
Throughout history there have been horrible and unspeakable things that the human race has done that the rest of society has turned a blind eye toward. The Holocaust, Internment camps, and the treatment of mental patients in the 1800s are all examples of these instances. Although the treatment of prisoners was due mostly to lack of knowledge and funds, there was an undoubtedly inhumane treatment of the mentally ill that most people at the time simply ignored, or were ignorant towards. In 1887, a brave woman, and some may argue even mad women herself for taking on such an intimidating and unknown task, feigned herself mad in order to expose the corrupted mental hospital and care taking system. 

An article written by Helen Buechl appropriately named “Open Mental Hospital Doors” describes a group of six directors of New York State Prisons who ventured to England in 1956, hearing that Great Britain had found a new approach to caring for mental patients. In England, they found the extreme contrast to the current practice of closed doors, metal bars, locks and lack of basic human necessities that the US was currently employing. They found a homelike environment, instead of an actual jail. These changes were meant to make the inmates feel more comfortable, and they were given clothing from a local store in order to increase their self respect. This policy encouraged the patient to take care of their own property, and were also given a personal locker instead of a communal room. The hospital was also operating on a voluntary admittance basis on the patients part and held a home-care plan for the elderly which included daily visit from nurses, a bi-weekly visit from a social worker, or a weekly visit by a district health officer. After returning to the states, the first mental hospital to adopt the open door policy was St. Lawrence State Hospital in Ogdensburg, NY. They began with opening the doors for eight hours and slowly worked their way up to nine to over twelve hours a day. The result was less restlessness and a large increase of independence and dependability in the patients. The patient’s newfound responsibility when it came to their own clothes posed no problem, and they all took good care of their things with no problems presented from lost or stolen articles. 

The contrast that is presented with Nellie Bly’s 10 Days in a Mad-House and the article written for the Science News Letter by Helen Buechl is startling. These articles are seventy years apart, and the treatment and philosophies are almost polar opposites. Bly describes a prison with both mental and physical torture devices, and women committed for things such as “enjoying reading too much”. We see senseless killing and brutal dehumanizing of these women, who are given no freedom what so ever. The patients were unable to read entirely, write, or do much of anything except sit in a cold room day in and day out. But just a mere seventy years later and a trip across the sea gives a completely different perspective when it comes to the patient’s treatment. They are treated like human beings who possess common knowledge and self awareness, and are given the opportunity to act along with social norms. This shows the impatience, neglect, and ignorance due to pure laziness that America has shown toward topics just like these, and after seventy years finally making the effort to seek out alternatives.

In the book by Anne Borsay, chapter one focuses on the mental health nursing in the 1800 to 1990’s. She begins by expressing that recently there have been researches that delve deeper into the history of the mental health system in order to gain more insight for future mental health care. She also states that there has been a gap in previous research that neglects to concentrate on the paid staff and the contributions they had. The staffing issues have been focused on the most, but also developed were insights on how throughout time, the caretakers have changed the way they talk and interact with the patients. There is mention of an early account of mental nursing written around the 1930’s that brings attention to the problem that many nurses working in mental hospitals had barely any legitimate nursing training. She focuses a lot on the struggle and tension that nurses in a mental hospital carried with them, and how often they are pinned as victims who were subject to over work and poor living conditions, and as oppressors of the patients. Although it is easy to paint the nurses as the criminals, the reality that they were being paid minimum wage with terrible hours and little to no supply is inevitable. 

In the book 10 days in a Mad-House, we see so much abuse of the patients due to the staff. We even may ask ourselves how these nurses and doctors can live with themselves after treating the patients like they are less then human. We also have to appreciate that some of the nurses and doctors maybe did truly believe that these women were insane, and where only trying to do the best with the resources they were given. Many of the nurses that Nellie Bly encounters makes it difficult to be optimistic about their intentions. The incessant mockery of the patient who was in an accident that made her believe that she was still 14 years old, and the pure lack of compassion and help to the women who were suffering from physical illnesses. Again some may argue this can not be blamed entirely on the nurses, because they were put in a position without proper training. 

This article recites the care of the mentally ill in the 1880’s to the 1980’s and the progression accomplished in terms humanization of the patients and advances in mental health. It reveals the shifts of patient population, burdens of responsibilities when it comes to the patients, and the role of psychiatry. The founding of the psychiatry specialty and the studies and information that it brought to the surface played a huge part in the changing of mental hospitals. Mental Hospitals tended to developed systems that made assumptions about the nature, etiology, and treatment of mental illness in general. At the time, many believed that knowledge was transmitted to the brain through sensory organs (eyes, ears, tongue, skin and nose) and would travel there directly without any intermittence from a nervous system, which would mean that the cause of mental inhibitions was due to problems involving the senses.  Many doctors invested in the curing of mental diseases believed that it could just simply be cured like any other ailment of the physical body. Because insanity was attributed to improper behavioral patterns associated with a deficient environment, the obvious first step would be to change the surroundings of the patient. Once placed in the hospital patients were often treated with tonics, cathartics, laxatives, and drugs which would often included narcotics to subdue violent behavior.

In 10 Days in a mad house, we see so much incompetence and lack of understanding when it comes to the condition of the mentally impaired. Nellie Bly was fed medicine every night along with the other patients. We can make the assumption that these pills weren’t tailored to the specific patients because many of the patients weren’t even given a diagnostic, just simply labeled as insane. From the article, we can decipher that these pills were most likely tonics, cathartics, or narcotics, probably administered in order so the patient would sleep through the night. Nellie Blye also witnessed the physical abuse of patients, which to the modern mind seems contradictory. Why would a mentally ill patient undergo physical treatment? From the article we can see that the doctors did actually think that by inflicting physical treatments they were curing the patient.

Although the treatment of mental patients in the 1800’s to 1900’s in the US was less then ideal, we do have to realize that lack of information and resources played a big part. It is still irrefutable that the basic human dignities of the patients were stripped from them, and that is something that our country should not soon forget. We should take this history of our nation and recognize it not as a flaw in our countries history, but as a learning process, and learn to acknowledge and mourn for those who were not as fortunate as the mentally impaired are today. There is no denying that the mental health care system today is astoundingly more accepting, as well as knowledgeable, which would only be expected. Looking at how far we have come as a nation and recognizing the progress we have made and the information we have learned in such a short time, gives the future of medicine both physical and mental, a very bright future. The brave and somewhat controversial findings of Nellie Bly not only shocked the people of the time into recognition of a real and present problem in the mental healthcare system, but also sparked the change that it needed so desparately.
