



Mental health has always been prominent in the United States. What is not so common, however, is quality treatment of those who are mentally ill. Dating all the way back to times in ancient Egypt, India, and Greece, “many cultures have viewed mental illness as a form of religious punishment or demonic possession” (PBS Online’s “Timeline: Treatments for Mental Illness”). These beliefs carried on throughout time and into the first “establishment specifically for people with mental illness” (PBS Online’s “Timeline: Treatments for Mental Illness”) built in  1407, causing the patients to be treated inhumanely. 

Moving into more recent times, changes started to take place in 1840 when “activist Dorothea Dix lobbied for better living conditions for the mentally ill after witnessing the dangerous and unhealthy conditions in which many patients lived” (uniteforsight.org). For 40 years, Dix advocated for the mentally ill and in turn, the U.S. government funded 32 state psychiatric hospitals. Instead of being “incarcerated with criminals and left unclothed and in darkness and without heat or bathrooms”, (PBS Online’s “Timeline: Treatments for Mental Illness”), the patients were now living in hospitals and being treated by staff that was trained specifically to meet their needs.

Despite Dix’s efforts to give mentally ill patients fair and quality treatment, there was still a lot of work to be done. In the late 1800’s, Nellie Bly, an undercover journalist, published a book called “10 Days in a Mad-House.” The book is a compilation of Bly’s reports after she got herself admitted to Blackwell’s Island Asylum. In her recordings, Bly speaks of her scarring experiences. She records being fed “pinkish-looking stuff” (Bly, 285), beatings, and a terrifying atmosphere put on by one of the women in charge, Miss Tillie Mayard (Nellie Bly “10 Days in a Mad-House”). Something that stuck out to me most was Bly’s encounter with the ice bath. A lack of privacy and apparent dehumanization can be found when Bly writes “ They began to undress me, and one by one they pulled off my clothes. At last everything was gone except one garment. ‘I will not remove it.’ I said vehemently, but they took it off.” Just in this one account from Bly’s work, it is easy to see how the mentally ill were being treated as less than. After the publication of her story sprung more investigations and more funding.

Bly was not the only one to sacrifice themselves for their work. Psychologist David L. Rosenhan conducted an experiment in which eight “pseudopatients,” one being himself, gained admission to psychiatric hospitals. Like Bly, Rosenhan kept his journal close by while living in these conditions. He then published his work as “On Being Sane in Insane Places.” Rosenhan’s work differs from Bly’s in the way that he reports. Because his experience was a psychological experiment, Rosenhan spends more time explaining his experiment and the data collected, whereas Bly talks more about her experience. In Rosenhan’s experiment, among the psuedopatients, three women and five men, were three psychologists, a psychiatrist, a painter, a housewife, and a pediatrician; all mentally healthy. Rosenhan and the other patients gained admission to 12 different hospitals in five different states. Gaining admission was simple, “after calling the hospital for an appointment, the pseudopatient arrived at the admissions office complaining that he had been hearing voices. Asked what the voices said, he replied that they were often unclear, but as far as he could tell they said ‘empty,’ ‘hollow,’ ‘thud.’” (Rosenhan, 29). Just based off of these conversations the subjects were admitted. The experiment began and “Immediately upon admission to the psychiatric ward, the pseudopatient ceased simulating any symptoms of abnormality.” (Rosenhan, 29). The pseudopatients would go on to interact “normally” with the nurses and other patients. When prescribed medication, the pseudopatient would follow directions, but would not swallow the pill. When the researchers were not busy with activities directed by the hospital, they spent their time writing everything down. This was not an easy job however and Rosenhan states that “the psychological stresses associated with hospitalization were considerable, and all but one of the pseudopatients desired to be discharged immediately after being admitted.” (Rosenhan, 30). Eventually, after an average time of 19 days in the psychiatric ward, all pseudopatients were released with a diagnosis of  schizophrenia “in remission” (Rosenhan, 30). After reviewing their data, Rosenhan found that other patients would accuse the pseudopatients of being healthy, but the staff never questioned their sanity. Rosenhan blames “the fact that patients often recognized normality when staff did not” (Rosenhan, 30), on “what statisticians call the Type 2 error. This is to say that physicians are more inclined to call a healthy person sick, than a sick person healthy.” (Rosenhan, 30). Throughout the experiment, Rosenhan was exposed to a new kind of treatment. He got first hand experience at what it is like to be treated as mentally ill. Rosenhan admits that the treatment of the mentally ill has improved over the years, but he now knows for sure that there is still a lot of work to be done. He makes the point that mentally ill patients will never be treated the same as physically ill patients; “a broken leg does not threaten the observer, but a crazy schizophrenic?” (Rosenhan, 34).

When we look at the history of treatment of the mentally ill, it is hard to believe humans were ever treated such a way just as a result of being sick. This problem that has always been around, has improved drastically due to the early work of Dorothea Dix. We have come a long way from using chains and shackles, to providing specialized institutions with professional staff for those with mental health issues. Dix sparked the change in treatment of mentally ill and Nellie Bly and David Rosenhan took it to the next step it needed to make a permanent change. Even though one worked in a psychiatric hospital and the other in an asylum, both Rosenhan and Bly went undercover to get an inside look on the life of a mentally ill patient. They both felt there was a need, rightfully so, to expose the treatment of the mentally ill especially after other’s efforts were not enough. Their work furthered the improvement of psychiatric wards. I believe the reason for their success is due to the fact that they put themselves in the patients shoes and, while we may not have anything in common with the patient, we can relate to the researchers who are mentally healthy, and we are able to put ourselves in their shoes. We then imagine what it would be like to be treated as insane, and that is disturbing to us. Although there may always be some hesitation to provide the same level of care to, like Rosenhan states, a schizophrenic and someone with a broken leg, Dix provided the grounds for Rosenhan and Bly to have successful experiments that helped raise awareness and make changes. 





