Chapter 23: Deteriorating Health

JJ Muggivan

In the twenty months before the trial, Brendan’s mental and physical health deteriorated dramatically. He developed new and life-threatening illnesses. By the time of the trial, he probably was already terminally ill with only about eighteen months to live. His new illnesses were brought about by a long hunger strike and psychotropic medication. None of these illnesses were identified by any of the experts who testified at his trial. Evidence of these new illnesses appeared in comments made by his defence lawyer, Mr Paddy MacEntee. Visitors who went to see Brendan in the twenty months prior to the trial were alarmed at his deterioration. They became more alarmed in the months after his trial until his death in July 1997. His visitors included Fr Neylon, Mary Quinn, Ann Marie, Tony Muggivan and Patrick MacEntee SC.

At the trial, Brendan’s defence counsel, Patrick MacEntee SC, argued that the defendant was insane. He drew attention to Brendan’s physical condition, brought on by the drugs he was taking. He described Brendan as being grossly overweight, with his tongue lolling to the side of his mouth, and his fingers stained with nicotine. He spoke of how Brendan had had dealings with mentalhealth professionals throughout his life from the age of about four.

It was reported that Brendan sat in the courtroom throughout, showing no reaction to anything that was said. A muscle in his jaw twitched and he ground his teeth. Later, he became fidgety and pulled at his moustache, bit his nails, tapped his foot and drummed his fingers on the wooden shelf in front of him. It is fairly clear from such reports that Brendan was in much distress from anti-psychotic medication at the time of his trial. He had become obese and a chain smoker.

It would seem that, at the time of the trial, he had been on the medicine for more than one year. He died a little over a year after the trial. In all, it seems that it took over two years for him to die from his medication.

Visitors were alarmed about Brendan’s medicine from shortly after his imprisonment. Ann Marie and her grandmother saw him every couple of months. They had extreme trouble understanding what he was saying, whether on the phone or during a visit.

Brendan never discussed the murders with his sister or grandmother. Once, he said to them that they were shocking and should never have happened, but it was as if someone else had been

responsible. His hands shook a lot, and Mary Quinn and Ann Marie felt that he was on heavy medication during the trial.

Brendan’s visitors noticed that his memory seemed to be gone. On the phone, he would ask them when they were coming up, apparently thinking that they had not been there for a long time. Later, he gave up writing, calling or taking phone calls from his sister and grandmother. Ann Marie complained on more than one occasion, but the staff told her that he would come out of it. Brendan phoned Tony about two months before he died. Tony had a lot of difficulty understanding Brendan as he was unable to talk. He promised to go to visit Brendan, but the visit never took place.

Mary Quinn recalled two men having to help her grandson to walk, as his head rolled from side to side. She said that she had never seen anything like it in her life and complained that he would not survive twenty-four hours if he did not receive medical care.

At the trial, Dr Charles Smith, Director of the Central Mental Hospital, testified that he had first seen Brendan in June 1988. Brendan was fourteen at the time and Dr Smith suspected that he was ‘very close to psychosis, if not already there’, and prescribed treatment for him. Brendan talked about powers, which Dr Smith did not regard as usual symptoms of schizophrenia, such as an ability to draw sparks. Dr Smith again saw Brendan in the Central Mental Hospital following his transfer from Spike Island. Dr Smith testified that self-injury, such as Brendan’s to his left wrist, was quite common in people suffering from personality disorders. However, according to Dr Smith, in the three months that Brendan spent in Dundrum, there was ‘no evidence to worry us about psychosis’ and nothing to suggest psychiatric illness. They had diagnosed anti-social personality.

When Dr Smith saw Brendan on 14 May 1994, in the week following the discovery of the bodies of the missing people, he did not consider that Brendan was suffering from schizophrenia or a major mental illness. He and Dr Damian Mohan regarded him as very exited, animated and ‘a disturbed young man’. He was almost an ‘unmanageable prisoner’. They felt that Brendan might injure himself through aggression or frustration.

Dr Smith was unable to say what might have been going on in Brendan’s head at the time of the killings. He believed that the defendant was suffering from a personality disorder, not schizophrenia, and said that people with personality disorders are usually held to be criminally responsible, as they do not have the interference experienced in schizophrenia.

According to Dr Smith, there was nothing about the case that would indicate a lack of criminal responsibility. He said that while psychosis fit with the concept of legal insanity, personality disorder did not.

Dr Smith, who had been a forensic psychiatrist for twenty-six years, gave the opinion that Brendan’s trial hinged on the difference between psychosis and personality disorder. The latter was, he said, mainly a behavioural disorder, whereas in the former, behaviour was secondary to symptoms. He believed that Brendan suffered from a combination of an anti-social and borderline personality disorder. It was his view that Brendan had been feigning illness when, for some months in 1994, he had insisted on calling everybody Seamus. Later, in cross-examination by defence counsel Patrick MacEntee, Dr Smith agreed that he had been mistaken in saying that Brendan had ceased calling everybody Seamus when he had been returned for trial. However, he still maintained that Brendan had been doing it to mislead people into thinking he was insane.

In Dr Smith’s opinion, it was possible that Brendan had had an organic psychotic episode. Staff at the Central Mental Hospital, believing his illness to be related to his self-imposed starvation and fluid deprivation, had organised for him to be sent back to Mountjoy Prison in January 1995. Brendan had mutilated himself again and had been returned to Dundrum.

In Dr Smith’s experience, it was rare for psychotic people to kill, and when they did, they were usually willing to admit to what they done.

When cross-examined by defence counsel Patrick MacEntee, Dr Smith agreed that at the age of fourteen, Brendan had been ‘very close to psychosis if not already there’. He had prescribed antipsychotic drugs for Brendan in 1988, and had assumed that his diagnosis was correct because Brendan’s delusions had appeared to fade.

Mr MacEntee raised the issue of notes at the Central Mental Hospital in which psychiatrist Dr Gerry O’Neill had found Brendan to be ‘normal’. Dr Smith agreed that these notes were inaccurate.

However, he denied that they were ‘a gross distortion’.

A note, dated 18 November 1994, was read in which Dr Art O’Conner had stated that Brendan wanted to die to get back to his mother. Brendan had been on a prolonged hunger strike in Mountjoy Prison and was admitted to the Central Mental Hospital that month. Dr O’Conner said in his note that there ‘was an element of manipulation but [Brendan was] probably ill as well.’ He had written that Brendan would probably be psychotic and depressed at times. He had therefore suggested an anti-psychotic drug and an anti-depressant.

Dr Smith testified that Brendan was being given Largactyl, an anti-psychotic drug, at that time. He said that his concern was to stimulate Brendan’s appetite and he believed that the hunger strike had been decided on rationally.

Mr MacEntee produced a medical report from Mountjoy Prison, dated 29 May 1994, in which it was noted with regard to Brendan that there were ‘no hallucinations now’. Dr Smith agreed that this implied that there had been hallucinations between 9 May and 29 May 1994.

Dr Smith agreed with Mr MacEntee that the assessment of Brendan by Ballinasloe Mental Hospital had been ‘far from ideal’. Mr MacEntee suggested that the hospital had had an obligation to discuss Brendan with Dr Kennedy, who had referred him there, and Ann Marie, who had had him committed. However, Dr Smith said that the diagnosis made by the staff at Ballinasloe did not differ from that which had been made at the Central Mental Hospital in 1990.

A medical note from Mountjoy Prison, dated 21 September 1994, stated that Brendan was ‘medically fit for punishment’. Dr Smith said that in his view it was ‘totally unprofessional to think in those terms’.

The next psychiatrist to give evidence was Dr Damian Mohan, who first saw Brendan on 9 May 1994, two days after his arrest. Between then and February 1995, he saw Brendan forty-two times.

Dr Mohan testified that when he interviewed Brendan on 9 May 1994, he saw no evidence of abnormality or defective reason, and that there was no evidence of schizophrenia or of depressive illness. Brendan told him that he had not been hearing voices, and apparently held no abnormal beliefs.

When Dr Mohan asked Brendan if he wished to die, the latter replied that he had ‘nothing to lose’. ‘A dog would have a better life than me,’ he said.

Later, Dr Mohan had been concerned about Brendan’s mental state and it had been reported that Brendan had told of the devil spiking his food and of being very lonely. According to Dr Mohan, on 7 September 1994, doctors interviewed Brendan from behind glass screen doors. When they asked about the deaths of Imelda and Liam Riney and of Fr Walsh, Brendan replied that when he had been doing ‘this’, he had been ‘fucked up’. He told them that he had been on ‘a trip’ at the time of the ‘tragedy’, and said, ‘My head just went.’ He asked the doctors, ‘Why did I do it?’

Dr Mohan testified that in his dealings with Brendan, he had seen nothing that would have required in-patient treatment at the Central Mental Hospital.

From 4 July to 18 July 1994 and for other periods during his imprisonment, Brendan had been kept in a padded cell. Dr Mohan did not think that fourteen days was too long to keep someone in seclusion and said that he did not know how else the people in charge would have been able to handle him. On several occasions when Dr Mohan had seen him, Brendan had been dressed only in his underpants. Dr Mohan said that he had not been aware that Brendan had defecated in the cell and had been seen sucking his thumb.

Dr Mohan agreed that drugs used to treat Margaret O’Donnell during her time in Ennis Psychiatric Hospital suggested that she had a psychiatric illness that might have been schizophrenia. However, when Mr MacEntee put it to him that Brendan was schizophrenic and that those doctors who said otherwise were affected by the determination not to have ‘this troublesome patient’ in the Central Mental Hospital, Dr Mohan replied that he had no vested interest in so doing.

Dr Brian McCaffrey, a consulting psychiatrist with the Eastern Health Board, had met Brendan in Mountjoy Prison in August 1994 at the request of the defence team. Brendan was handcuffed behind his back throughout the meeting and was accompanied by a prison officer, and there were other prison officers looking in at the door. Dr McCaffrey found the meeting unusual and very

tense, and felt it to be a dangerous situation. He said that Brendan was ‘very bizarre’ and looked out of control.

Throughout the interview, Brendan called Dr McCaffrey Seamus, from which the doctor concluded that they were not on the same ‘wavelength’. He asked Brendan who was in the government and Brendan said that he did not know. Albert Reynolds was Taoiseach at the time but when asked about him, Brendan responded, ‘Does he make TVs?’ He described Eamon de Valera as ‘the best poet in Ireland’. Brendan’s replies to questions were garbled and disjointed and he appeared not to be bothered at some level.

Dr McCaffrey testified that from this and subsequent meetings with Brendan, he formed the conclusion that he was ‘quite psychotic’ and suffering from a serious mental illness. He believed that Brendan had been suffering from a mental disease when he had shot Imelda Riney, and that he had been acting on commands from outside his mind. Dr McCaffrey said that he doubted that Brendan had known the nature or quality of his acts when he had shot his victims. While Brendan would have understood that he had a gun, that it was loaded and that a bullet came out, Dr McCaffrey was not sure that Brendan would have understood that a hit from the bullet would result in death. He said that Brendan seemed to have a blurred concept of death, citing as an example Margaret O’Donnell’s funeral when her son had believed that she was smothered in her coffin and that he could save her.

It was Doctor McCaffrey’s opinion that Brendan suffered from hebephrenic or disorganized schizophrenia at the time he killed his three victims and that he continued to suffer from this illness at the time of the trial. The illness would have rendered him incapable of understanding his actions. Dr McCaffrey told the court that he also believed Brendan to be psychotic.

Dr McCaffrey had interviewed Michael Pat O’Donnell in February 1995 and had found him to be friendly and cooperative. They had spoken about psychiatric illnesses experienced by Michael Pat’s wife, mother and uncle. However, the doctor testified that he believed that Michael Pat O’Donnell had little insight into his son, whose material but not emotional needs were looked after by him.

According to Dr McCaffrey, when Brendan laughed when he talked of killing people, it was not an indication that he was feeling good. The fact of an outside expression not equating with an inner feeling was characteristic of schizophrenia, he said. He recalled that during his third interview with Brendan, in August 1994, Brendan had displayed a marked and obvious laugh and there had been big delays in his responses.

Dr McCaffrey testified that, on 11 November, he had noticed a big change in Brendan who was still in hospital. He had seen no signs of mental illness and no schizophrenia on this occasion.

In January 1995, Brendan was moved back to Mountjoy Prison where he cut his right wrist to the bone, through the tendons and arteries.

Dr McCaffrey testified that while Brendan could appear normal on occasion, he was actually very abnormal. He believed that the defendant was also exhibiting some features which might indicate a possibility of minimal brain damage, but said that this could not be established. It was his opinion that Brendan’s schizophrenia had continued, with spikes of psychotic activity.

Dr Frances Knott, a clinical psychiatrist attached to the Eastern Health Board, also gave evidence at the trial. She expressed the view that Brendan was suffering from disorganized schizophrenia and was in a state of acute psychosis at the time of the killings.

Dr Knott testified that it was her belief that Brendan had been floridly psychotic when he was freed from prison in England in March 1994, and that he had remained in that state and would have been unable to control himself because of this. She explained that a person with hebephrenic schizophrenia was never well, although the severity of their symptoms might vary.

The doctor said that she was not surprised by the discrepancy between Brendan’s statement that he had shot Fr Walsh twice in the head, and the pathologist’s report that the priest had been shot once. Nor was she surprised by the fact that Brendan had not killed Imelda Riney in her house but had taken her to Cregg Wood. She believed that Brendan felt ‘some magic’ about the woods and that it had probably been ‘a sort of ritual, bizarre killing’.

In his testimony at the trial, Dr Gerry O’Neill said that in laughing when he was describing the killing, Brendan had shown incongruous affect or emotion, which was very suggestive of schizophrenia. The doctor felt that while it was true that Brendan sometimes heard voices at apparently convenient times, such as when he was faced by a difficult question, he believed that

schizophrenics could tell self-interested lies, as the disease does not absorb the whole personality.

When asked by the prosecution about the possibility that Brendan might, in fact, be suffering from a behavioural personality disorder, Dr O’Neill said that there were indications of botha personality disorder and schizophrenia.

Psychologist Dr Graham Turrall, for the defence, spoke in his testimony of Brendan’s having chronic thought disorder and episodic disorganized schizophrenia. He testified that Brendan was suffering from a severe personality disorder which included avoidance, paranoia and an anti-social element.

The doctor described Brendan as an impulsive person who had difficulties with his identity. He believed that the killings had occurred because Brendan had been trying to control a situation in which he was not comfortable. He said that Brendan lied because he was trying to survive.

Dr Turrall referred to a doctor’s note from 1988 in which there was a mention of ‘the history of schizophrenia’ in Margaret O’Donnell, and he said that that was the only reference he could find in Brendan’s notes. He had also seen medical notes from jails in England where Brendan had been incarcerated from March 1993 to March 1994. These notes expressed concern about Brendan’s mental state, and some mentioned bizarre behaviour and auditory hallucinations.

Fr Neylon, the former curate at Eyrecourt, also gave evidence. The priest had spent fifteen years in Eyrecourt and testified that Brendan had told him in 1992 of having slashed his wrist and been sent to the Central Mental Hospital. However, Fr Neylon was not aware that it was, in fact, another prisoner who had cut Brendan’s wrist, at the request of the latter. Nor was he aware that Brendan had required microsurgery and had picked out the stitches with his teeth.

The priest testified that when he had asked Brendan if he knew that Fr Walsh was dead, Brendan had replied ‘You must be joking. I know nothing about Fr Walsh. I know f... all. You must be

raving.’