Many asylums in the nineteenth century lacked the adequate treatment that their patients required to make a healthy recovery. A lot of patients during this time experienced no positive progression during their stay at the asylum. The story Ten Days in a Mad House, written by Nellie Bly, describes her experiences as she feigns insanity in order to gain entrance to Blackwell’s Island Lunatic Asylum. Performing stunt journalism, she writes about how the nurses treated the patients on the island, which were all female. She discusses the poor treatment of the patients and the lacking environment they had to live in while in these asylums. It took ten days for any of the doctors to even realize she was not mad. But the reason as to why these patients were treated this way, and how it affected their health could explain why such poor treatment occurred in these mad houses. The context of this time period can help to understand the why and how. By understanding how patients were treated in asylums in the nineteenth century, it helps shape the text by showing the negative effects it had on the patient’s mental health. 

In the nineteenth century, medical practices were nowhere as near as good as they are in current society, especially in the area of psychiatry. Pliny Earle was a nineteenth century psychiatrist who worked in many asylums, including Blackwell’s Island Lunatic Asylum, where the story takes place. Almost everywhere he went he claimed that there were unprecedented recoveries rates, reaching ninety percent and higher. Other psychiatrists were astounded by these numbers; they could not even reach numbers lower than that by degrees of ten. Earle had actually misused statistics in order to claim his own point. He counted anyone who showed even the slightest evidence of recovery as part of the “recovered” group, even if they were not able to be put back into everyday society and be functional. Later in his life, Earle’s view on this subject switches quickly. Earle claims that mental illnesses are incurable, which was an idea also accepted by other psychiatrists. Why he switches his view on the subject has a lot to do with what was known about mental disorders at the time, which was very little. Mental disorders were considered an ontological mystery, and a lot of things that don’t necessarily fall under the category of mental illnesses today could have you put in an asylum in the nineteenth century. Most people were put into the category of “hysteria”, because they couldn’t really figure out what was wrong with them. Also, being overly sexual or even attracted to the same sex got a person into an asylum. Not only that, it could get their reproductive organs removed. Today it is known that this is not a mental disorder, but rather just sexual orientation. Also, some people did not believe that mental disorders were even obtainable. Quaker beliefs stated that the mind is eternal and cannot succumb to disease or die. Since not a lot was known about mental illness during this time, a lot of things were just accepted as the norm, especially when spoken from a higher-up person in the psychiatric industry. The head of the Quaker York Retreat, John Thurman, said that “if ten people are stricken with insanity, five will live, and five will die”. The curability of a patient’s mental disease had more to do with the condition during their acceptance into the asylum, rather than their condition during discharge. 

While a lot of asylums were inadequate in the proper treatment of their patients, there were a few that practiced moral treatment in their facilities. The practices in these mental hospitals helped the patients reach positive results. By understanding what healthy practices were used in these asylums versus the unhealthy processes used in Blackwell’s Island Lunatic Asylum, we can clearly see that Blackwell’s asylum had negative effects on the patient’s mental health. One thing that was beneficial to the mental health of patients was the “home away from home” atmosphere. Many asylums had their patients live in attics, shacks, or cellars, which would only make the patient more uncomfortable and potentially worsen their mental state. Acceptance as well a discharge from these asylums were based more on social and moral criteria than anything else. Pre-Civil War Americans were to thank for this aspect of asylums. The prevailing social values of Christianity at the time led a lot of asylums during the nineteenth century accept the use of spiritual and character development. Monitoring the content and ideas that came into and out of the facility also helped the mental condition of the patients. By putting up walls or fences, inspecting packages that came to the patients, and controlling how often visitors came, patients were kept away from their previous environment, which could have been an unhealthy social and physical environment. The use of moral treatment in these asylums helped the patients build their mental state back up to the point where they may be able to enter back into society. 

In Ten Days in a Mad House, these moral treatments are almost nowhere to be found. It shows exactly how not to treat a patient if the goal is mental recovery. The women are treated very poorly; one example is the women are kept in cells. The nurses give each patient a freezing cold bath and then send them to bed still dripping wet. The nurses would also beat, choke, and spit on patients who were being difficult or weren’t complying with their commands. The food was also a problem, it was almost inedible, causing a lot of patients to not eat and become malnourished, worsening the patient’s mental condition. 

Asylum is a word that generally comes with a bad connotation. The nineteenth century helped imprint the negative aura into the word. Knowing the poor treatment of patients in asylums during this time and the lack of knowledge in the area of mental illnesses helps the reader understand the impact that the nurses had on the mental condition of the patients in Blackwell’s Island Lunatic Asylum. By understanding how much was known about mental disorders during that time, we see how their practices only had negative effects on their patients. Doctor’s during this era a lot of times could not even discover what was causing most people’s mental issue, and labeled it as “hysteria”. The asylums that did practice moral treatment were far and few, but seeing how they treated their patients, and the positive outcomes, we see how the nurses in Blackwell’s Island Lunatic Asylum could only have hindered their patient’s mental recovery. Being able to understand the context of how patients were handled in the nineteenth century helps the reader understand the points Ten Days in a Mad House conveys better than if the context were unknown. 
