In the year 1864, 369 patients were admitted to an asylum with “not assigned” as their diagnosis. In the late 19th and early 20th century the system that dealt with the mentally ill was in disarray 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 not successful because of the underfunding of the asylums by the state and federal government. 

The mental healthcare system was flawed in the second half of the 19th and first half 20th centuries. The source of the problems was that the government at both the federal and state levels put aside barely any funding for public health institutions, leading to a variety of issues. First and 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 random and admitted to a local institution. The 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. In 1860 Elizabeth Packard was admitted with diagnosis of an “unbalanced mind” (Wood 25). Another major flaw was that the buildings used as asylums were often severely inadequate for their designed purpose, and possibly contributed to the actual insanity of patients. Primarily made out of stone they were designed to look liked medieval castles and temples. The conditions were unfit for people with normal mental situations to live in. It was illogical to put people who were presumed to be insane into these places and expect them to be rehabilitated or cured. The employees of the institutions were untrained and hired by the government to watch over people deemed mentally incompetent. Free treatment was given as a civil curtesy, but it often unwanted and ineffective. All of these issues stem from the government’s underfunding of the mental healthcare system.

In 1887 a journalist who went by the name of Nellie Bly moved to New York. Nellie Bly’s real name was Elizabeth Jane Cochran, who came up with Bly to use as a pseudonym to publish under. Once in New York she feigned insanity to that she would be admitted to the Women’s Lunatic Asylum on Blackwell’s Island. She did this so that she could report on the conditions of the asylum. This was later deemed as an immersion journalism piece, more commonly known as stunt-journalism. In immersion journalism the journalist but themselves into the situation they want to report on, just as Bly did. The conventional journalistic approach would have been to interview employees who had worked there and women who had spent time there. Immersion journalism allows reporters to see for them-selves the situations they are reporting on.  Throughout her ten-day stay at the asylum, Bly witnessed first-hand the atrocious conditions these women were living in and the disrespect they received from the staff was borderline inhumane. The food was awful, living quarters cramp and uncomfortable. The bathing situation was nearly fifty women bathing in cold water with no privacy, sharing towels with each other because not enough were provided. 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, and 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 mentally insane would have been a genetic pre-disposition or actual traumatic life events. The 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 her (admit her to an insane asylum) until she recovered. The treatment administered was often unneeded as the women were perfectly sane individuals (Wood 25). 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 beginning in 1860, talks about how the relationship between her husband and the doctor resulted in her institutionalization. She began to have differing views on religion than 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. The doctors hired by the state to work in the asylums were not well trained, if they had been trained or gone to medical school in the first place. These men were working because the asylums did not have the money to hire doctors who had been trained the in recognizing, diagnosing, and treating mental illnesses. This would have prevented many sane people from being admitted into asylums. Similarly, the doctors in Nellie Bly’s 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. Had the doctors known what they were actually doing, they would have realized Bly was faking and not admitted her.

The buildings that were built were not adequate for the work they had been designed 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 1). A large factor of mental illness is genetic predisposition. That can not 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. The buildings were designed this way due again to the belief that improved surroundings helped mental patients (Yanni 1). They wanted patients to enter these buildings and feel like they were living in a real life castle or temple. The state used the little funding it had to try and build something that was not necessary. There was no evidence to support the theory that improved surroundings hastened the recovery of a patient. When it came time to work on the inside, there was little funds left and no plan. The insides of the buildings were dreadful, barren rooms filled with hard furniture if any. Bly writes 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). Another risk created from the design 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. It is clear that if such a fire occurred, the nurses would be able to free the women if they tried. 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 did not 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). If the staff had received proper training this form of treatment would have never existed. They did not receive training because the institution did not have the proper funding.

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 should not 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.
