Although Jennifer Hough’s older sister, Valerie, was diagnosed with bipolar disorder when she was fifteen, Hough never saw her sister as mentally ill. “To me, she was just my sister,” Hough explains. “I knew she didn’t have a brain disease.” After all, Hough recognised what her sister’s doctors never could: that Valerie’s sporadic psychotic and depressive episodes weren’t medical symptoms but the natural results of growing up in a household where their father struggled with alcohol addiction.
Yet the trauma underlying Valerie’s struggles was generally treated as irrelevant to her psychological state, something that only became worse once Valerie received a diagnosis. “Once you get a label in psychiatry, that’s the answer to everything,” says Hough. “There’s no room for your story.” For Valerie, this label led to what Hough has described as a self-fulfilling prophecy, with Valerie’s distress only amplified by her intense cocktail of medications and the constant insinuation that she was at the root of her own suffering.
After Valerie’s suicide in 2020, Hough felt a need to fight for change in the system that failed her sister. Following a keynote speech she gave about Valerie at a Critical Voices Network of Ireland conference, Hough, already a Mad in America reader, got the idea of starting an Irish affiliate—soon after, she learned that others were already discussing this.
This group included Líam MacGabhann, a mental health nurse and counsellor who became disillusioned with traditional approaches to mental distress after years working in the field. Since then, MacGabhann has been involved with various movements aimed at empowering service users, as well as lecturing in Dublin City University’s nursing department.
Hough joined MacGabhann, along with Harry Gijbels and Lydia Sapouna, both lecturers at University College Cork, to launch Mad in Ireland. As Hough notes, her experience as a journalist brought a new skill set to the group—and the Mad in Ireland team’s diverse range of professional backgrounds remains one of its strengths.
Some members, for example, have past experience that allows them to spearhead website operations, while Hough uses her journalistic background to take the lead on editorial tasks like formatting and proofreading. Submissions, meanwhile, are typically reviewed by the members with the most relevant expertise.
“There isn’t a hierarchy,” explains MacGabhann. Instead, they meet as a collective every two months, using a roster to assign tasks to different members and communicating over WhatsApp in the meantime.
Mad in Ireland’s website, meanwhile, follows a new paradigm approach to mental health, meaning it intends to shift the way distress is understood and treated in Ireland. Hough notes that, while Ireland’s mental health system has recently started using terms like “biopsychosocial model,” “human rights,” and “trauma-informed,” actual practices remain essentially the same as always. “In Ireland, we’re very good at paying lip service to these things,” she explains. “But when you have a service underpinned by legislation saying you can lock people up, you can’t have a human rights-based system.”
Therefore, Mad in Ireland aims to speak up about psychiatric harm that often goes unrecognised. “I remember when my sister would go into hospital, people would be like, oh, that’s great, now she’ll get the help she needs,” says Hough. “And I was like, no, she actually won’t. People go into these institutions, and we lock them up, and it feels good for us… That’s about it.”
Hough also remembers Valerie pretending to feel better so she could escape institutions that claimed to act in her best interests while offering nothing but drugs and diagnoses. “It probably is fit for purpose, but the purpose is wrong,” MacGabhann says of this treatment approach. “If you use the evidence that supports their treatment, then by definition the purpose is to harm others.”
Often, Hough points out, the purpose is also to manage risk rather than genuinely helping people heal. “It might appear that you’re putting someone into a little cocoon,” she says, “but they get people to a certain point with all different medications, and then they send them out into the community… How is that safe?”
Unfortunately, it can be difficult to actually address these issues. “Like a lot of big bureaucracies, [HSE] enables control of the population,” says MacGabhann, referring here to the Health Service Executive, Ireland’s public healthcare system. “They have a very powerful lobby group and a very powerful mainstream media that supports the psychiatric paradigm.”
Hough notes that, while she’s noticed English and Australian media incorporating more critical views of psychiatry, the Irish media still tends to leave these out. “It can be quite frustrating to see great research coming out and it just doesn’t get picked up by the media,” she says. Based on her own experience as a journalist, she feels that this stems from pressure to cover only the accepted stories or points of view—something that has also made it hard for Mad in Ireland to find writers.
As MacGabhann explains it, there’s sometimes a “fear mentality” holding potential writers back. “Because it’s a small country, people are worried about being perceived to write for Mad in Ireland,” he says. This is particularly true for those who work for the HSE. “If you say anything against company policy, at the very least, you’d be called into the office and told not to do that again,” MacGabhann explains. “I worry about people who would like to write and aren’t writing.”
Still, over time, Mad in Ireland’s team has created a strong website showcasing Irish research news, investigative pieces, blogs by people with lived experience, podcasts, and creative pieces submitted by readers. Through this work, they aim to both criticize existing approaches to mental health care and highlight positive changes.
In this way, Mad in Ireland serves as a forum for “things that the media should be covering but aren’t,” as Hough puts it. For example, they published a piece in 2024 about an Open Dialogue service in West Cork, which diverged from typical biomedical treatments by following a person-centered approach. Despite an expert report recommending the service’s expansion across Ireland, an Open Dialogue service was shut down in 2024—an event that received shockingly little attention from mainstream Irish media.
From here, Mad in Ireland hopes to expand their site further, particularly by growing their podcasts and arts sections, as well as taking on new projects, such as webinars. In addition, MacGabhann hopes to diversify the team more, since, while the group comes from a variety of professional backgrounds, they’re more homogenous culturally.
Continuing to build Mad in Ireland’s website won’t come without challenges, of course. For example, the site’s greatest tool for promotion is currently its X account, and the group is unsure of how they’ll share content with a wider audience as the platform’s popularity continues to drop. In addition, Hough is concerned about how Mad in Ireland will sustain itself if it develops further. “Manpower is one of our biggest challenges,” she says. “We’re a small core group, and we’re all volunteers.”
Even so, Hough reports that she’s “really happy with where we’re at at the moment.” So far, the site hasn’t received any negative backlash; instead, readers have expressed gratitude that a publication of this kind finally exists in Ireland. The group has also been mentioned a few times in mainstream Irish media, and recently, they were even asked to co-host an international conference—an offer they had to decline but still took as a sign that Mad in Ireland is seen as a trusted voice.
Being part of the Mad in the World network has been crucial to building this reputation. “We’re not just some random website that sprung up in Ireland,” says Hough. She and the rest of the team also value the way this network lets them connect with people from other countries who share the same values and bring a global perspective to Mad in Ireland’s coverage by reposting pieces from other affiliate sites. As MacGabhann puts it, “Part of the strength for all the affiliates is that we are a global group.”