
In the year 1864 359 patients were admitted to an asylum with “not assigned” as a cause. In the late 19th and early 20th century the system that dealt with the mentally incompetent was in complete shambles for a variety of reasons including no strict polices for admittance, the use of ill designed and maintained buildings, as well as the blatant disregard for proper training of the employees of the asylums. In her stunt journalism piece, “ten days in a mad house”, Nellie Bly exposes the mental health correctional system. In the late 1800’s and early 1900’s mental health treatment was either not successful or not needed because of the underfunding of the asylums and doctors by the state and federal government. 

The mental healthcare system was extremely flawed in the second half of the 19th and early 20th centuries. The source of the problems was that the government at both the federal and state levels put aside barely any funding for the public health institution, leading to a variety of issues. First a foremost were the diagnosis of patients being admitted to the asylums, a majority of the time there was no real problem based on science or health testing. These patients would be given a reason at almost random and admitted to a local institution. These causes of their insanity ranged from dementia, acute mania, chronic mania, and melancholia to borderline insane reasons such as religious enthusiasm, political excitement, masturbation, asthma, and bad company. All these were written down and recorded as the actual reasons for the institutionalization of an individual for an undetermined amount of time. Another major flaw was the buildings used as asylums were often severely inadequate for their designed purpose and possibly contributed to the actual insanity of patients. Largely made out of stone and designed to look liked medieval castles and temples. Filled with hazards that were unsafe for people with normal mental situations, it was insane to put insane people into these places and expect any sort of rehabilitation or curing of them. The employees of the institutions were untrained common folk hired to watch over people deemed mentally incompetent, hired by the government who were doing the patients a civil curtesy by giving them treatment free of charge, when largely the treatment was unwanted and ineffective. All of these issues stem from the government underfunding of the mental healthcare system.

In 1887 a Journalist by the of Nellie Bly moved to New York and feigned insanity so that she would be admitted to the Womens Lunatic Asylum on Blackwell’s Island so that she could report on the conditions there. This was later deemed a stunt journalism piece, the first of its kind. Throughout her ten-day stay at the asylums Bly witnessed first-hand the atrocious conditions these women were living in and the respect they received from the staff was less then someone walking down the street gives a homeless dog in. The food was awful, living quarters cramp and uncomfortable. The bathing situation was near 50 women bathing in cold water with no privacy, and less the half as many towels as were needed, forcing them to share. She watched one of women she was brought in with be driven insane by the treatment she received. All in all she saw just how unfit these establishments were for human habitation, let alone rehabilitation.

Women were often institutionalized because of their strong views. It was the view of the medical society that women were driven insane for various reasons such as religious beliefs, anxiety, reading too much. There was no scientific or medical reason for a large majority of women to be admitted into these asylums. Actual reasons for women to be mental insane would have been a genetic pre-disposition (not that doctors in this time period would have had anyway to prove that) or actual traumatic life events. In real reason these women were being sent to the asylum was because their husband wanted them to. All a husband had to do was claim his wife was insane for whatever reason, and ask that the state hospitalize (insane asylum) her until she recovered. The treatment administered was often unneeded as the women were perfectly sane individuals. The re-occurring point is that the government had great misconception as to what a mental illness was. In her autobiography Elizabeth Packard, a woman who spent three years in the McFarland Asylum for the Insane, talk about the relationship between the husband and doctor. She began to have differing views on religion then her husband, who was a minister, doing things such as holding her own prayer groups. She believed that it was up to an individual to find their interpretation of the bible. Her husband believed that the disbelief was the sign of an unbalanced mind and brought her to a doctor who signed for her to be admitted to the institution. Similarly, the doctors in Nellie Blys case has no medical reason for their diagnosis ““who sent you here?” “the doctors,” I answered “what for” she persisted” “they say I’m insane”” (Bly 281). All Nellie had to do to be admitted was act crazy for a few moments in front of the right people. The doctor performed no tests because they didn’t have the money to do so because of the lack of funding they received. Had the doctors been able to test the patients they would have found that Nellie, and countless others who were not actively trying to get into the asylums, from ever being admitted.

The buildings that were built were not even close to adequate for the work they had been designed for. For a majority of the 19th century doctors believed that 70 to 90 percent of all insane cases could be cured by an improvement in surroundings (Yanni).  This goes to show that doctors of the time had no idea what they were talking about. We know today that insanity and other mental illnesses are not caused or cured by surrounds, that there are often something wrong inside of us that isn’t easy to fix. A large factor of mental illness is genetic predisposition. That can’t be cured by living in a nicer room. Alas states worked with architects to design and build grand buildings, to model ancient Greek temples, arts and crafts cottages, and even medieval castles. While intentions for these buildings were good, execution was not. It was not the fault of the builders that the buildings came out wrong, because they lacked the funding by the state contracting them to actually build what the state desired. The state wanted places that wouldn’t look bad from the outside in order to hide what was going on in the inside. The insides of the buildings were dreadful, barren rooms filled with hard furniture if any. Nellie Bly talks about how the rooms, practically cells, were difficult and uncomfortable to live in. “ I was taken to room 208, and left to try and make an impression on the bed. It was an impossible task. The bed had been made high in the center and sloping on the side. At first touch my head flooded y pillow with water, and my wet slip transferred some of its dampness to the sheet” (Bly 287). After the government spent the money building the building itself it has nothing left to furnish it with, leaving them left with nothing but cheap old furniture. Another risk from the designer of the building that was actually raised by Nellie Bly was the dangers of fires due to the locking of each door separately. In countless asylums across the united states the doors of the cells lock individually, requiring a nurse or other employee to come and unlock each door one-by-one with a separate key. Bly raised this concern to one of the doctors saying if there were to be a fire or other such accident there was no way that many, if any, of the patients would survive. The doctor responded that the nurses are supposed to let them out. The state tried to cut costs by buying the cheaper locks, rather than installing a system that unlocks all of the doors in the hall at once. This is a blatant disregard for the safety of patients they have entrusted themselves to help. If there had been more funding for these buildings this would have been entirely avoidable.

There were little to no qualifications to be a “nurse” who worked in these insane asylums, and the state didn’t want to pay to have them properly trained. As a result, the care they administered was not helpful to the rehabilitation of the patients, in fact in some instances it had a negative effect on their health. This can all attributed to the training they never received due to the lack of funding. Some of the firsthand accounts of the “care” given to the patients was awful “”but the city pays to keep these places up” I urged “and pays people to be kind to the unfortunates brought here”” (Bly 287). The employees of the facility were anything but nice to the patients, more often than not taking advantage of the “insane” to amuse themselves. The food offered to the patients was not nutritious, or filling in the slightest, with patients often going to bed hungry. The food is another example of the under-funding of the “public” institutions. One of the more torturous methods observed by Bly was what the inmates called the rope. In the section of the asylum where violent patients were sent women were leather bound to a rope and forced to pull a heavy metal crate occupied by two other women (Bly 291-292). There is no way that anyone with the proper training would let that happen, or even think of that happening in the first place. If the mental asylums had the proper funding they would have been able to train their employees and this never would have happened.

As a direct result of underfunding by the government the mental healthcare system failed a large majority of the people it was supposed to help, and thousands it shouldn’t have helped in the first place. The underfunding led to people with no mental health problem being admitted for time periods completely unnecessary and not sanctioned by any governing body. Only to be released when unfit doctors deemed they had been cured of a problem that never existed in the first place. Public intuitions were poorly designed and built for their intended purposes. They were unfit then and are left unfit now as a barren scar in the country side, a constant reminder of how the government failed so many people they pledged to help. The last two failures of the system would have been excusable if they had been staffed by adequately trained nurses and doctors, yet due again to the lack of funds people who were severely under qualified were hired to watch over people who were deemed unable to care for themselves. These employees often abused their powers and made life in the asylum hell for their patients for their own amusement. If the government had seen it fit to properly fund this healthcare system, then these problems never would have arisen in the first place.