep during work. I got a place in ...named city... but we ...(former co-residents)... got thrown out of that because we couldn’t pay. I then got a job as a labourer, it was a job, it was just there, nobody asked questions, you didn’t have to fill a form up or anything. I was there for 12 years. ... I felt ashamed, I didn’t want people to know who I was.

Health

Male and female witnesses provided information about their current physical and mental health status and wellbeing, either directly or in the context of discussing their adult life circumstances. Many witnesses reported multiple health concerns, currently and in the past. For the purposes of writing this Report, witnesses’ health status was categorised as good, reasonable and poor based on the information witnesses provided either directly or indirectly about their past and current health history in the course of their hearings.

The following table outlines the physical health status described by male and female witnesses at the time of their hearing:

Physical health status	Males	%	Females	%	Total witnesses	%
Good	163	39	131	35	294	37
Reasonable	148	36	170	45	318	40
Poor	101	24	77	20	178	23
Unavailable	1	(0)	0	0	1	(0)
Total	413	(100)*	378	100	791	100

The information provided by 294 witnesses (37%), 163 male and 131 female, indicated that they enjoyed a good level of physical health and well-being, notwithstanding the fact that they may have some health problems currently or in the past. Three hundred and eighteen (318) witnesses (40%), 148 male and 170 female, described having reasonable physical health. The most common feature of this group of witnesses was that they reported having physical health problems either currently or in the past, which continued to have an impact on their lives. They generally regarded their physical health problems as being manageable and often age-related. There were 178 witnesses (23%), 101 male and 77 female, who gave a history of poor physical health. The fact that poor health was reported by 25% of male witnesses compared with 20% of female witnesses may be in part related to the older age profile of the male witnesses.

The most frequently reported physical health complaints for both male and female witnesses were cardio-vascular problems such as heart disease, angina and hypertension. One hundred and forty (140) witnesses (18%), 76 male and 64 female, reported various combinations of these conditions including a number who had suffered strokes or had heart surgery. Eighty nine (89) witnesses, 45 male and 44 female, described having gastric conditions including ulcers and gall bladder problems in addition to kidney and liver disorders. Seventy four (74) witnesses, 49 male and 25 female, reported respiratory problems of various kinds including asthma, emphysema and chronic bronchitis. Sixty seven (67) witnesses, 31 male and 36 female, reported suffering with different forms of arthritis and rheumatism all of which negatively affected their mobility and sense of well-being.

Certain health problems were more frequently reported by either male or female witnesses; for example 17 male witnesses, compared with three female witnesses, reported that their health problems were directly linked to their alcohol abuse. Thirteen (13) female witnesses reported having had hysterectomies and 10 also reported having osteoporosis. Eleven (11) male witnesses reported having hip, knee or other joint replacements and operations compared with four female witnesses. Twenty three (23) witnesses, eight male and 15 female, reported being diagnosed and treated for cancer. Twenty two (22) male witnesses reported being treated for diabetes and gout, compared with seven reports by female witnesses of treatment for diabetes. Eleven (11) witnesses, five male and six female, reported being treated for tuberculosis as adults.

Three (3) male witnesses reported being HIV positive and a further three male witnesses reported having hepatitis.

Finally, the Committee heard 60 reports of multiple health problems from female witnesses compared with 47 similar reports from male witnesses and male witnesses generally reported being less inclined to seek medical advice than female witnesses.

The following table provides an overview of the mental health status of the witnesses as described by them, either directly or indirectly, in the course of their hearings. Good mental health was less frequently reported than good physical health:

Mental health status	Males	%	Females	%	Total witnesses	%
Good	117	28	74	20	191	24
Reasonable	183	44	181	48	364	46
Poor	112	27	123	33	235	30
Unavailable	1	(0)	0	0	1	(0)
Total	413	(100)*	378	(100)*	791	100

One hundred and ninety one (191) witnesses (24%), 117 male and 74 female, described good mental health and well-being. These witnesses reported being reasonably happy and did not feel that their personal or social relationships were markedly affected by emotional or psychological difficulties. There was a notably larger proportion of male than female witnesses who reported good mental health, 28% compared with 20%.

Poor mental health was indicated by a constellation of current and debilitating mental health concerns including suicidal thoughts and attempts, depression, alcohol and substance abuse, eating disorders and treatments including psychiatric admission, medication and counselling. One witness gave the following description of the enduring effects of his childhood abuse; I used to sleep rough and I’d have to ask a garage “Can I clean your cars?” I tried to get back my dignity that I lost, I can’t get it back. They broke me, they did...the problem is still there when you wake up. I’m on tablets for the best part of my life, I’m in and out of hospitals, I took overdoses, I tried to hang myself. All the pressure builds up. I’m kinda seeing psychiatrists all my life. Doctor...named psychiatrist...is very good, I talk to her. Counselling was very disturbing for me. I couldn’t take any more of it ...I should not have been on medication all my life. There’s times I sat in my bedroom for 2 to 3 days without coming out.

Substance abuse was reported by 22 witnesses, 12 male and 10 female, who reported poor mental health and 10 other witnesses of this group, four male and six female, reported ongoing eating disorders.

Witnesses described as having reasonable mental health were differentiated from those who were described as having poor mental health by the degree to which they reported their lives to be currently affected by depression, alcohol and substance abuse. Many remarked that memories of past trauma were not easily forgotten and that they abused alcohol at times in their attempts to cope with painful memories and intrusive thoughts. A number of witnesses reported being assisted by mental health and other support services during stressful periods of their lives. Mental health indicators are shown in the following table:

Mental health indicators*	Reports by male witnesses	%	Reports by female witnesses	%	Total witness reports	%
Psychiatric admission	86	21	84	22	170	21
Suicidal thoughts & attempts	197	48	210	56	407	51
Counselling required	204	49	217	57	421	53
Alcohol abuse	217	53	90	24	307	39
Substance abuse	59	14	31	8	90	11

Alcohol abuse was reported to be a dominant feature in the lives of 307 witnesses (39%), 217 male and 90 female. One hundred and thirty eight (138) of those witnesses reported a history of alcohol abuse combined with suicidal thoughts and attempts. Of the 86 male witnesses who reported having been admitted to psychiatric hospitals for treatment, 63 also reported a history of alcohol abuse. There were 84 female witnesses who reported having been admitted to psychiatric hospitals for treatment, 35 of whom reported a history of alcohol abuse. By 17 or 18 I was an alcoholic. It ...(alcohol)... blocked it off for me, the orphanage ...(Industrial School).... I’ve had 5 operations on my arm and the doctors say it is muscle damage from the beatings, the one with a brush. I have 5 scars ...(scars on arm shown to Commissioners).... I have been in mental hospitals and tried to kill myself. The psychiatrist asked me what am I keeping in my head? I said “I can’t tell, you wouldn’t believe it”. You would be afraid to tell, the fear is still there. I am now in counselling and it took me an awful long time to say it ...(to describe abuse)..., a long time. • I went to England, I think I was about 34, not working, just drifting. I had a job on building sites but lost that through the drinking. I went to a lot of places for the drink, drying out, I’m still attending group therapy. I’m not working at all, I’m on disability because of health problems. I just drink away the day...The doctor says it has to do with what happened...(childhood abuse).

Substance abuse was a less common feature, with 90 witnesses (11%), 59 male and 31 female, reporting that either they were using or had used illegal substances or abused over-the-counter or prescription medication. Reports of substance abuse, both legal and illegal, were strongly associated with reports of alcohol abuse, in 47 instances for male witnesses and 22 instances among female witnesses.