During the nineteenth century, the treatment of individuals in mental institutions ranged from adequate to unethical. There are few reports of asylums successfully rehabilitating the mentally insane. However, there are plenty of examples of asylums that were unsuccessful. One example of an unsuccessful mental institution is exposed by a stunt journalist named Nellie Bly. She goes undercover as an insane woman to see what it is like to live in a mental institution. Nellie Bly’s Ten Days in a Mad-House highlights the mistreatment of asylum inmates in the late nineteenth century. 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 an insane asylum in New York in 1887. Asylums in the late nineteenth century 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 their presence would not burden the community. A journal published in 1884 that states the rights of the insane says, “The insane have a right to expect, and should find it, in the hospital a home… it entitles to a home, with all which that word implies” (Godding 5). This standard was not met in many cases. Overall, these institutions were underfunded, and lacked the adequate necessities to care for the patients. Some wards had miniscule doctor to patient ratios. In one particular institution in 1881, a ward in Harrisburg, Pennsylvania had a doctor to patient ratio of 1:77. This only got worse with time, decreasing to 1:105 in 1891 (McGovern 8). The more shocking statistics is that only about half of US citizens that needed to be in an asylum were institutionalized, according to the American Journal of Insanity in 1864.  The underfunding of mental institutions also meant that mental institutions had to spend their money wisely. Nana Tuntiya states that the main factor for how mental institutions were structured was in the ability to, “minimize the cost of their maintenance” (472). A medical journal in 1884 states that some institutions reported that the total expense to completely care for one inmate was 50 cents per day (Godding 6). In an asylum in New York, it was reported that asylums only received fifty-six percent of the funding needed to meet the minimum condition for the standard of living (Williams 399). These statistics show that the underfunding of mental institutions was a problem in the late nineteenth century.

Nellie Bly was a stunt journalist that lived at the Women’s Lunatic Asylum in New York for ten days, and recorded her findings in the form of a story, which she titled Ten Days in a Mad-House. She recorded the poor conditions of the institution, noting the underfunding of the establishment, and the corruptness she saw. The asylum she studied was similar to general asylums in that time period, in that it lacked the necessities required to adequately care for the patients. In her short visit of ten days, Nellie goes hungry, endures the cold weather without proper warm clothes, sees asylum staff mistreat patients, gets verbally abused, notices safety hazards, and sees firsthand the doctor’s neglect for the inmates’ health. By going undercover, Nellie Bly was able to experience an underfunded mental institution and record her findings. 

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 additional clothes multiple times throughout the story but never receives any. 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 had to eat was also affected by underfunding. 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 safety of the inmates was also determined by the funding the institutions 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 were 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. 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 Western Penitentiary at Pittsburg, Pennsylvania, 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. The safety of the patients and inability to supply the inmates’ basic needs was caused by not having enough money for adequate supplies and facilities. Because institutions had very little money to spend, they were forced to only have the bare minimum amount of supplies, which means that the inmates’ physical needs were not met.

The lack of funding for mental institutions also affects 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 the reasoning behind why the daily walks outside in Ten Days in a Madhouse were so strict. Nellie writes 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 option to freely walk around would have been a possibility. Since this was not the case, however, the workers had to make the women stand in a formation so that no inmate would get lost or wander off. This is also the reason that the women are forced to sit down and do nothing all day. Because the nurses could have a large number of patients to look after, letting the patients roam free would be difficult. Underemployment of mental institutions due to underfunding caused the institution’s staff to use harsh methods to manage the numerous patients.

The lack of funding for government research on mental illness contributed to the mistreatment of mental institution inmates. The lack of thorough research on mental illness contributed to the 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 in 1883 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, including the doctors that are supposed to treat these patients, saw all mentally ill people as unstable and violent creatures, which only added 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, rather than when the patient had learned to cope with his or her disorder. 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). These stigmas directly affected the inmates in the story. The nurses’ attitude towards the patients were apathetic because they were unable to understand their conditions, which contributed to the abuse of inmates. In Nelly Bly’s story, a woman named Urena was often harassed by the nurses because of her mental condition. 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 funding of institutions negatively affected 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 does not do anything to help her. In 1884 in a medical journal there were reports that the physicians in mental hospitals were not properly trained. The author has to explicitly state that doctors need to be trained, and cannot just be a “steward, engineer, architect, farmer, florist, landscape gardener and financer…” (Godding 18). The patients had to suffer through the sicknesses they had because the institutions could not afford proper health care. 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. 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. Ultimately, the lack of funding is what caused poor living conditions in mental institutions in the late nineteenth century.
