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 (Goodheart 173-176). 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 (Goodheart 194). 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. 

Another key to understanding what caused such a negative effect on patient’s mental health is understanding the actual asylum itself. Blackwell’s Island was purchased from the Blackwell family by the city of New York in 1828. New York at the time was a city of industrialization and immigration. With the growth of the city, the number of mad people grew as well. Plans for an asylum on Blackwell’s Island were drawn up, with moral treatment as a main focus of this asylum, as well the dividing of patients into four divided sectors based on mental condition (Boardman 581). In Ten Days in a Mad House, these moral treatments are almost nowhere to be found. These plans never made it to the final design, monetary restrictions prohibited the original designs from ever making an appearance. Instead only two sectors were made and obviously did not help in treating the patient’s condition. These conditions are very obviously displayed in Ten Days in a Madhouse. 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 instead of rooms. The nurses give each patient a freezing cold bath and then send them to bed still dripping wet, causing them to lose sleep. The nurses would also beat, choke, and spit on patients who were being difficult or weren’t complying with their commands. The cause of this is probably the fact the guards and attendants of the asylum were convicts from the local penitentiary. Dr. Thomas Kirkbride describes the patients as being “abandoned to the tender mercies of thieves and prostitutes.” (Boardman 581)

Asylum is a word that generally comes with a bad connotation. The nineteenth century helped imprint the negative aura into the word. Blackwell’s Lunatic Island Asylum was a total mess. 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. The insufficient funds to create an adequate asylum caused an environment that was completely unhealthy for anyone that stayed there. The conditions that Nellie Bly both witnessed and underwent show just how awful this environment was. Convicts working in the asylums, lack of knowledge of mental illness, and poor living environments for patients all prove this point. 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 patients in Blackwell’s Island Lunatic Asylum, we see how the nurses 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. By understanding how much was known about mental disorders during that time, we see how their practices only had negative effects on their patients.
