The mental health system in America during the late 1800s and the early 1900s was far from perfect. The issues ranged from over admittance to unhealthy living conditions within the asylums. The book Ten days in a mad house was written by Nellie Bly who admitted herself to an insane asylum in order to uncover all of the injustices that were occurring within. She stayed there for ten days and documented her experiences once she was released. She goes into detail about all the things that the asylum did wrong or didn’t do right.  This book is great at showing what the main problems of the mental health care system were, it is important to see how far America’s mental health system has come to make sure it doesn’t happen again.   “Ten days in a madhouse” accurately portrayed, over and wrongful admittance, lack of proper sanitation and safety within the asylums, as well as the total corruption of the asylums. 

Within the book “Ten days in a madhouse” the author discusses how many people that were in the mad house didn’t seem to belong there. She points out how some of the patients couldn’t even speak English. She gives one example of a German woman who didn’t understand any English. The doctors weren’t able to tell if she was insane since they couldn’t communicate with each other but they still had her admitted to the hospital instead of trying to find someone who could speak to her (Bly).  In the 1880’s the rate of admission to asylums like the one that Bly visited were “99.5%”. This means that out of 1,000 people that would go to see doctors about mental issues only 5 of them would not be admitted into an asylum. This number is an extreme contrast to the percentage of people who were admitted in the 1970’s, which was only 27% admitted into any type of asylums (Grob).  The amount of people that were being put into these institutions was so rampant that by 1900, “27.8 percent of the nation’s total patient population had been institutionalized for twelve months or less”, according to Grob’s study (7). This number is astounding given the fact that the population of the united states was 76,212,168 (By County) in 1900. With 27.8% of those people have being put in an asylum that means that over 22,000,000 people were put into mental intuitions in 1900. There was also a problem with the elderly people in the communities being put into these places. Grob stated, “Communities were more than happy to transfer responsibility for their aged residents to state-supported facilities” (6). This ease at which people were able to give their elderly up to asylums largely contributed to the over population in the asylums, specifically the government funded ones.  These figures show that the problem of over admittance that is being described in “Ten days in a Madhouse” truly was an extreme issue considering how large of a portion of the population was put into an asylum.    

Another large issue that Bly discussed was the lack of sanitation and the safety within the asylum for the patients. She describes multiple issues that she encounters first hand. For example, she says that there were only a few towels that all of the woman were expected to share, along with only one brush that they all had to take turned using. She also discussed some of the safety issues like the fire safety. Bly said that she was afraid if there was a fire that they would not make it out since all of the doors would have to be unlocked one at a time and it would take too long (Bly). The state of the mental institutions in the united states was at an all-time low. The state of the asylums was decaying along with those inside of them. The employees disregarded all of the patients’ basic needs which lead them to be in abysmal conditions. They would often times not bath or even be able to wash or change clothes for months at a time. This would lead to the spread of disease throughout the asylum. They also had to share toiletry items which contributed to even more disease spread, and the nurses and doctors would, instead of helping, would say they were faking their illnesses (Sutton). Bly’s concerns for fire safety are also touch on by Sutton when he talks about how the employees didn’t seem to care. If the nurses and doctors didn’t care enough to give them medicine or viable living conditions, then it is extremely likely that in the case of a fire they would worry about getting themselves out way before they thought about going around to every single room to unlock it before they ran to safety.

In “Ten days in a Madhouse” Bly also discusses how there seemed to be some type of ulterior motives that the doctors where going by other than trying to help the patients as best they could. In her book she describes horrible things that were done to her and the other woman in the asylum like being beaten, but there are not many cases of her talking about how the doctors are doing an amazing job helping these people with their problems. Grob talks in his essay about how some asylums would only take in more patients to get money. Since the government gave out money to the institutions based on how many patients they had, more specifically how many patients with insufficient funds, the doctors and other staff would go out of their way to gain more patients. Then once they had they them didn’t have to actually treat them, but they still got more money (6). This loop hole made the asylums start to gain more patients just for the rise in government funding but it didn’t encourage them to do anything more for the patients’ health. In order to keep the patients for as long as they could the asylums started to classify whether or not someone could be cured or not based on their diagnosis. During the late 1800’s of the classified diagnoses, “Only 435 were identified as curable, as compared with 2,018 as incurable” (Grub). Since they made so many of these patients “incurable” they were able to keep them for lie and therefor were able to keep getting the amount of money that they wanted. When they were allowed to do this and keep patients their whole life they were able to accumulate much larger populations in their asylums so they gained much more funding from the government. Although instead of using this money to better the conditions of the asylum for the patients it was used to better the lives of the patients.  The people running the asylums went out of their ways in order to find cheaper ways to treat different patients. This made it so the people running the asylums were able to keep more of the money from the government (Grob). They also found a way to take money from the patient’s families as well. Grob describes how they did this in his article by saying “Families with sufficient resources could commit their relatives to state institutions, provided the families were willing to assume financial liability”(5). This meaning that any family that had money would have to pay for their loved ones to be put in asylums.   This corruption is similar to what Bly was seeing in her time in an asylum. She saw that the people running the asylum weren’t trying as hard as they could to help the patients get better. Bly’s time in the institution was similar to what most people in institutions at that time saw. 

The accounts of Bly in “Ten Days in a Madhouse” seem to be what the normally experience was like for anyone who was unfortunate enough to be admitted into a mental hospital in the late 19th century. There are many more accounts of other people that were stuck in the same type of abysmal conditions. Through accounts like Bly’s the world was able to see            the Issues there were in the mental health system. When she published her account it made          it so that the public could see that there needed to be change. The mental health system that was in place was not one that benefited the patients, from the inconsistence diagnosis and over admittance into these institutions, to the horrible conditions once inside them, as well as how they exploit the patients’ illness without any thought to their health. 
