The stigma surrounding mental health has existed for centuries in American Society. Although research and understanding has further developed in today’s world, the principal causes of mental illness were widely misunderstood in the previous eras. Many people believed mental illness was not an illness at all, in fact, and was actually the acquiring result of supernatural forces and in turn, treated those suffering like “dangerous beasts” (Williams 394).  This misrepresentation helped to breed inhumane treatment tactics and unfair representation of the mentally ill in insane asylums towards the late 1800’s, even though the understanding of mental illness was improving. Bly discusses this in her firsthand account, “Ten Days in a Mad-House” in which she paints a vivid picture of the hell she faced during her stay at the Blackwell’s Island Insane Asylum, in New York. These “unsatisfactory conditions” were depicted from the perspective of another country in the British Medical Journal while the North American Review and Inquiries Journal gave context as to the historic background along with realms of treatment for those suffering in America. Overall, Bly’s account substantiates the poor conditions of insane asylums, and the unfair treatment of women struggling with mental illness in these facilities in the late 1800’s in America only further exacerbated the condition of patients, rather than rehabilitating and returning them into society.

The conditions found in insane asylums in America were horrific and resulted in further deterioration of their patients. The first problem Bly recognized during her stay on Blackwell’s Island was the large amount of overcrowding in the institution in which Bly states, “These benches… would hold five people, although in almost every instance six were crowded on them,” emphasizing the lack of space (284). The limited amount of space was a common issue in many asylums around the world. A similar occurrence was found in an asylum in New York City in which there were 6,000 insane patients, yet the normal capacity of the institution they were being held in was 4,000 inhabitants (Williams 398). This was due to the “lamentably deficient [number] of resources” in which nearly all facilities did not have the adequate funding to provide comfortable living quarters for their patients (The British Medical Journal 20). In addition, Bly recognized the asylums inability to provide wholesome meals, stating, “It is impossible for me to eat that stuff” (286). The asylum regarded watered-down tea, prunes, and moldy bread as supper because that was all that was available to serve. Foerschner states that, “little attention was paid to the quality of the food or whether or not the patients were adequately fed” (3). Many institutions also faced the issue of intolerable, cold, temperatures inside the facilities as well as an absence of hot water during bathing times. This was a prominent theme in Bly’s account in which she actively describes the water as ice-cold in which she explains, “My teeth chattered and my limbs were goose-fleshed and blue with cold,” regarding that, “For once I [Bly] did look insane” (287). Using straw to cover a cold floor to help with the temperature was an accurate portrayal of a typical scene in an asylum in America from the 1500’s to the early 1900’s because it was known to aid in walking and sleeping on the freezing floors (Foerschner 3). The reason conditions fall so short of appropriate is because of the lack of funds available for mental health institutions. In New York City, an average of $2.80 was spent per patient per day for living costs when the average cost should have been $5.00 per patient per day to provide the proper care in which “nothing more need be said as to how the insane dependents of New York city are clothed and fed and attended” (Williams 399). Bly supported this asserting that the poor conditions did not aid any of the patients in their recovery, and only further worsened their condition.

Those in mental asylums in the late 1800’s were mistreated immensely while they stayed at the facility, which resulted in the patients becoming sicker and weaker. This came in the form of misrepresentation, along with inadequate treatment plans. Bly noted that being regarded as insane was a prison sentence during this time period in which she explains, “Pronounced insane by four expert doctors and shut up behind unmerciful bolts and bars of a madhouse!” (281). Once that diagnosis is received, an individual loses all chance to prove their sanity yet “Compare this with a criminal, who is given every chance to prove his innocence” (283).  The issue with this idea is that the goals of asylums were not to heal their patients and help them cope with their illness. Foerschner explains, “asylums were merely reformed penal institutions where the mentally ill were abandoned by relatives or sentenced by the law and faced a life of inhumane treatment, all for the sake of lifting the burden off of ashamed families and preventing any possible disturbance in the community” (3). The mistreatment of mentally ill patients was expected in asylums and was therefore condoned by those who were supposed to support the inhabitants. The doctors and nurses at these facilities were consumed with ignorance about mental disease and did not have the knowledge to properly create individualized treatment plans for their patients. This stems from early centuries of the idea that the mentally ill were a result of sin and therefore were thrust and chained into dungeons, scourged with whips and clubs, or simply burned to death during the witchcraft era (Williams 394). In the middle ages, “aside from secular exorcisms, prayers, charms, amulets, and other mystical treatments were available” (Foerschner 3). Although it was no longer believed that the mentally sick spawned from the devil, there was still a lack of understanding in how to treat mental illness during the late 1800’s. During this time, it was regarded that mental illness was a woman’s disease which further prevented those who struggled in these facilities from ever being taken seriously when discussing their condition. When Bly tried to explain that she was not ill, “He [the doctor] took no notice of my [Bly’s] remarks” (284). The treatment plan of those who resided on Blackwell’s Island consisted of nothing more than a daily routine and occasional medication to help sedate the patients. In other facilities, use of mechanical restraint was used during the treatment process (The British Medical Journal 20) along with iron cuffs and collars (Foerschner 3). Foerschner clarifies, “Very little treatment was offered to help patients with their mental illnesses with the exception of minimal occupational therapy and agricultural work as well as the administration of sedatives to keep patients calm and under control”, and those options were best case scenarios for patients for the time period (4). This was noted as, “a practice that was likely more beneficial to the staff than the afflicted” (Foerschner 4). This lack of knowledge of proper treatment tactics and compassion for the patients only further hurt their chances for healing during their stay at the insane asylum. Patients did not have the support system or proper medical advisement to recover.

Those in these asylums were also mistreated through the use of verbal and physical abuse. Nurses and doctors during this time period held no genuine care for the patients in their facility. During Bly’s stay, her nurse stated, “You are in a public institution now, and you can’t expect to get anything. This is a charity, and you should be thankful for what you get.” as well as, “You don’t need to expect any kindness here, for you won’t get it” which is the similar attitude most caretakers shared (287). Because of this lack of compassion, physical and verbal abuse was a repetitive issue in insane institutions that contributed to the mistreatment of patients. Physical abuse, such as, “a shove and a push… and often a slap on the ears” was a common sight along with the use of verbal abuse in the form of silencing patients with threats in which Bly’s nurse exclaimed, “There isn’t much fear of hurting you. Shut up, or you’ll get it worse” to their patient (285, 287). The aggression is linked to “indifference and selfishness” along with the lack of empathy of just how difficult it is to live with a mental illness (Williams 394). This lack of proper treatment for the patients only causes them to further unravel in their delusions being they are not taught the proper techniques to heal and cope with their reality. This absence of proper technique prohibits the patients from ever receiving the chance to assimilate back into everyday society and regain mental normalcy. 

Bly’s account proves the mental health of the female inhabitants in insane asylums continued to worsen in America during the 19th century as a result of the poor conditions of the institutions, and the unfair treatment of the mentally ill in these facilities. This resulted in few ever integrating back into society and returning to a normal life. This problem was born from ignorance of what it means to have a mental illness, and a lack of empathy for those struggling. Bly’s accounts during her stay in, “Ten Days in a Mad-house” depicts the unbearable living conditions and harsh treatment the mentally ill faced during this time, and witnessed many patients worsen during her short stay. These conditions were exposed through the sources The Inquires Journal, The North American Review, and The British Medical Journal in which all three tell of misunderstanding of mental illness from society as a whole, as well as cruel treatments and abuse demonstrated from doctors and nurses inside these institutions. This created a prison-like environment that did not catalyze the healing of its individuals. Although mental institutions in the 1800’s showed improvement from previous decades, the era still proved further change was necessary to truly rehabilitate those who struggle with mental illness. The stigma surrounding mental illness still exists in today’s society, however, treatments have vastly improved since the previous era.
