In Nellie Bly’s book, “Ten Days in a Mad-House,” she reports firsthand on the mistreatment of the mentally ill, particularly women, within asylums while visiting the Women’s Lunatic Asylum on Blackwell’s Island. This issue has been notably horrid throughout history. In the 19th century, innocent women were frequently committed to these mental institutions for ailments unrelated to mental health. In many instances, such as Elizabeth Packard’s, women were committed to asylums at the request of their husbands. Back then, men were viewed as the dominant partner in relationships. Upon arrival to the asylums, the patients had almost no say in their treatment and were often put to work like slaves. Residents were treated more like property and objects rather than people or patients. The treatment of mentally ill women was horrific, and the abuse they received while institutionalized did not help their unrelated sicknesses. Rather, the way the nurses and doctors treated these women resulted in them becoming even more ill. Even if an individual was sane upon entering the institution, this maltreatment often caused them to become mentally unstable, such as what occurred during Bly’s commitment. Nellie Bly, in “Ten Days in a Mad-House,” expresses that the mistreatment suffered by women in asylums during the 19th century which gave them little chance of becoming healthier and returning to their normal lives. This was a result of misdiagnoses by doctors, the inability to refute their diagnosis and treatment, and mandatory laborious chores. 

  The women committed to these institutions were not only mistreated, but were also often misdiagnosed and perceived as mentally unstable for erroneous reasons. The doctors had no regard for their well-being and simply wanted to pass patients through as mentally ill to make their jobs easier. Bly, a completely sane individual, was thought to be insane by the workers who examined her inside the facility. The treatment she received, particularly the ice cold bath she was forced to take, made her peculiarly burst into an uncontrollable montage of laughter (Bly 287). This was interpreted by the nurses to be the behavior of someone who is mentally unstable. Instead, this laughter was a reaction to the corrupt mistreatment the patients were receiving. Mary Ann Jimenez, in her article "Gender and Psychiatry: Psychiatric Conceptions of Mental Disorders in Women, 1960-1994," explains that during the 19th century, doctors sometimes diagnosed women to be insane for something as simple as hysteria (157). The term hysteria was later replaced by the term “borderline personality disorder” (Jimenez 157).  Jimenez explains that “borderline personality disorder is used as a diagnosis far more often for women than for men” (161). Women were diagnosed with insanity for almost any behavior men viewed to be out of the norm. Doctors diagnosed women as mentally ill more often than men, and even being very emotional was considered to be unstable. Bly, along with numerous women, was incorrectly diagnosed in the 19th century because of doctors’ views toward women’s natural behaviors. The majority of women who were diagnosed as mentally ill in the 19th century exhibited behaviors that, in today’s society, are viewed as completely normal.

Many of the women committed to these facilities were confined unjustly and did not truly need mental help, but unfortunately, they did not have the right to fight against their imprisonment. The women residing at the same institution as Bly had a very slim chance of proving their sanity. One individual whom Bly encountered did not speak English and therefore, was not able to dispute her insanity. Bly explains, “thus was Mrs. Louise Schanz consigned to the asylum without a chance of making herself understood” and continues by stating, “but here was a woman taken without her own consent from the free world to an asylum and there given no chance to prove her sanity” (283). The doctor who examined Schanz deemed her mentally ill because he simply could not understand her, and there was nothing she could do to avoid being institutionalized. The language barrier between the two was the determining factor for her diagnosis, which had absolutely nothing to do with mental health. She was going to have to suffer confinement due to a false diagnosis. In their article “Elizabeth Packard: Nineteenth-Century Crusader for the Rights of Mental Patients,” Myra Samuels Himelhoch and Arthur Shaffer reveal that patients were not allowed to challenge their alleged abusers due to the fact that “there could be no motive for misdiagnosis, mistreatment, or unjust detention” (345). Women had no power to rebel against the doctors’ diagnoses. Whatever the doctors determined was final. The laws at this time made it nearly impossible for a patient to question their diagnosis of mental illness, and the doctors refused to listen to any objections that they had while trying to fight for their freedom. This is a representation of the very few rights the patients possessed upon entering the asylum. 

Women in mental institutions throughout the 19th century were forced to maintain the facilities in which they were constrained to live, from scrubbing the floors to cleaning the nurses’ bedrooms.  Nellie Bly’s experience of the abuse and mistreatment of the mentally ill closely paralleled the maltreatment Elizabeth Packard underwent, including the forceful maintenance of the institutions. Patients being detained at both asylums were assigned chores that typically should have been done by the attendants. Whether it was cleaning their own rooms or common areas, the women were expected and forced to keep everything tidy. Bly described that the women in her ward “were ordered to make the beds, and some of the patients were put to scrubbing and others given different duties which covered all the work in the hall” (290). Similarly, Packard reported she personally cleaned the Eighth Ward until it “became a model of cleanliness” (Himelhoch 354). These patients, who already had minimal rights, were now made to clean these heinous institutions against their will. Upon entering the asylum, Bly was under the assumption that the hired workers kept up with the cleanliness of the facility. She soon discovered that was not the case. She reveals that “it is not the attendants who keep the institution so nice for the poor patients, as I had always thought, but the patients, who do it all themselves-even to cleaning the nurse’s bedrooms and caring for their clothing” (Bly 290). If the patients did not complete these chores, then they would ultimately end up living in squalid wards, such as the ones described by Himelhoch and Shaffer. Himelhoch and Shaffer note that some of the institutions were so filthy that “the odor emanating from these premises was nauseating, and clung to the occupants even when they were outdoors” (354). The conditions in which these patients were held were not livable, and there was nothing they could do to change their situation. The asylums emitted such foul odors that the women would continue to smell them even when they went outside for a break. They were viewed as slaves and endured hard labor on a daily basis. These institutions did not aid those who truly needed their help and by forcing the patients to complete these filthy tasks, made their lives horrible. 

The maltreatment of mentally ill patients, especially women, was despicable throughout the 19th century. Female patients being held in mental institutions had minimal rights and were viewed as less than human, simply because they were incorrectly thought to be mentally ill. The nurses and doctors possessed similar characteristics to those of dictators. Many of the patients were not mentally ill at all, but because of the doctors’ misdiagnoses and disregard for the patients’ wellbeing, they were confined to these heinous places. Once the doctors or psychiatrists deemed the women to be insane, there was nothing they could do to fight for their freedom. Many of them were institutionalized unjustly. The women were forced to clean not only their own rooms, but also the rooms of those superior to them, such as the nurses and doctors.  They were slaves of those employed by the asylums. Women thought to have mental health issues during the 19th century were treated horribly, which lead to them to becoming even more ill. Nellie Bly exposes this in “Ten Days in a Mad-House” through the revelation of doctors’ misdiagnoses, women’s suppression and lack of rights to fight for their freedom, and their endurance of forceful chores and labor. These issues resulted in the need for major changes regarding the treatment of patients in asylums subsequent to the 19th century.
