According to the National Institute of Mental Health, more than 43 million people are diagnosed with a mental illness every year (NIMH). Mental illnesses have had a very long history. Many kinds of mental illnesses have been treated since the late 1700’s. During this time period, there were a few different ways they could be treated: either patients were placed in an insane asylum, or they were isolated from the public in order to de-stimulate them. In the excerpt from Ten Days in a Mad-House, Nellie Bly pretends to be insane so she can experience how the mentally ill were treated in asylums during that time period (Bly 281). Though Bly ventures into the asylum during the late 1800’s, one can assume that the practices described by Bly were prevalent since the beginning of asylums in the 1700’s. Bly’s book helps readers understand what kind of attitude people of that time had towards the mentally ill, and explains both the historical and cultural context of the people who ignored mental illnesses. As time went on, the treatment of mental illnesses became more humane, with the development of medications to help improve the ill (Shorter 13). By illustrating in great detail the poor treatment and conditions experienced by asylum patients, and the historical and cultural factors that led society to view them as less than human, Bly sparked both institutional and social reform.  

Poor treatment of people with mental illnesses had been an ongoing epidemic from the 1770’s to around the 1900’s. In an excerpt from the book, Conscience and Convenience: The Asylum and Its Alternatives in Progressive America by David J. Rothman, asylums were seen as, “the lesser of the evils, or more enthusiastically, that they could be upgraded and redesigned to accomplish good” (Rothman 40). As Rothman explains, relatives and friends of insane individuals during the eighteenth, nineteenth, and twentieth centuries recognized that asylums were doing harm, rather than good, but they believed that asylums were the only option that could help treat those illnesses. Rothman states that it was known to the public that asylums and other institutions were known for poor treatment of the insane, but, “the conveniences of asylum care [was] attractive” because the relatives and friends of the insane individuals would have someone else take care of the mentally ill person, rather than themselves (Rothman 40). This mentality helped to develop the notion that the mentally ill were just a burden on society, rather than normal humans that needed help, as well as medical advice to help treat their illnesses. 

After looking at the history of psychiatry and the rise of mental illnesses during this period, there may be an explanation as to why asylums arose, and why patients in asylums were treated poorly. In the introduction of Edward Shorter’s, A Historical Dictionary of Psychiatry, Shorter explains that there was a rise in the number of people diagnosed with mental disorders in the nineteenth century: “An actual increase in the incidence of insanity seems to have occurred as a result of rising alcoholism” (Shorter 4). During this time period, the price of alcohol fell drastically, resulting in the number of people who developed alcoholism to increase drastically. Due to the stigma and attitude towards the mentally ill (including those suffering from substance abuse), many of them were placed in asylums to treat their illnesses. One main reason why more people were being placed in asylums due to alcoholism was due to the expansion of the definition of insanity. Insanity during and after the nineteenth century was classified as anyone suffering from a mental illness or substance abuse, in this case it was alcohol.

In Bly’s exposé of the cruel asylum system, the reader sees the cruelty imposed upon the mentally ill. In this case, the asylum is publicly funded, where the patients are staying there because the government is paying to have their illnesses treated. The nurses in this asylum treat the patients extremely poorly by subjecting them to ice cold baths, inedible food, and physical abuse. No matter how much the women protest and try to stop the nurses from harming them, the nurses remind the women that, “‘This is charity, and you should be thankful for what you get.’” (Bly 287). This mentality of the nurses in the asylum gives the reader a historical context of the cultural attitude towards the mentally ill in the past. Those who were being treated in an asylum were seen as a burden upon the public, and therefore alienated and treated like second-class citizens compared to the rest of the country. Bly also gives the reader evidence as to how the patients were treated as second-class citizens based on what they were fed. The patients, “had to choke down fresh fish, just boiled in water…The most insane refused to swallow the food and were threatened with punishment” (Bly 293). From this excerpt, one can inference that the treatment shown was the norm among asylums across the country during this time period. These patients in insane asylums were fed inedible food, which only perpetuates the notion that the administrators in asylums saw mental illnesses as an excuse to treat the patients as if they were less than human.  

As a result of Bly’s, Ten Days in a Mad-House, people around the world realized how cruel asylums treated their patients, and demanded institutional reform. After Bly originally published her exposé in a New York newspaper, people were enraged with how nurses in asylums were treating patients. A large-scale investigation of the asylum was launched soon after the publication of Bly’s exposé, and only proved Bly’s claims correct. As a result of the investigation, policies were put in place so that abuse of patients was prevented, and more funding would go towards assisting mental institutions in the state of New York. Also, changes were made to asylums so that patients were not living in terrible, dirty, and overcrowded conditions that contributed to their growing insanity during their time in the asylums (Biography.com). The reform that began in New York after Bly’s Ten Days in a Mad-House eventually spread across the country and led to how society views mental illnesses today. Rather than institutionalizing the mentally ill, now people go to specialists to talk about their problems, and more often than not, are prescribed medications to help manage their conditions (MHA).

In today’s society, mental illness is still a prevalent issue that millions of people face every day. Looking back on the history of treatments of mental illnesses is shocking and almost repulsive, as Bly illustrates in Ten Days in a Mad-House. After researching the history of these asylums, as well as the history of mental illnesses as a whole, it is easier to see the rationale behind why doctors would be willing to throw thousands of people into institutions that made almost no effort to treat the mentally ill. The combined convenience of asylums, as well as the stigma surrounding mental illnesses, helped the rise of the use of asylums in the eighteenth, nineteenth, and twentieth centuries. With the massive increase in mental illnesses due to alcoholism and post-war related illnesses following the end of World War Two, the use of asylums became more appealing to the friends and relatives of those suffering from mental illnesses during that time period. Although asylums were a terrible attempt to treat mental illnesses, society can learn from the history of asylums and ensure that people with mental illnesses get treated more humanely today.
