The mentally ill or mentally unstable is a class of society that are extremely misunderstood and taken advantage of. Before even being given a chance, they are thrown into these structures where inside, they are driven madder than they were to begin with. It is important to note that with a lot of cases, the treatment was extremely immoral and unfair. Often times, individuals would leave these institutions more mentally insane and unstable than they started, or sometimes, they would not be leaving at all. Nellie Bly describes her experience in the insane asylum in her journal, “Ten Days in a Madhouse,” to create public awareness and concern to how unjust the treatment of these individuals was. The article “Founding Friends: Families, Staff, and Patients at the Friends Asylum in Early Nineteenth-Century Philadelphia,” written by Gerald N. Grob, focuses in on the moral treatment of individuals living inside insane asylums in the late 19th century. Danielle Terbenche writes her article to share the research she found regarding the treatment of the patients in her article, “Benefits of Patient Treatment at the Asylum for the Insane.” In all three sources, the authors claims that these individuals were treated as if they were not humans, and it was important that Nellie Bly made it a point to bring this issue to the public’s attention. As argued by Nellie Bly in her text; “Ten Days in a Madhouse,” patients left 19th century insane asylums were more mentally unstable than they were when they were first admitted due to the unfair, unsettling conditions and treatment, which had detrimental effects on these individuals mental health.   

By providing historical background to this journal through different outside sources, it creates an allusion for readers to be able to fully envision the treatment of those admitted. From the actual process of being admitted, to the treatment of the patients, as well as the conditions that they were living in, it is clear that insane asylums were not fit to care for those with mental health issues. 

19th century insane asylums are among the most well-known historical structures. This is because of the horror stories people hear from what went on inside these buildings. People that were locked in insane asylums dealt with severe mental and physical abuse. They were driven more insane each day that they spent inside. With an understanding of the history of the way that these individuals are treated, readers can see what those placed in mental facilities must go through, and specifically, what Bly had to go through. They had almost no power as; “…families continued to play an important role. They decided when it was necessary to send a distressed relative to the Asylum, and its members negotiated with the staff over their care and treatment.” (Grob 406). Due to this, a lot of individuals that were not actually that insane, were forced to live in these institutions. Once inside, they were treated like animals, as the doctors and nurses had no regard for their well-being and instead only cared about curing the patients. This went on for years before there was any public knowledge of what was actually going on inside. Nellie Bly’s journal was among the first texts to publicize insane asylums in the 19th century. 

One of the major issues with 19th century insane asylums was the process of being admitted into the institution. There was no real structure or proof that the person who was placed inside was actually “mentally insane.” As Bly communicates with individuals locked in the asylum, she learns that a lot of patients were not actually insane. She asks patient Tillie Mayard; “Are you crazy?” to which Mayard replies “No…but as we have been sent here we will have to be quiet until we find means of escape. They will be few, though, if all the doctors, as Dr. Field, refuses to listen to me or give me a chance to prove my sanity” (Bly 281). Cases like this were extremely common because as said prior, there were no real standards to be met that proved insanity. It is unfortunate that a lot of the say of whether an individual should be admitted was by close family, who had no real knowledge of what is was to be insane. As soon as this controversy was brought about, research was conducted to see if they were over-committing people into these asylums. What they found was that; “avoiding revisionist images of helpless populations of custodial patients, these historians identified the powers of families and patients to initiate committal, influence treatment and act as agents in the implementation of asylum policies” (Terbenche 30). Due to this, it is very probable that a lot of patients were never actually insane, and instead were just driven to be that way due to the neglect and the brainwashing. 

Nurses and doctors mistreated patients constantly. People of the outside public heard stories and now, almost 200 years later, horror movies are being made about asylums because the treatment was just that cruel and absurd. While inside the asylum, Bly herself experienced extremely inhumane treatment, treatment that would drive any normal person insane. Patients were hit, locked in dark rooms, and given no say on anything. This behavior would definitely take a mental and psychological toll on any mentally unstable or normal person. As Bly lived through it and experienced it, she could see just how often this was occurring. 

Almost every aspect of the insane asylums was cruel. Just by walking into the building, one could see how unsetting the rooms were. Bly was extremely disturbed by the set-up of the asylum as she describes; “Barred windows, built about five feet from the floor, faced the two double doors which led into the hall” (Bly 284). By forcing individuals to stare at blank walls and sleep on rock hard beds, this created a constant state of being uncomfortable. 

Nurses, doctors, and caretakers working inside of these asylums struggled to balance between providing a morally correct and ethical treatment with finding a cure to their mental disorders (Grob 406). In the end, they failed to do this because all that was of true concern was to find a way to rid the patients of their mental diseases. They believed that their unrealistic treatments and exercises with the mentally ill would be successful. Yet, it proved to do the exact opposite. Those that were deemed mentally ill were driven even more crazy the longer they stayed in these asylums. Instead of dealing with each patient individually, and taking into consideration each person’s needs, they grouped everyone together and intended to treat them as a whole, rather than reaching out to each patient; “equally significant, the distinction between care and cure, while admittedly gendered, may in fact be artificial” because cure was the first priority (Grob, 406).  Even when they were aware that this was not always an attainable and realistic goal, this was still the basic structure of most insane asylums in the late 19th century. 

One of the most important aspects to the treatment of these people, was discipline. Rather than the well-being and the true passionate care for these individuals, the most important thing to the workers was an extremely structured and obedient environment. Due to this, nothing was done except compromising the well-being of those confined within the walls of the institution. A study was conducted to see if the way that doctors and nurses are treating the mentally ill is not just beneficial, but successful as well. According to these studies, in almost all of the cases, it can be assumed that a lot of the patients left the insane asylums crazier than they were when they were admitted as; “this paper studies a selected group of 240 women admitted to the Asylum for the Insane in Kingston, ON, between 1878 and 1884, examining the asylum's treatment program during the late nineteenth century and its influence on the outcomes of committal” (Terbenche 29). By doing this study, the public was able to see into insane asylums and visualize just how cruel the treatment was. The effect of this treatment is what caused such insanity in those admitted.

Bly’s journal sparked extreme controversy, as it was the first in depth criticism of the governments take on mental health that opened the eyes of the public. It could be deemed a historical turning point for mental health nationwide. Between the treatment, setup, and standards of these asylums, all three authors agree that insane asylums were extremely unfair and immoral. With a basic understanding of what went on inside these insane asylums, this will help the reader fully visualize what Bly was talking about and had to go through in her text, “Ten Days in a Madhouse.” It is very clear that placing a person, sane or insane, into an asylum has detrimental psychological effects on the brain and essentially, will not help their mental stability, or well-being.   
