The human mind is mysterious and amazing, allowing people to perform the simplest tasks to imagining the great scale of the universe and possibilities yet unheard. But the heartbreak of when things go wrong with the mind can destroy lives if not treated. In the 1800s, very little was understood how to treat mental illness, and those with maladies that could be overcome with patience and kindness were so often tossed aside.
One reformer, Dorothea Dix, saw their basic humanity and campaigned across the country and across the world to change the way they were seen and treated, transforming mental health care.
Dix was born in Maine in 1802, the eldest of three children. Her father was a Methodist preacher. Her childhood, however, was marred by her father’s descent into alcoholism and her mother’s poor health, which often left her bedridden. She spent most of the latter part of her childhood with her grandparents in Massachusetts.
At the age of 14, she began teaching at a girl’s school and opened her own school in Boston at age 19. Her own struggles with her health forced her to close this school. She nevertheless opened another school within a few years and also wrote a number of devotionals and books for children. She traveled to England in the late 1830s, where she briefly worked as a teacher in a women’s prison and saw the serious problems with lack of medical care for prisoners, particularly the mentally ill.
When she returned to Massachusetts in 1840, she began investigating care for the mentally ill and was shocked by her findings. What few facilities existed were houses of horrors. Many were locked up in pens or stalls with the most violent and were often beaten or tortured or starved by overseers – those who were supposed to be caring for them. Others were jailed as homeless vagrants. Others were confined to poor houses, abandoned in small rooms with no way to sustain themselves. In either case, they received no treatment and were abandoned by family and forgotten by society. However, where some saw the rejects of society, Dix saw people in pain who needed help.
She lobbied the state legislature for reforms. In 1841, the state dramatically increased public facilities for the mentally ill. Emboldened by her success, Dix decided to take her cause from state to state. In 1842, she successfully lobbied Rhode Island to expand its facilities. In the process, she brought the sick out of the literal dark and into sanitary facilities with proper care.
In 1844, Dix brought her work to New Jersey, where she studied each prison, hospital, and poor-house in the state to learn about the conditions of the mentally ill. Reformers had tried to improve care for the mentally previously in the state, but Dix managed to convince legislators to establish a state psychiatric hospital, with resolutions echoing her ideas that society had a duty to care for the sick and the conviction that mental distresses could be cured. What became the New Jersey State Hospital opened in 1848.
In the meantime, she convinced Pennsylvania to build a new hospital. Over the next few years, she traveled across the country pushing for expanding and reforming facilities. She visited hundreds of jails and poor-houses and established an additional six hospitals by 1850.
In 1848, she also began lobbying Congress for a bill that would set aside the proceeds of five million acres in federal lands to fund hospitals for the mentally ill in the different states. By 1850, she expanded this request to 10 million acres with an additional two million acres for facilities for the blind and deaf, which came to be called the “Twelve Million Acre Bill.” The bill finally passed in 1854 by wide margins, only to face a shocking veto by President Franklin Pierce.
After the defeat of the legislation, Dix took her reform mission to Europe. She convinced Britain to enact new reforms after visiting facilities in Scotland. She met with Pope Pius IX and convinced him to visit the Roman Catholic facilities for the mentally ill in Italy, inspiring the pope to commit to new reforms.
The move to treat the mentally ill with respect and dignity was gaining a foothold across the Western Hemisphere because of Dix’s work. She would return to the United States on the eve of the Civil War and work to reform the nursing profession as the war began and the need for nurses arose. In the years after the Civil War and after her passing, her ideas of treatment and insistence on compassionate care continued to be the standard as Texas continued to build and expand its own facilities.