
Extremely low funding, high concentration of poor and immigrant patients and their mistreatment in asylums show that early psychiatric institutions and programs were used more to separate and condemn people of lower social status than to treat mental illness.  This can be seen in Nelly Bly's nonfiction book, Ten Days in a Madhouse, a story that tells about the corruption of asylums from the patients perspective. Nellie Bly goes undercover as a diagnosed mentally insane women Nelly Brown and is placed into Blackwell's Island Lunatic Asylum for two weeks.  She observes and describes the women in the psych ward and how they were being treated.  Living in the same condition as the patients and being treated in the same manner, she is able to fully understand and explain to her audience the corrupt system and poor treatment that she and others had endured.  

There were many critics of asylums in the late 19th century about the diagnostics and therapies used by psychiatrists for the mentally ill.  There was a lack of funding for research and asylums relied on the state to pay for the building and the programs maintenance.(Sutton, 1991)  However the money given to the asylums were not enough for the patients to live a comfortable lifestyle.  This uncomfortable lifestyle often included poor quality food, clothes, little to no use of heating or air conditioning as well as other amenities to conserve energy and money.(Sutton 1991)  As Bly mentions in her book, when she was in the asylum she too complained of the low quality, itchy clothes and indigestible food as well as her cold environment.  It can also be noted the remarks from the nurses telling Bly to be thankful they have anything at all and that they do not have the money for anything better whenever Bly would report to them the poor conditions she and the patients were under.  The lack of capital for psychiatric research hindered the understanding behind mental illnesses.  With such little knowledge, it was almost impossible to correctly distinguish mental illness based from signs and symptoms.  There was not much distinction between the mentally handicapped and the physically handicapped for psychiatrists during this time period. (Maeda, 2016)  This only served as a crutch to psychiatrics and unfortunately, many people were misdiagnosed.  Without proper scientific testing and knowledge, there was a lot of lee-way for prejudice in determining who was sane or insane.  In the early development and growth of psychology and psychiatry, there was not much scientific evidence or technology to understand mental illness or test for mental illness. This lead people to deemed others as insane based on if they did not fit the cultural and moral ideals of society.  In its early years of existence, many asylums were primarily used as a "convenient way to confine undesirable people".  

A large part of these "undesirable people" mentioned above include immigrants and the lower class.  The mid 18th century and early 19th century marked the second wave of immigration in the US.  Unlike the first wave of immigrants, who were from North and Western Europe, this wave included an influx of people from Eastern and Southern Europe in search of a better life such as Ireland, which was under famine and Germany, which was under political unrest.  The immigrants came to the US with different religious views or political and cultural tension, causing American citizens to become wary and even afraid of their new neighbors.  This fear caused the alienation or outcast of anyone who was an immigrant or a close descendant of one.  Immigrants were forced to beg for labor intensive jobs for very little pay if they had the opportunity to find a job opening willing to take them.  Nativism became a strong policy and continued to grow in the time period as a result.(Maeda, 2016)  Therefore because of the strong prejudice against these immigrants and the vague test for mental illness, it is no surprise that immigrants took up a very high percentage of the insane population in an asylum. (Maeda,2016)  Bly's book records many different encounters with immigrant patients.  Bly would always inform her audience of a character who was of German descent, constantly noting several patients who were.  One particularly interesting character is the head nurse, who is of German descent.  Upon checking in the women, one of the new German patients could not speak English.  When asked if the nurse could translate, she refused to admit that she spoke and understood it even though it was clear that she could.  Her refusal shows her disapproval and shame for her nationality proving that such a cultural social gap existed. 

There was also an ethical issue on the treatment and experimentation on patients.  Some of the therapies that were criticized include but are not limited to physical restraints, cold baths, tooth extractions, and unnecessary surgery.(Sutton, 1991)  None of these treatments proved to be effective.(Sutton,1991)  In Bly's book, she discusses what seem to be more of torture methods than treatment methods.  For example, Bly describes her cold bath experience that was filled with humiliation and discomfort to say the least.  She goes on to describe the cold rooms and poor quality clothes which is part of not having enough money to get the patients better quality.  Most importantly, is not just what their treatment was, but how it was conducted.  Right off the bat when the women are being brought in, the staff were more focused on socializing with each other than they were on their job of checking the patient.  The nurses were rude and almost abusive to their patients.  Periodically in the story, the patients were told to "shut-up".  The patients voices were never heard, being almost completely ignored by the doctors, the nurses, or any other staff.  Unfortunately this kind of treatment and behavior does not differ from other asylums and similar institutions.  Most of employees in the psychiatric field were not trained and did not properly take care of patients in an ethical manor.  Psychiatric institutions were made ideally to help and treat people, but sadly ended up as more of a prison than a sanctuary for them.

Unfortunately psychiatric institutions were used as a form of alienation and condemnation instead of for the treatment and hospitality to those who were truly mentally ill.  This discrimination in the asylums is an exaggerated reflection of what was going on outside of them as well.  Due to political tension between Germany and the US during the mid 19th century to the late 20th century, many Americans became skeptical and suspicious of Germans, abroad and at home.  Their fear and their ignorance resulted in discrimination and alienation of people based on their background.  As a result many immigrants had been put into asylums because they fell under the vague description of insane, not being able to take care of themselves and was seen as a threat to society, and were continued to be dehumanized even more.  It is important to realize these outlets with which discrimination occurred throughout history because they hid a very illegal and immoral action, discrimination and condemnation, behind a legal and moral institution such as a psychiatric institution, where not much scientific research had been conducted and were in many ways ignorant about mental illness, whose supposed goal is supposed to be to treat and take care of mentally ill patients who cannot take care of themselves.  It is important to note that Americans during this time period did not think of themselves as persecutors but they did so as an act of "defense", even though they had nothing to fear from the German immigrants and descendants, many of whom were American citizens and where trying to escape Germany.  It is critical to understand and educate oneself and society about the things or people they fear and have self awareness of thoughts and actions to prevent themselves from becoming the oppressor or bully.  As the phrase "history repeats itself" ceaselessly proves itself to be true, it is very relatable and fearfully similar to the 21st century in the US  and it is important to keep this self-awareness and knowledge in mind to create union between all Americans.
