
When comparing the knowledge of the 19th century psychiatric community regarding mental illness to present day psychiatrists, it is made apparent that the 19th century knowledge is elementary at best. Most people in the 19th century were also uneducated on the matter because information was not easily available to them. Because of the lack of knowledge regarding mental illness amongst most people at this time, there was a stigma associated with mental hospitals, the patients in these hospitals, and the patients’ family members. The lack of knowledge amongst the professional community and the public, paired with the social stigma related to mental illness prompted the unethical admittance of people, women in particular, into mental asylums. Once these women were admitted, next to nothing was known about their mental state, or the conditions of which they were held in. Because very little information was available to the public regarding the practices within mental institutions, a curious reporter named Nellie Bly got herself admitted into the Women’s Lunatic Asylum on Blackwell’s Island. Bly successfully feigned insanity, with a goal of exposing the truths behind the walls of mental hospitals in 19th century America. For ten days, Bly lived and was treated as if she were mentally ill, and when released she hoped to have uncovered enough information in order to bring about a positive change in the way the mentally ill were treated. 

Not much was investigated concerning mental illness in the medical community. Most doctors simply assumed that their peers were correct and used the same practices to ‘fix’ these women. As  “hysteria, [was] the most commonly diagnosed ‘female malady’ of the 18th and 19th century” (Ussher 63), it was the main reason for women being admitted into these mental institutions. During this time period, women still had very little respect in the professional world, and women who acted out of the social norms for this time were seen as ill, or hysterical. “The 19th century physicians were highly critical of this feminine ‘state’ describing women as difficult, [and] narcissistic” (Ussher 63). This quote explains the thought process behind doctor claiming that women were suffering from hysteria. Women were inferior and meant to be submissive during the 19th century, and those who were independent were seen as narcissistic. With a lack of research and concrete knowledge about hysteria, it essentially left doctors with free reign to diagnose anyone they saw fit with this mystery illness, hysteria. Without a known cause of the disorder, doctors began to associate all of a women’s problems as an aspect of hysteria. “Women diagnosed with hysteria could exhibit symptoms of depression, rage, nervousness, the tendency to tears and chronic tiredness, eating disorders, speech disturbances, paralysis, palsies, and limps, or complain of disabling pain” (Ussher 64). This long list of conditions supports the idea that doctors did not know much, and as a supplement for their lack of knowledge, they related just about anything they could think of to hysteria. 

In addition, the treatment these women received was not often based on their physical conditions, but rather had “as much or more emphasis on the patient’s moral and spiritual development and character rehabilitation” (Luchins 586-587). The fact that there was a heavy focus on moral and spiritual rehabilitation provides evidence to the idea that the doctors were less concerned with the physical well-being of the patients, but more on making them into the women they saw as ‘normal’. 

Despite Nellie Bly not truly being insane, it was not much of a difficult task for her to get admitted into the Women’s Lunatic Asylum. It did not take a lot of effort on Bly’s part for people to be convinced that she was suffering from insanity, as in the 19th century, “it was always considered to be a ‘woman’s disease’, a disorder linked to the essence of femininity itself” (Ussher 63). Because there was very little that a woman could do besides succumbing to the societal norms, it was very difficult to be released once admitted to a mental institution.  In “Ten Days in a Mad-House”, when Bly is waiting to be examined with the other women, she speaks to a woman named Miss Tillie Mayard. She asks Mayard if she is crazy, and when Mayard replies, she tells Bly that she is not crazy, “but as we have been sent here we will have to be quiet until we find some means of escape” (Bly 281). Mayard continues by saying that the doctors will likely “refuse to listen to me or give me a chance to prove my sanity” (Bly 281). After Bly and Mayard’s discussion, Mayard was given a chance to explain herself to the doctors and show her mental sanity.  Bly described her attempt to prove her sanity as  “rational as any I ever heard” (Bly 282). Despite Mayard’s pleas, she was promptly escorted back to her seat, along with the other “insane” women. After Miss Mayard was returned to her seat, Mrs. Louise Schanz was also given an opportunity to express her sanity. Mrs. Schanz could not speak or understand English, and after Dr. Kinier realized this he asked Miss Grupe, a nurse who spoke German, Schanz’s native language, to translate for him. Miss Grupe then refused to translate, claiming she “could understand but few words of her mother tongue” (Bly 282). Unable to communicate with the doctor, Mrs. Schanz was not given a chance to prove herself sane.  These are two strong examples of how unjust the system was, as one, a woman who could communicate clearly was still sentenced to the asylum despite her sane pleas, and two, a woman who was not given a chance was simply admitted without cause.

Beyond the professional community’s lack of knowledge and research regarding mental illness, the general public knew nothing more than what was made available to them by the doctors themselves. Because “at that time [there was] no sharp delineation or differentiation between social and medical thought” (Luchins 590), there was no reason for the public to question medical professionals who had much more education than most people. In addition, because it was mostly women being accused of insanity, and it was these women who protested against the doctors, making themselves appear more mentally unstable, very few people spoke out against the doctors and their practices. With this freedom from criticism, doctors saw no reason to change their inhumane treatments or diagnoses. 

In the 19th century, mental hospitals were very frowned upon, as “the home, not the hospital, was commonly regarded by laymen and physicians as the proper place to care for the sick” (Luchins 587). It was a common trend for the poor and people without families to be treated in mental hospitals, so, because of the negative stigma associated with mental asylums, mostly single women and immigrants were treated in them, as they had no family and were most likely financially unstable. Because of this, entry, amongst most people, was avoided to preserve social status. Anyone who could possibly afford a home to be treated in or a private physician kept away from mental institutions “because [they] stigmatized them and their families” (Luchins 587). Because most people were more concerned with their societal status rather than the mental stability of any family members, many people kept it as a secret, as mental illness was considered to be an embarrassment, not reflecting well upon the family. This stigma explains why very little was know about the practices inside of mental hospitals because those who did have family rarely saw them once inside, because no family members were willing to visit such a place. While there were rumors spread about the torturous treatments patients were subjected to, Nellie Bly was the first truly sane person to be admitted and later released. During her admittance she was able to gain awareness of the maltreatment firsthand to later publish a story about her experiences. 

In the 19th century, as proven by Nellie Bly, there were a vast number of severe issues within the psychiatric community. In an attempt to see the inside of a mental institution from the point of view of a patient, Nellie Bly successfully feigned insanity and gained admittance into the Women’s Lunatic Asylum. Due to a lack of research on mental illness, the extremely uneducated psychiatric community falsely diagnosed many women, giving false hope of mental health  to them as well as their potential families. These women were imprisoned without cause, given no real opportunity to prove their own sanity, and treated like criminals. With the ignorance of the medical community on her side, Bly infiltrated the Women’s Lunatic Asylum, and was able to escape and unveil the harsh truth about the unjust medical practices within mental institutions across the country in the 19th century.
