Throughout the 19th century, there was an extreme lack of knowledge in the professional psychiatric community, a naïve trust in these professionals, and a stigmatization associated with mental hospitals, asylums, patients, and their families. This lead to a vast number of patients being admitted unjustly, and the absence of knowledge regarding the conditions of mental hospitals and what actually occurred in such institutions. These obvious issues lead to the (self) admittance of Nellie Bly, as she pretended to be insane, into the Women’s Lunatic Asylum on Blackwell’s Island. Bly lived like an inmate, as if she were actually mentally ill, for ten days, in attempt to trigger an investigation of mental institutions with an aim of changing the way the mentally ill are handled. 

During the 19th century, little was known about mental illness in the medical community. Among these illnesses included “hysteria, the most commonly diagnosed ‘female malady’ of the 18th and 19th century” (Ussher 63). Originally, hysteria was considered to be the natural state of a woman. It was thought to be linked to femininity itself, and “the 19th century physicians were highly critical of this feminine ‘state’ describing women as difficult, narcissistic” (Ussher 63). The “everyday” hysteric was thought of as an “idle, self-indulgent and deceitful woman, ‘craving for sympathy’” (Ussher 63). Despite these accusations of the “hysterical woman”, there were no clear diagnoses, as there was little scientific evidence to base these claims off of. 

The symptoms associated with hysteria were not linked to a mental disorder, but in fact to a woman’s personality. Women who were not complacent or “ideal” were targeted by society. The treatment within these asylums had “as much or more emphasis on the patient’s moral and spiritual development and character rehabilitation as on the treatment of [her] physical illness” (Luchins 586-587). Because there was little to no scientific evidence of an actual mental illness, the rehabilitation of patients in mental hospitals was more focused on the patient’s principles and personality attributions. 

For Bly, it was quite simple as a 19th century woman to feign insanity in order to admit herself into the asylum. Because of the belief that hysteria was the natural state of a woman, it was very easy to get others to believe you are insane. While it was very easy to be admitted into one of these institutions, proving one’s sanity and getting released was quite difficult. In “Ten Days in a Mad-House”, Tillie Mayard was given the chance to talk to the doctors and plead her case, as what Bly described as “rational as any I ever heard” (Bly 282). Despite this, Mayard was simply escorted back to her seat with the other women. The next women, Mrs. Louise Schanz, was admitted simply because she could not speak English. The nurse, Miss Grupe, who spoke German, Schanz’s native language, refused to translate for Schanz, claiming “I can’t speak but a few words”. A woman who may as well have been perfectly sane was admitted to The Women’s Lunatic Asylum, and was given no opportunity to defend her sanity because she was unable to communicate the way the doctors wanted her to. Beyond some women not being able to communicate with the doctors, women who argued with their husbands, whom of which often sent their wives to these institutions, and doctors only made themselves appear more ill. The men who sent their wives to these institutions were blinded by misinformation from doctors who knew very little more than the men themselves.

Beyond the lack of knowledge in the professional community, the general public had no knowledge of mental illness beyond what physicians and doctors told them to be true. Because “at that time [there was] no sharp delineation or differentiation between social and medical thought” (Luchins 590), no one ever thought to question the professionals. Only the women who were accused of insanity questioned these doctors, which proved no real threat to the professional opinions of the doctors, as one is more likely to believe the words of an “educated” doctor over a woman who is said to be insane. Without people questioning the practices of these medical professionals, the doctors were able to diagnose and treat women as they saw fit. This led to the continuation of inhumane treatment of women, and doctors abusing their power to imprison women who may have been perfectly sane.

In the book, “Ten Days in a Mad-House”, when Bly is being measured for her height and weight, the nurse was unable to read both the measuring tape for her height, as well as the scale for her weight. This provides evidence to the lack of education amongst society, especially women, even those working within the mental institutions. When the nurse is not able to read the measurements, the doctor must assist her. This is another example of the influence doctors in this time period had over the rest of society. Just like the doctor who helped the nurse obtain Bly’s measurements could have easily lied to manipulate the results, the doctors of this time also would have had the power to diagnose people without being questioned. 

Continuing on with the time period of the 19th century, most wealthy people chose to avoid treatment in hospitals “because it stigmatized them and their families” (Luchins 587). “Even the poor avoided hospitals” (Luchins 587) because hospitals were seen as places where only the most needy went because they had no place to be nursed, and could not afford medical care. Because most people chose to deal with illness and mental illness within the home, it was mostly single women and immigrants who ended up being treated in the mental institutions. Because of the inadequacy of knowledge related to mental illness, people generally did not want other people to know that anyone in his or her family was mentally ill. Mental illness was seen as embarrassing and did not reflect well upon the family. This is a big part of the reason that not much was known about what really went on inside of the mental institutions, as most families treated their mentally ill family members in the home, and those who were admitted to the institutions were either shunned, or did not have many close family members who were willing to come visit such a place. While there were rumors and other stories regarding the conditions inside of the asylums, Bly was the first to get admitted and experience the reality of the rumors firsthand as a patient. Bly really had no idea what to expect, as she was under the impression “that [she] would be released in a few days” (Bly 281). 

As discovered by Nellie Bly, in the 19th century there were many extreme issues with the psychiatric community. Bly admitted herself into the Women’s Lunatic Asylum in order to unveil the mistreatment and misconduct within the institution, and other mental institutions across the country. The negligent and uninformed medical community gave false hope to families and thousands of incorrectly diagnosed women who were imprisoned for practically no reason. Due to the ignorance of the medical professionals, Bly was able to successfully infiltrate the asylum, and uncover the unjust truth about the practices within the mental hospitals.  
n Psychiatric Nosology." Feminism & Psychology 23.1 (2013): 63-69. PsycINFO. Web. 2 Nov. 2016.