
During the nineteenth century, the treatment of individuals in mental institution ranged from adequate to unethical. There are few reports of asylums successfully rehabilitating the mentally insane. In Ten Days in a Mad-House, by Nellie Bly, the mistreatment of asylum inmates in the late nineteenth century comes into the light. The inmates had to deal with inadequate food, lack of clothes, and abuse from the institution’s workers due to the lack of funding from the government.

Ten Days in a Mad-House, takes place in 1887. Asylums were generally large institutions where communities and individuals sent people who were not seen as fit to be in society. This means that not only insane people were sent to mental institutions, but criminals and lower class citizens were sent so that the community would not have to deal with them. Overall, these institutions were underfunded, and lacked the adequate necessities to care for the patients. Some wards had a doctor to patient ratio as low as 1:77 (McGovern 8). This also meant that mental institutions had to spend their money wisely. According to Nana Tuntiya, a main factor for how mental institutions were structured was in the ability to, “minimize the cost of their maintenance” (472). Some institutions reported that the total expense to completely care for an inmate is 50 cents per day (Godding 6).

Ten Days in a Mad-House is a story written by Nellie Bly where she lives in a mental institution for ten days. She records the conditions of the institution. The asylum is underfunded and corrupt. The asylum is similar to general asylums in that time period, in that it lacked the necessities required to adequately care for the patients. This particular institution also had poor medical care, and safety hazards. 

Nellie Bly describes the lack of physical needs that the inmates had to endure. The inmates did not have adequate clothing for the weather. She asks for clothes multiple times throughout the story. Every time she is met with a response similar to, “You are in a public institution now, and you can’t expect to get anything” (Bly 287). Nellie mentions that there were only two towels and six combs for the forty-five inmates on her hall. The food the inmates received was hardly edible. It is so bad that Nellie has trouble forcing down her food. It had no seasoning, spices, salt, and was made with the cheapest ingredients possible. The lack of physical needs was caused by not having enough money for adequate supplies. Because institutions had very little money to spend, they were forced to only have the bare minimum, or perhaps below the bare minimum, amount of supplies. This means that they could not afford to properly care for the inmates with clothing, food, and other supplies.

The lack of funding for the institution also effects the methods used to treat the patients. Because of the underemployment of the institutions, each worker had a large number of inmates to look after and control. Because of this, harsher methods were the only way to manage the entire population of inmates. Tuntiya states the effect of underemployment has on the methods the workers used, saying, “This resulted in a growing number of accidents and, consequently, wider application of restraint” (473). By restraining patients, workers were able to reduce their workload into a manageable amount, at the expense of the inmate’s wellbeing. This is also the reasoning behind why the daily walks outside were so strict. Nellie states that there were long lines of women forced to walk two by two, guarded by nurses. They were all chained together by a long rope attached to their belts. If there had been more workers per woman, the possibility to freely walk around would have been a possibility. Since this was not the case, the workers had to make the women stand in a formation so that no inmate would get lost or wander off. It is also important to mention that the reasoning behind the inmates’ inability to have fun or do anything throughout the day is also caused by a lack of funding. Since the inmates’ basic needs are barely affordable, there was no money to invest in quality of life goods. This means that no one could have journals, books, newspapers, or any means of entertainment. 

The inmates’ safety was also determined by the funding the institution received. Nellie mentions the inefficient lock system that the asylum used. All the doors lock individually, and the doors were always locked if the inmates are inside. This means that in case of a fire, the nurses would have to individually unlock every door which would take too much time to save everybody. By knowing how cruel the nurses were, Nellie states that if a fire occurred, “All would be left to roast to death” (288). Nellie compares this flawed lock system to the lock system at Sing Sing, which has crank at the end of a row of cells that unlocks all the cells at the same time. This lock system would make the inmates much safer in times of emergency. Sing Sing was a maximum-security prison for criminals, which shows that even prisons for criminals are given enough funding for appropriate locks. By not having enough funding, the mental institution is endangering the life of all the inmates. 

The lack of funding from the government also effects the lack of knowledge surrounding “insane” people. Because there was not thorough research on mental illness, there were social stigmas surrounding insane people. Society saw mentally ill people as degenerates, even though we know today that they cannot help it. Tuntiya notes a man named Dr. Bradner who says, “I see this man constantly on the street and expect nothing else than to find some of these days he will become violent, and treat us to a massacre in true lunatic style” (475). Some members of society saw all mentally ill people as unstable, and violent creatures, which contributed to their mistreatment. Because there was no universally accepted information on mental illness in the late nineteenth century, the patients’ status was subjective to what the doctor thought was right. McGovern mentions that “All the institutionalized patients were not necessarily ill in modern terms and, of course, in some cases ‘recovery’ meant changing one’s behavior patterns or attitudes to fit the doctor’s or community’s expectations” (5). This means that patients did not get released when they coped with their disorder, but rather when the doctor personally thought they were ready. These stigmas directly affected the inmates in the story. The nurses’ attitude towards the patients were apathetic at best. Because they were unable to understand their conditions, the nurses mistreated and abused the patients. One patient, Urena, was often harassed by the nurses. Urena thought she was eighteen, when in fact she was thirty-three. Knowing that Urena was sensitive about her age, the nurses would tease her telling her she was thirty-three and watch her yell as they laughed. This cruelty is not entirely because of ignorance, but ignorance does contribute to this abuse. If there was enough money to fund researching these conditions, the treatment of these patients would have been better.

The lack of money also effects who is put into mental institutions in the first place. Mental institutions turned into places where communities could put people that did not fit in with everyone else. People were often accused, and could not afford to prove themselves innocent. Nellie mentions a fellow inmate of hers, Mrs. Louise Schanz, saying, “…here was a woman taken without her own consent from the free world to an asylum and there given no chance to prove her sanity… Compare this with a criminal, who is given every chance to prove his innocence” (283). Because of the lack of funding and the cheapness of taking in patients, it was cheaper to just institutionalize people than to pay for a trial, which means that people that are not in need of mental care are put into “mad houses.”

The lack of funding of institutions effected the medical care that the patients received. Since these institutions could not afford to research, or carry out, the most effective methods, they had to work with what they could afford to do. This is shown in Ten Days in a Mad-House with Miss Tillie Mayard. Nellie lets the doctors know that Miss Tillie is sick and needs medical attention, but he ignores her. Because the institution could not afford proper health care, the patients had to suffer through whatever sickness they have. The lack of funding mixed with the cruelty of the workers left the patients’ medical problems untreated.

The story Ten Days in a Mad-House displays the horrors that happened in mental institutions during the late nineteenth century. The underfunding of mental institutions caused the patients to suffer through inadequate food, a lack of clothing, and little to no health care. This, mixed with the cruel treatment of asylum staff, was the cause of the patients’ horrible living conditions. Mental institutions have changed for the better, but were not regulated until quite recently, in the late twentieth century. Mental institutions progressively got less funding until 1963 when John F. Kennedy signed the Community Health Centers Act of 1963. This act increased funding to mental health services to improve the conditions of the mentally ill. Laws to protect the mentally ill were created throughout the late twentieth and early twenty first centuries. There is still debate on whether the care given to mental patients in the modern day is as good as it could be. Overall, by increasing the funding of these institutions, along with more information on mental illness, the quality of care given to individuals in mental institutions has gotten much better.
