During the nineteenth century, mental health and mental institutions were dissatisfactory and newly introduced in America. A majority of the mental institutions were unsanitary, in poor condition, and didn’t provide proper care. The institutions were torture instead of therapeutic for the patients, causing some to slip further down into insanity. Author Nelly Bly conveys this in her piece, “Ten Days in a Mad-House,” by putting herself inside of a mental institution and faking insanity to show the corruptness of the American mental institutions. Nelly Bly was a writer in the nineteenth century who was held back in her writing career because she was a female. To break free of this barrier she had to produce something that no one else would ever imagine to do. For her it was to fake insanity and be placed into an insane asylum. By doing so she created a first-person view of the mental institution and the corrupt nature of it.  Her first-hand view provides a new insight on the torture the women in these institutions face.  

During the nineteenth century, many asylums were looking to develop and reform, which   was also Nelly Bly’s goal. She wanted to improve the quality of life for the patients who would be forced to live in the conditions for much longer. Bly wrote that “two months would make her a mental and physical wreck” (Bly 297). This was indeed happened to numerous patients that surrounded her. Being starved and beaten by the nurses surely did some physical harm to their bodies as well as to their mental health. She saw the filth of the rooms and conditions of the asylum. Not only was sanitation an issue, but there was no heat and some of the patients were freezing and had almost no help when they asked for more blankets or coats. The goal of the reform was to improve all of it and to better the treatment options and how they selected the patients. This was not only an issue at the asylum that Bly was at but others as well. However, there were few that excelled and had no issues other than being bombarded with chronic cases rather than short term. Peter Tyor discussed how the older generation was replaced by a “nascent group of professional administrators” they were bringing in “the most troublesome cases” (Tyor 24). This could have been the cause of overcrowding within the asylums. With more and more patients being brought in that had to stay longer to improve, the less space there was available for other patients. They were soon forced to take theses troublesome cases and were no longer able to treat like they needed to. In doing so the patients were no longer receiving the necessary treatments to improve and were forced to stay. 

While inside of the asylum Bly experienced the abuse and torture of the patients. In Bly’s piece the reader can see that patients were assessed based off qualities irrelevant to mental health as well as treatments that were unnecessary for them. When Bly went to speak to the so-called expert, she was given a basic exam of her height, weight, age, and her eye color. When the nurse was asked to measure her she said, “Now you know I can’t tell” and “I don’t know there are some figures there, but I can’t tell” showing how poor the training was (Bly 283). She was unable to read the numbers shown although this is most likely what she does repetitively throughout the day. From just the basic physical information and from observing her he concluded that she was indeed insane. No other tests or examinations were done. They also used a form of water treatment on Bly, where they placed her into a cold tub to attempt to cure her insanity, which did not exist in the first place. Many mental institutions used water therapy for treatment of the insane as well as the one Bly was in. They were meant to be therapeutic by shocking the body and relieving any pain. However, many asylums would instead use it as a form of discipline. Leonard Smith explains that it was used to “punish inappropriate behavior, or to deter be inducing fear of the unpleasant consequences” (Smith 203). Many would force patients in regardless of what they needed for treatment and would do so consecutively. For some of the patients it would drive them further into insanity rather than helping to improve their mental health. In Bly’s case, they were forced to take cold baths, and when they complained there was nothing that would be done about it. Many of the institutions in America were failing to give adequate treatments. Joseph Morrissey stated that “American psychiatrists had come under attack from their British counterparts” (Morrissey 18). British asylums were far more advanced than the American asylums. They had training that kept them from giving incorrect care and harming any of the patients by admitting them into the institution without proper tests. British institutions were more advanced in evaluating patients while the American institutions were new to the world of mental institutions during the nineteenth century and needed help improving from outside the United States.  

With Bly’s piece being from the first-hand, we know that it is very true to the asylum she went into. Bly’s piece is also relevant for other asylums as well because there is evidence of poor treatment and cleanliness at other asylums during the era. The same water therapy treatments were used all over the world by institutions and even though they were meant to improve conditions they were often twisted to harm the patients instead. Bly played a great role in reforming the institutions. While it wasn’t solely Bly’s work that revolutionized institutions, her contributions were a tremendous help in changing the way that they function. 
