In her book Ten Days in a Mad House, published in 1887, Nellie Bly gives a chilling account of what it is like to spend ten days in a New York asylum and exposes the deplorable living conditions and brutality that were the norm for asylums during the 19th century. Negligent admittance procedures, mistreatment of patients by personnel, and horrible living conditions are a few of the countless injustices Nellie Bly experiences while in the mental health facility. Over twenty years later, Professor Tamburini authors a plan for asylum reform that would potentially be able to resolve many of the issues Bly faced while in the mad house. The ongoing struggle for quality mental healthcare continued throughout the 20th century with writers, such as Frances Rommal and Wendy Stevens, advocating for women just as Bly did in her day. Bly’s courageous acceptance of an undercover assignment led to public enlightenment and outrage and inspired writers such as Professor Tamburini and others to call for reformation of legal rights, care, and treatment to assist the mentally ill. 

The admittance process was one of the most deeply flawed aspects of the mental health care system. Nellie Bly recounts the negligence she witnesses during admittance. Patients were admitted with out just cause especially women and foreigners. Bly talks about witnessing a woman name Miss Mayard who gave a very rational explanation for not being admitted to the doctor because she had just been going through a rough patch recently. Bly recounts “She begged that they try all their tests for her insanity, if they had any and give her justice.” (282) The doctor never gave her any of these tests and signed off on her admittance without just cause. Another heart- wrenching example of Bly witnesses is a German woman, Mrs. Schanz, who could not speak English. The doctor did not take the time to find a proper translator so Mrs. Schanz was not given a chance to argue her case for being there, nor could anyone tell her why she was there. These shocking accounts of blatant negligence would influence people like Tamburini to call for change in the system. Tamburini describes how patients should ideally be admitted in Tamburini on Individual Liberty. He starts by saying that “great care should be taken that individual liberty is not taken away lightly.” (597) This clearly was not the case for Miss Mayard and Mrs. Schanz. Reading how they were stripped away of their freedoms with little to no thought caused him to think of ways to prevent this loss of individual freedom without due cause. Tamburini then goes on to lay out a plan for admittance into an asylum to go through a court system. With his plan, there are different levels of the court that would have to approve the admittance of a patient. Bly makes a point that a criminal has ample opportunities to prove their innocence but an insane woman gets none. She goes on to say “Who would not rather be a murderer and take the chance for life than be declared insane, without hope of escape?” (Bly 283) Going through the many court system levels, Tamburini lays out what would insure that sane and insane individuals would not end up stripped of their individual liberties with out a chance to argue for their freedom in contrast to the experience of the women Bly encounters.

Another problem Bly and many others in the asylum face is mistreatment by personnel. Bly tells the story of Urena who was born with a mental disability and was the target of the nurses sick humor. One day, the nurses provoked her to the point that she could not stop sobbing so they “pounced upon her and slapped her face and knocked her head in a lively fashion. This made the poor creature cry the more, so they chocked her.” (Bly 297) Another instance she recounts is a nurse targeting an old woman named Mrs. O’Keefe. “She caught the woman by her gray hair and dragged her shrieking and pleading from the room, she was also taken to the closet, and her cries grew louder and louder and then they ceased.” (Bly 297) The telling of these victim’s stories by Bly brought attention to the fact that this kind of treatment should be illegal and have consequences. Tamburini includes in his legal outline that “treatment should be humane, and whipping be absolutely prohibited.” (598) By recounting the inhumane treatment she witnesses, Tamburini and other like-minded individuals were compelled to help the helpless victims of abuse in mental institutions. 

Bly not only inspired writers in the early 1900s to take legal action but she continues to motivate future generations of women to help other women. Taking Control: Feminist Alternatives to Mental Institutions was written in the 1970s. It begins by the authors saying that they have watched feminist sisters being committed to institutions. They say it is especially hard as feminist to see these women committed, “That was not an easy task for women who have a strong commitment to other women.” (Rommal 10) They did not want to let the women be committed but they felt they had no other options, “At the time there were no other alternatives. Nothing to do but submit a close friend to an institution which is known for brutal treatment and lack of recognition of a woman’s situation.” (Rommal 10) After reading a piece like Ten Days in a Mad House that exposed the brutally that women face while in mental institutions, it is not surprising they were uneasy about seeing their friends go to a facility. Rommal and Stevens write that they want to establish a farm that would be a safe haven for women with mental illness as an alternative to the traditional mental health facility. “She sees the farm as a place where any woman can go rather she could afford to pay or not.” (Rommal 11) 

The deeply flawed system of caring for the mentally ill was clearly in need of drastic reformation in the 19th century and Nellie Bly was willing to take on the challenge to bring about change.  By bravely going undercover, she was able to give a first hand account of what the patients in the asylum were facing. She was able to draw her fellow and future reformers’ attention to problems such as negligence in the admitting process, mistreatment of patients by personnel, and substandard living conditions. Her accounts of the experience lit a fire in future writers, such as Professor Tamburini, to call for a drastic reformation of mental health care facilities and overall improvement in the care of the mentally ill for generations to come.
