Student Number: 11005025

11005025 OT6054

MSc Occupational Therapy

(Professional Qualification)

(OT 6054)

Student number: 11005025

Occupational Therapy Project 4.

Module Leader: Dr Judi Pettigrew

Word count: 4987 nd 22 April 2013

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To construct a timeline of significant events in Dr. Eamonn O’Sullivan’s life time, particularly relevant to Occupational Therapy practice.

Author: Ciara Faughnan and Dr. Katie Robinson

Abstract

Background: Documenting history in health care practice such as occupational therapy has become increasingly important to highlight the philosophical foundations of the profession. Much is known about pioneering occupational therapists in other countries; however the contribution of Dr. Eamonn O’Sullivan (1897-1966) to date has been completely unrecognised. Dr. O’Sullivan was one of the philosophical founders of modern occupational therapy in Ireland and worldwide publishing the first known occupational therapy book of its kind in Europe, ‘Textbook of Occupational Therapy with Chief Reference to Psychological Medicine’ in 1955.

Objective: To construct timeline and narrative account of Dr. O’Sullivan’s lifetime with particular emphasis on significant events, relevant to occupational therapy describing practice and development during the twentieth century.

Methods: Historical research of inquiry relevant to Dr. O’Sullivan using primary sources of; personal biographical transcripts, records of events, photographs and secondary data sources of; newspaper articles, published books, and internet searches.

Results: Comprehensive biographical account of Dr. O’Sullivan was obtained from data sources. Dr. O’Sullivan is widely acknowledged for his contribution to Gaelic Athletic Association. This research emphasises his contribution to psychiatry, mental health practice and his involvement in the evolution of occupational therapy practice during his 37 years working at Killarney Mental Hospital.

Conclusion: Evidence based research has highlighted the importance and value of occupational therapy. A comprehensive and detailed biographical account of Dr. O’Sullivan and key events are presented in chronological order. The analysis presented explores influences on Dr. O’Sullivan and details his contribution to occupational therapy.

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Introduction

Dr. Eamonn O’Sullivan (1897-1966), one of the philosophical founders of modern occupational therapy in Ireland and worldwide, was a psychiatrist, visionary, practitioner, pioneer and a ‘man before his time’ (Fogarty 2007). Dr. O’Sullivan is well known for his contribution to Gaelic Athletic Association (GAA) when he trained the Kerry team to win eight All-Ireland championships. He is less well known as a founder of occupational therapy in Ireland. During his 37 years working at Killarney Mental Hospital, Dr. O’Sullivan made a vast contribution to the treatment of those with mental illness through his development of psychiatry and occupational therapy. His achievements are astounding when considered against the economic challenges, negative attitudes and the lack of supports available to the treatment towards the mentally ill.

Literature Review

Why history is important. “The roots of occupational therapy lie deep in the soil of political, social, and artistic ideals prominent at the turn of the 20th century” (Friedland 2003, p.211). In 1981 Bing highlighted that occupational therapy had neglected to document its history (Bing 1981). Since then numerous occupational therapists have made significant contributions to researching the evolution of occupational therapy internationally (Reitz 1992; Yerxa 1992; Frank 1992; Mayers 2000; Wilcock 2001; Hocking 2007; Sedwick et al 2007; Friedland 2007; Molke 2009).

History is a valuable tool in occupational therapy which enables the profession to develop and offers critical perspectives on current practice (Schwartz and Colman 1988; Lusk 1997; Canadian Nurses Association 2007). Occupational therapy is a unique health profession due to the fact that philosophy came first; therefore the profession was founded on sound theoretical underpinnings (Dunton 1919; Meyer 1977; O’ Sullivan 1955).

Although founded on the premise that occupation is central to health in the mid Twentieth Century occupational therapy became increasingly reductionist due, in part, to alignment with the medical model (Reilly 1962; Yerxa 1992). This led to a theoretical crisis within the profession and prompted the development of occupational science and a refocusing on the founding principles to the profession (Clark et al 1990; Yerxa 1990; Clark 1993; Molineux 2004). Identity crises of the profession and a struggle to communicate the core concepts of occupational therapy have been reported for decades (Wilcock 2001; Molke 2009). Documenting and analysing occupational therapy history allows critique and scrutiny of the professional philosophy (Reilly 1962) and

11005025 OT6054 connects us to the original principles and concepts that inspired the inception of occupational therapy (Sedgwick et al 2007; Schwartz and Colman 1988).

History of Occupational Therapy Occupational therapy is based on philosophical foundations built over many decades by those dedicated to the profession including founders and pioneers (Sedgwick 2007; Hocking 2007). Treatment of the mentally ill transformed as a result of the ‘Moral Treatment’, ‘Arts and Crafts movement’, and later ‘Mental Treatment Act 1821 (Bing 1981; Levine 1987). The term ‘occupational therapy’ was first used during the early 20th century in New York by a disabled architect named George Barton (Bing 1981). The National Society for the Promotion of Occupational Therapy (NSPOT) now known as the American Occupational Therapy Association (AOTA) was founded by six individuals from multiple disciplines in 1917 (Peloquin 1991). The six founders included; William Rush Dunton, George Edward Barton, Eleanor Clarke Slagle, Susan Cox Johnson, Isabell G. Newton and Thomas Bessell Kidner, all of whom continued to contribute to the development of the profession (Peloquin 1990; Peloquin 1991; Meyers 2000; Schwartz 2003) through their belief that engaging in occupation could affect the health and well being of individuals (Harvey-Krefting 1985; Schwartz 2003).

Role of psychiatrists The importance of occupation for mental health was a strong theme in the conceptual and practical development of the profession (Harvey-Krefting 1985; Yerxa 1998; Reitz 1992; Ion and Beer 2003). The foundation of the profession was influenced by a number of key psychiatrists working within institutions who pioneered the use of therapeutic occupation (Ion and Beer 2003). Dr. William Rush Dunton Jr. (1868-1966), an American psychiatrist, used occupation therapeutically with his patients and advocated at large for occupation as a means of treatment for the sick through his academic publications including; "Reconstruction Therapy (1917)", and "Prescribing Occupational Therapy," (1928). “Occupational therapy serves many purposes, such as keeping the mind occupied, awakening new interests, directing the patients from delusions and hallucinations (Dunton lecture notes 1911, p.193 cited in Schwartz 2003).

Another notable psychiatrist who was influential in the development of occupational therapy was Adolph Meyer (1866-1950), a psychiatric professor at John Hopkins University. Meyer mentored Dunton and Slagle. Meyer contributed to an understanding of treatment of mental problems that were concerned with time use and work “habit-deterioration of the mentally ill through systematic engagement of interest, and concern about the actual use of time and work” (Meyer 1977, p4.)

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Meyer was the first to use therapeutic occupations with group and argued Occupational Therapy was not a prescription but rather opportunities (Schwartz, 2003).

Psychiatry in Ireland / Asylums

In 1840 there were eleven asylums in Ireland (Finnane 1981; Grimsley-Smith 2011 Walsh and Daly 2004). Conditions of public asylums were reported to be appalling. The Lunacy Act 1821 and subsequent Irish Office of Lunacy (1846) and Dangerous Lunatics Act (1838) led to involuntary admission and the construction of a new wave of institutions in the mid C19 (Robins 1986; Kelly 2008; Prior 2012). The Great Irish Famine (1845-1849) led to increased numbers entering asylums, by 1958 there were in the region of 21,000 Irish people residing in asylums (Walsh and Daly 2004; Prior 2012). Those deemed to be mentally ill otherwise labelled as insane, lunatics, idiots, epileptics or mad went under minor judgement procedures to verify insanity (Grimsley-Smith 2011). During this time psychiatry was non-existent as medical practice, it wasn’t until 1885 when there was a serious shift in treatment for mental illness. The Killarney Mental Hospital presently known as St. Finan’s Hospital opened its doors in 1852 on 30 acres in Killarney, Kerry (Dwyer 2002).

Dr. Eamonn O’ Sullivan In 1925 Dr. Eamonn O’Sullivan became assistant Medical Officer at Killarney Mental Hospital where he transformed psychiatry and the treatment methods used (Fogarty 2007). Dr. O’Sullivan trained the Kerry senior football team from 1925-1962 winning eight of nine All-Ireland Gaelic Athletic Association (GAA) games. He was immensely involved in various leisure activities and sport committees. Dr. O’Sullivan was a pioneering occupational therapist developing an occupational therapy unit in Killarney Mental Hospital in 1938 after visits to other European Hospitals (Fogarty 2007; Dwyer 2002). In his retirement Dr. O’Sullivan wrote (1935-55) and published ‘Textbook of Occupational Therapy with Chief Reference to Psychological Medicine in 1955. This publication is the first known Occupational Therapy book written in Europe. Despite Dr. O’Sullivan’s contribution to occupational therapy there is no reference to him in contemporary occupational therapy literature. In contrast the contribution of Dr. O’Sullivan to Gaelic football has been documented and is widely acknowledged (Fogarty 2007).

In this paper a narrative account of Dr. O’Sullivan will be presented. Key influences and events will be identified and a timeline will be presented representing Dr. O’ Sullivan’s contributions to occupational therapy. This is an essential contribution to describing a hitherto unknown Irish occupational therapy pioneer.

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Methods:

Methodology Methodology illustrates the “overarching approach to research and encompasses philosophy and methods” (Finlay and Ballinger 2006, p.10). Conducting this research involves the intersection of philosophy, strategies of inquiry, and specific methods using historical research (Creswell 2009). Documenting the history of Dr. Eamonn O’Sullivan will provide “interpretations of events and ideas” during the evolutionary events of occupational therapy in Ireland (Schwartz and Colman 1988). Additionally, “documents are the accounts, returns, statutes and proclamations that individuals and groups produce in the course of their everyday practice (Scott 1990, p12). This is a parallel study alongside co fellow student Yvonne O Riordan, and part of a wider clinical therapies project of occupational therapy history at the University of Limerick.

Approach Historical research used in this paper includes “prescribed techniques for the collection, organisation, and analysis of historical data” identified which relates to Dr. O’Sullivan (Schwartz and Colman 1988 p240). It is significant that fact is separated from idea to maintain truth in history and to ensure that the evidence is solid (Scott 1990; Schwartz and Colman 1988).

Data Collection Strategy of inquiry is based on contemporary literature from primary and secondary sources. Primary sources are the first hand data and included; personal biographical transcripts, records of events and photographs (Schwartz and Colman 1988). Secondary sources are information which “has been from the original source”, such as newspaper articles, published books, and internet searches (Schwartz and Colman 1988, p241). Whenever possible the researcher used primary sources, however due to the lack of documentation of Irish occupational therapy events, secondary sources have also been used widely.

Personal documents written by Dr. O’Sullivans detailing his biographical account were obtained from the Croke Park Archive. Archives provided “a unique insight” to the doctor’s life events (Scott 1990, p173). It is noted that autobiographies were usually produced in the nineteenth century from working classes with the intention of survival and publication for cultural changes (Scott 1990). Dr. O’ Sullivan details the ‘oral tradition’ autobiography highlighting story telling events of his life recording events and reminiscence (Scott 1990). In table 1 all data sources and how they were located are identified.

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Table 1. Description of data collection sources. Data Collection Source Description Google Search Eamonn O’Sullivan; Dr. Eamonn O’Sullivan; Occupational therapy and Eamonn O Sullivan; Killarney Mental Hospital; St. Finans Hospital Killarney; history of mental health occupational therapy Ireland; Fitzgerald Stadium Killarney; Occupational Therapy in Ireland 1920- 1955. Google Scholar History of occupational therapy and ‘Ireland’; psychiatric occupational Search therapy history; mental occupational therapy; occupational therapy 1920-1950s; Occupational therapy pioneers Book Search - Textbook of occupational therapy: With Chief Reference To Psychological Medicine (O’Sullivan 1955). - The Art and Science of Gaelic football' (O’Sullivan 1958). - St. Finan's Hospital, Killarney: A Medical, Social & Sporting History 1852-2002 (Dwyer 2002). - Dr. Eamonn O’Sullivan: A man before his time (Fogarty 2007). - Reconstruction Therapy (Dunton 1919). ‘Textbook of - Backett (1956) reviewed in British Journal of Industrial Medicine. occupational - DiMichael (1956) reviewed in Journal of Counselling therapy’ reviews Psychology. - DUBOTS (1956) reviewed in American Journal of Psychiatry. Archive searches Croke Park; Kennelly Archives; Gaelic Athletic Association (GAA) archive; St.Finans Hospital Newspaper archive Irish Times 1920-1965; Irish Newspaper Archive search Websites - Terrace talk website [online] http://www.terracetalk.com/articles/Dr-Eamonn-O-Sullivan - Youtube - Dr. Eamonn O’Sullivan History [online] http://www.youtube.com/watch?v=Q7ZKDMFrxwo Image Search Google image; Keneally archive of images; St. Finans images; GAA archive images. University College Confirmation of BA (1918), MB BCH BQA (1925), Dip in Mental Cork Diseases (1930) and MD (1956). MD awarded after publication of ‘Textbook’. Contacts Weeshie Fogarty (biographer of ‘Dr. Eamonn O’Sullivan: A man before his time’, retired psychiatric nurse and former colleague of Dr. O’Sullivan); John Kelly (retired psychiatric nurse & former colleague of Dr. O’Sullivan); Dermot Dwyer (author St. Finans Hospital History).

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Data analysis

The researcher investigated the data to identify significant life events of Dr. O’Sullivan and his contribution to mental health services and the occupational therapy profession. The qualitative strategy of inquiry used a biographical approach, referring to collections of Dr. O’Sullivan’s life from past experiences and narrative events to understand the individual life in its social context (Roberts 2002). This type of research highlights the experiences and outlooks of Dr. O’Sullivan in his daily life, focusing on important events.

Quality According to Scott (1991), four criteria for assessing the quality of documentary research are central include; authenticity, credibility, representativeness and meaning. Authenticity was ensured due to published sources. Original data was sourced from immedicate family and colleges of Dr. O’Sullivan ensuring credibility of data. Using Dr. O’Sullivan self-outline of biographical details represented an accurate account of events. Finally, meaning refers to the level of clarity and scope of the documents to the researcher.

Ethical Considerations: Formal ethical approval is unnecessary for this study, as all information is accessible to the public. Ethical research practice is highly dependent on the climate within which the research is carried out, “embracing moral issues rising out of the conduct of research and proposes the interchangeable use of ethical and moral in relation to research” (Gregory 2003 cited in, Finlay and Ballinger 2006).

Findings:

Dr. O’Sullivan (1897-1966) grew up in a village named Firies in County Kerry. Many generations of the O’Sullivan family were heavily involved in sport mainly Gaelic football and athletics. His father James Patrick O’ Sullivan (JP) was a well known champion athlete and Gaelic footballer, so too was J.P.s father known as a well established Gaelic scholar before that (Fogarty 2007 p1). J.P. was a high achiever winning athletic championships at an early age of 17 and continuing through his adult life. He was involved in the Gaelic Athletic Association (GAA), he was a local councillor and supported the Nationalist cause (Fogarty 2007 p.2). Dr. O’Sullivan was “influenced” and “inspired” by his fathers achievements enabling him to pursue his own “sporting and training career” (Fogarty 2007 p. 2). J.P died suddenly when Dr. O’Sullivan was 12 years old.

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Figure 1. Dr. O’Sullivan

Education 1909-1925 Dr. O’Sullivan attended Firies National School for nine years prior to attending St. Vicents College in Castleknock under the supervision of Vincentian fathers for two academic years. He transferred back to Killarney where he attended St. Brendans Seminary in 1911, following this in 1914 he left for Maynooth where he attended St. Patricks College to study for priesthood. An Fáinne the Irish speaking organisation gained Dr. O’Sullivan as a member at that time. In 1917 Dr. O’Sullivan spent some time in University College Cork to complete the 3rd Arts Degree. Dr. O’Sullivan resumed his studies in 1918 at the Irish Pontifical College in Rome following receipt of the Fr. Fitzgerald bursary from the Kerry Diocese. It wasn’t until 1919 that Dr. O’Sullivan decided priesthood was not a vocation for his future after ill health of unknown cause. It is known that he was a diabetic. After deep consideration of his late career transformation, he decided to pursue medicine at University College Dublin (O’Sullivan 1955). He was president of the Students Union while a medical student. Dr. O’Sullivan ultimately qualified in1925 as a Registered Medical Practitioner in the Medical Register for Saorstat Eireann following a six years educational journey, he was 28 years old.

Personal Life Dr. O’Sullivan married his wife Marjorie Gertrude in 1930, she was the third daughter of his former Registered Medical Superintendent (R.M.S) Dr. Edward G. Griffin at Killarney Mental Hospital (Fogarty 2007). Dr. Griffin had 30 years of active psychiatric experience. Dr. O’Sullivan, Marjorie and their four sons lived on the provided accommodation at the mental hospital. He then returned to play for Dr. Crokes Gaelic Athletics Association Club. Later training the Kerry football team to win eight of nine All-Irelands where he used ‘collective training’ methods. Athletics was also of great interest to Dr. O’Sullivan. He also was actively involved in golf along with his wife and he was

11005025 OT6054 captain of the Killarney Golf club twice. Dr. O’Sullivan contributed to the Bridge Congress coming to Killarney in 1940’s. He held position of president of the rowing and football clubs, he also established basketball, football and rowing clubs at the hospital (Fogarty 2007). Dr. O’Sullivan read the daily newspapers mainly the Dublin papers and the Cork Examiner, he also listened to radio talks daily (O’Sullivan 2007). He spent time in Rome where he travelled across countries after World War One during his priesthood education. He travelled across Europe to explore mental health practice in the 1930’s. Although little is known about these travels in Europe it is known that he visited Germany and observed occupational therapy in mental health institutions there. He had great admiration for Dr Simon a German man, influencing the directional pathways with hospital treatments and their general sense of accuracy and perfection (O’Sullivan 1955). In 1956, he travelled to New York with the Gaelic Athletics Association, where he refers to paper ‘Psychistric experiences in the U.S.A, which was unable source, he highlights the exaggerated and eulogistic recommendation of drug use and its temporary effects of medication (Fogarty 2007, p.251). Dr. O’ Sullivan’s son Eddie highlights his father was, “a remarkable person, he achieved so much and was a man before his time” (O’Sullivan 2007, p.5). His biographer and former colleague Fogarty describes Dr. O’Sullivan as, “tall, stately man, dressed in a suit, shirt and tie, wearing either brown or black shoes always shining and brightly polished” (Fogarty 2007, p.xv). During football training sessions Dr. O’Sullivan remained a calm man who never “once raised his voice to shout at, encourage or berate his players” (Fogarty 2007 p.xv). Fogarty (2007) pays tribute to Dr. Sullivan throughout his text, ‘He was a man of honour, a man of vision, man of knowledge in which he shared through the writing he presented in two of his books; ‘Textbook of Occupational Therapy, With Chief Reference To Psychological Medicine’ and ‘The Art and Science of Gaelic Football’, both published in 1955. A former colleague Dr. Jack O’ Connor describes the ‘Textbook of Occupational Therapy as, “excellent, translated to many languages and widely regarded as the standard work on the subject” (O’Connor 2007, p.30).

Figure 2. Killarney Mental Hospital

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Occupational Therapy in Killarney Mental Hospital Dr. O’Sullivan commenced his medical career as Assistant Medical Officer at Killarney Mental Hospital [figure 2] in 1925 under the supervision of Dr. Griffin the Registered Medical Superintendent (R.M.S). The concept of occupational therapy was present when Dr. Griffin embarked on a programme giving tasks to patients in order to stimulate the mind to conquer institutionalisation and isolation (Fogarty 2007, p.17). Dr. O’Sullivan continued developing occupational therapy over the next decades. In 1933, Dr. Griffin retired and Dr. O’Sullivan successfully requested to the hospital committee for the vacant position of Registered Medical Superintendent. At a time when medical treatment was restricted, he used his new status to promote the use of a new kind of psychiatric treatment ‘occupational therapy’. Patient numbers reached their highest at 1100 during the 1950s (Fogarty 2007; Dwyer 2002). Dr. O’ Sullivan opened his own Occupational Therapy Department in 1933 basing his treatments from Dr. Simon in Germany called ‘Simon System’. Occupational therapy treatments are represented in Table 2. Dr. O’Sullivan was granted permission at a meeting of the Killarney Mental Hospital Committee in 1932 allowing patients to work in the fiend adjacent to the hospital grounds as a means of occupational therapy represented in Figure 3. The football stadium manually built by the patients and staff from 1933-1935 became known as the ‘Fitzgerald Stadium’ shown in Figure 4. In 1977, Dr. O’Sullivan’s son officially opened the Pavilion and Stand at the Fitzgerald Stadium in honour of his father. Later in 2001 a plaque was erected at the stadium to honour the contribution of patients to the building of the stadium.

Figure 3. Residents of Killarney Mental Hospital building the Fitzgerald Stadium as part of

Occupational Therapy treatment in 1930’s

(Dwyer 2002, p. 29).

Figure 4. Opening of Killarney Stadium

1936 (Gaelic Art.com)

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Fogarty gives a detailed account of occupational therapy treatments established by Dr. O’Sullivan at the hospital as follows (Fogarty 2007);

Occupational therapy became the morn of treatment over the next twenty-five years at Killarney Mental Hospital. Ward treatment became very successful among the patients at the mental hospital. Gender division remained dominant at the mental hospital dividing occupational sections among male and female patients. The two sections involved, the ‘Special Needs’ section offering weaving, wire-craft, mat making, embroidery, seamstress and soft toy work (Fogarty 2007, p.193) Whereas the ‘utility section’ proposed laundry, kitchen and dining work. At this stage Dr. O’Sullivan had introduced a re-education therapy class in response to the new medical treatments of Electro-Convulsive Treatment and Insulin Therapy (Fogarty 2007).

Figure 5: Description of Occupational Therapy Department (O’Sullivan 1955, p.63).

Dr. O’Sullivan expanded occupational therapy in the hospital when the vacant Tuberculosis was converted to the new occupational therapy department 1938 (Fogarty 2007). Description of occupational therapy department is represented in figure 5 (O’Sullivan 1955, p.63). Additional occupational therapy developments expanded as the hospital farm and gardens were better developed for occupational therapy treatments becoming more self sufficient. The occupational

11005025 OT6054 therapy department preserved traditional treatments of ward therapy promoting and using occupational participation in areas of weaving, basketry, leather-craft, floor polishing and other various work. Dr. O’Sullivan produced innovative occupations to the clients to encourage motivation in a variety areas suited to a wide scope of people such as printing, book making, carpentry, shoemaking, engineering, painting, farming, gardening, tailoring and masonry. He set up ‘Ross Products’ printing in the 1930s, his colleague Dr. Hayes emphasises, “this was a big advance in those days, a great memorial to Dr. O’Sullivan” and describes this as “forward thinking in those days” (Fogarty 2007 p150). The occupational therapy department contributed to the community when household equipment became a produce of therapy such as; mats, baskets and baby wicker baskets, later further expanded as concrete blocks were produced and rolls of diamond wire. Figure 6 shows patients in the occupational therapy unit making house hold items.

Recreation therapy both indoors and outdoors was also a significant element of therapy. Outdoor recreation therapy consisted of football, hurling, walking, handball, athletics, golf putting, bowls and tennis. Dr. O’Sullivan arranged football matches with other hospitals for patients and also staff members. Day outings became another regular element of occupational therapy where sea outings, circus visits and yearly local regatta at the Lakes of Killarney were arranged by Dr. O’Sullivan. Other occupations engaged patients in cards, chess, draughts, billiards, table tennis and dominoes. Social interaction was encouraged through weekly dances and films, group performances on stage, debates and question time competitions were held. An advancement in the hospital resources installed radios in all the wards. Padraig O’Sullivan mentions in an interview, it was Dr. O’Sullivan’s therapy “which hastened the entry of patients back into normal lifestyle and helped their discharge from the hospital” (Fogarty 2007, p.84). There were only two doctors in the hospital initially; in 1938 Dr. Des Hayes joined Dr. O’Sullivan, also becoming involved in occupational therapy. Later a third Doctor, Robert McCarthy was recruited in 1940 after the hospital gained funding. At his time the hospital began to explore new treatments such as Electric Convulsive Therapy E.C.T., Insulin Therapy and Paraldehyde (Fogarty 2007, p.158). Many changes took place during the 1950s when modern treatments of drug therapy, psychotherapy and counselling dominated resulting in home discharges for the first time. Dr. O’Sullivan adapted to theses changes, establishing outpatient clinics throughout Kerry.

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Figure 6.

Occupational Therapy Department at Killarney Mental Hospital opened by Dr. O’Sullivan in 1938

(Dwyer 2002, p74).

Dr. Jack O’Connor who worked alongside Dr. O’ Sullivan emphasis the work carried out stating, “he had an excellent Occupational Therapy Department, he was a pioneer of the Industrial Therapy activities” (Fogarty 2007, p.30). Dr. O’Connor further speaks of Dr. O’Sullivan as, “an eminent doctor and psychiatrist”, “he had true sense of values, a main of uncompromising principles and high ideas” (Fogarty 2007, p.29). After his retirement in 1962, Dr. O’Sullivan worked at the outpatient clinic which he established in St. Catherine’s Hospital Tralee and worked in private practice. He also documented a detailed account of his life in his ‘Self-Outline of Biographical Details’ stored in the Croke park Gaelic Athletic Association archive. He died shortly after an illness in 1966 at 70 years.

A statement (Fogarty 2007, p.159) about Dr. O’Sullivan says, “he laid the foundations for modern day development in the complicated area of psychiatry”. He also refers to Dr. O’Sullivan during his time as a trainee nurse at the hospital in 1955 that, “it was very evident to me in the short time that I worked with him that his influence in the Hospital was huge”, highlighting “he was a truly remarkable person” Fogarty 2007, p.xvii).

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Table 2: Represents events in Dr. O’Sullivan life.

Timeline events of Dr. O’Sullivan Occupational Therapy pathway (1997-1966) 1909-1914 Firies National School, St. Vincent’s College Castleknock, St. Brendan’s Seminary Killarney 1914-1918 St. Patricks Maynooth to study for priesthood, attended UCC to complete 3rd Arts Degree, and gained bursary to resume his studies in Rome at Pontifical College 1918 Visit to Pontifical College Rome 1919-1925 Medical student at UCD, qualified 1925 as Registered Medical Practitioner in the Medical Register for Saorstat Eireann. 1925 Started three month post-graduate course at the Coombe Gynaecological Hospital 1925 Started working as Assistant Medical Officer at Killarney Mental Hospital 1925 Began training the Kerry Gaelic Athletics Association (GAA) winning eight of nine All-Irelands; 1924; 1926; 1937; 1946; 1953; 1955; 1959; 1962. 1930 Planning and negotiation of Fitzgerald Football Stadium location in Killarney 1930s Established ‘Ross Products’ printing in the hospital.

Stated planning building of football stadium (Fitzgerald Stadium). 1933 Dr. O’Sullivan visited European Hospitals while studying occupational treatments. 1933-1935 Building of the Fitzgerald stadium with patients participating in occupational therapy 1933 Applied for vacant position of Resident Medical Superintendent (RMS) of Killarney Mental Hospital and was successful. 1934 Established own Occupational Therapy Department based on observations while studying based on Simon System, an American-Canadian practice.

Received funding of £20,000 for improvements at the mental hospital 1935 Began to write ‘Textbook’ which took 20 years of research. 1936 Majority of patients in Killarney mental Hospital are participating in occupational therapy; 89% of females and 87% males

Involved in the development of Killarney Golf Course 1939 Public debate in Killarney about the economic consequences of Occupational Therapy for local Printmakers 1940 Request to Hospital Committee for a third medical officer, successful after debate. 1950 Hospital population exceeded maximum requirements with over 1,100 residents Dr. O’Sullivan adapted to new treatment era; Insulin Therapy, Electro Convulsive Therapy & Paraldehyde were replaced by drug therapy, psychotherapy & counselling resulting in home discharges 1955 Published two books; 1. The Art and Science of Gaelic Football. This book sold out in a matter of months. Textbook of Occupational Therapy. This 320 page book deals entirely with Occupational Therapy in Mental Hospitals. First 1,000 copies sold immediately p194. Book sold world wide & received acclaim from all quarter’s p210. There was no other book on the subject available.

1961 Establishment of training school for nurses and staff at the Mental Hospital established by E.O’Sullivan 1962 Forced Retirement from mental hospital, leading to private practice. 1966 Dr. O’Sullivan died after short illness, huge number attended funeral.

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Discussion During 37 years working at Killarney Mental Hospital, Dr. O’ Sullivan contributed greatly to psychiatry and mental health practice throughout his professional life career as shown in Table 2. His influence was broader than Killarney, as mental hospitals across the island followed his approaches to treatments. Furthermore, Dr. O’Sullivan became a pioneer of occupational therapy worldwide when he published the ‘Textbook of Occupational Therapy: With Chief Reference to Psychological Medicine’, one of the initial occupational therapy book introduced in Europe, demonstrating detailed accounts of occupational therapy treatments and practice. Throughout the textbook he presents occupational therapy treatments and highlights the importance of client centred treatment (Fogarty 2007). Undoubtedly his work impacted on mental health practitioners of the time internationally as all 1000 copies of his book were sold and a second press was requested however, was not possible as the typecase was lost. A request to publish the book in Spanish was made however; Franco’s Government would not permit the funding. Similar work was conducted during the same period by William Rush Dunton Jr in the USA, when he too published literature about occupational therapy. Evidence suggests that Dr. O’Sullivan was knowledgeable of Dr. Denton’s achievements. Dr. O’Sullivan was inspired by Dr. Dunton, as he documented the “valuable advice and assistance” he provided when he send over a draft copy of the ‘Textbook’ to Dunton before publishing (O’Sullivan 1955, p.x). Dr. Dunton contributed a foreword to the ‘Textbook’ expressing, “no other work on the subject, which is so complete and specific", further stating he, “admires the diligence of the author in his research and in the use of the material he has gathered” (Dunton 1955, p.vii). Dr. O’ Sullivan even then demonstrated the use of peer support, a highly important aspect of OT in today’s practice.

Dr. Dunton graduated from medical school in 1893 and worked as a psychiatrist in Maryland, USA and a recognised leading American authority who pioneered the promotion of occupational therapy (O’ Sullivan 1955). His published work included; three books entitled, “Occupational Therapy: A Manual for Nurses”, “Recreation Therapy” and Prescribing Occupational Therapy” from 1918 to 1928 (Knowles 2013) an article from Public Health Nurse entitled “The Principles of Occupational Therapy” in the year 1918. Dr. Dunton contributed to the development of The American Occupational Therapy Association throughout his career. Dr. Dunton believed occupational therapy had healing potential for the mentally ill (Knowles 2013). Dr. O’Sullivan was inspired and influenced by Dr. Dunton, as he followed in the footsteps highlighting his strong believe in the concept which Dr. Dunton wrote, “all patients should have occupations which they enjoy…., sick minds, sick bodies, and sick souls may be healed through occupation” (Dunton 1919, p.10). Throughout Dr. O’Sullivan’s career at Killarney Mental Hospital he aspired to ensure all his patients participated in daily occupations, at one stage 85-90% of the patients were fully involved in occupational therapy (O’Sullivan 1955). Dr. O’Sullivan illustrates in

11005025 OT6054 his writing his appreciation from former occupational therapy pioneers when he makes reference in his book to a quote from Galen, “employment is nature’s best physician, and is essential to human happiness” (O’Sullivan 1955, p.ix).

Considering Dr. O’Sullivan’s contribution to occupational therapy, evidence of this appears somehow misplaced throughout historical documentation of occupational therapy. Although historic evidence is a relatively new area of development in Ireland, a former occupational therapist Ann Beckett (1927-2002) is recognised as one of the first occupational therapists in Ireland (Butler and Ryan 2004). According to historical records, evidence suggests that in fact, Dr. O’ Sullivan is the first known pioneer for the practice occupational therapy in Ireland and is certainly the first to have published on the topic of occupational Therapy. Dr. O’Sullivan, a knowledgeable man, of high academic achievement, basing his practice of evidence based knowledge, as he investigated alternative methods of occupational therapy during his research in European countries. Power of evidence based practice is evident of Dr. O’Sullivan when in his book, when he emphasis the importance of other professions such as psychiatrists, physicians and surgeons being knowledgeable of the occupation therapy principles to fully appreciate treatment. Not alone was Dr. O’Sullivan an ambassador for advancing mental health in hospitals, he also envisaged a wider scope by using his book to highlight treatment to general, surgical, orthopaedic and other hospitals. It can be said his generous knowledge expanded throughout the years enabling him to use his learned skills to advocate for the development of mental health. Dr. O’ Sullivan’s published writing demonstrating his detailed knowledge of occupational therapy history and his skill in articulating his knowledge in advancing mental health. Additionally, he demonstrated his convincing aptitude expressing his interest to attain position as Registered Medical Superintendent at Killarney Mental Hospital. There was no uncertainty of Dr. O’Sullivan’s incisive understanding of occupational therapy subsequent to his detailed accounts of occupational therapy across the globe and advanced exploration of the profession throughout European countries.

Dr. O’Sullivan was advanced in his treatment methods using best approach from his research while travelling countries visiting psychiatric hospitals. He was inspired to use the ‘Simon Method’, which was widely used in Germany by Dr. Simon. This method moved away from industrial treatment based on curative end results only (O’Sullivan 1955, p.7). Subsequently Canada followed this view and approach proving to be successful with high levels of improvements observed among patients (O’Sullivan 1955). Dr. O’ Sullivan successfully trained Gaelic Athletic Association (GAA) with a similar philosophy to that of occupational therapy called ‘collective

11005025 OT6054 training’. Each player was trained with an individual approach to suit their intrinsic motivation for the game. Much is known about pioneering occupational therapists in other countries to name a few; Eleanor Clark Slagle, Adolf Meyer, William Dunton, George Barton, Thomas Bessell Kidner , Wilma West, Ann Beckett (Bing 1981; Peloquin 1991a;1991b; Friedland 2007). However, the contribution of Eamonn O’Sullivan has to date been completely unrecognised.

Extreme impoverished conditions as a result of the Great Irish Famine (1845-1849) led to increased numbers entering asylums requiring additional building of asylums throughout the country (Prior 2012). Dr. O’Sullivan had in access of 1100 patients residing in Killarney Mental Hospital during this time. His vision for the necessity for therapeutic treatment to rehabilitate patients back into society was admirable. During economic depression he gained essential funding for the diverse occupational unit represented in Figure 5. Mental hospitals were funded by tax payers predominantly farmers. Dr. O’Sullivan faced many stigmatising challenges of mental health when advocating for funding to support the occupational therapy unit.

Limitations and implications for future research The research has limited data sources due to lack of historical documentation of original material. Conducting interviews with other former colleagues would strengthen the quality of this article. Significant data sources from Dr. O’Sullivan’s sons were obtained from secondary sources, primary data collection from interviewing his three remaining sons could be included. Additionally, the research would gain strength from interviews from former football players and football trainers. Further primary data gathered from living patients and family members, and location and analysis of archival records from St. Finan’s would add significantly to this study. The Dunton archive could be searched in depth exploring inspirational ideas transferred by Dr. O’Sullivan in his treatments.

Implications for OT practice Identifying pioneers can inspire practitioners today and reading this analysis can aid reflection on the founding principles of occupational therapy.

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Conclusion

Occupational therapy pioneers have been documented and celebrated world-wide however Ireland has failed to adequately document historic events and pioneers of occupational therapy. In recent years, the profession of occupational therapy has expanded in Ireland with increased graduate numbers and greater recognition of the contribution of occupational therapy to health and social care. Evidence based research has highlighted the importance and value of occupational therapy. While pioneers from Britain, the United States of America, Canada and across Europe are well established the contributions that Dr. O’Sullivan made to the treatment of mentally ill, psychiatric treatments and mostly to the development of the profession of occupational therapy have to date been unrecognised. This study presents a comprehensive and detailed biographical account of Dr. Eamonn O’Sullivan and key events are presented in chronological order. The analysis presented here explores influences on Dr. O’Sullivan and details his contribution to occupational therapy.

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