1. Mental Health Reform Nicole Christos & Emily Andersen

2. PROBLEMS in prison? The injustices of having men, women, and children kept in the same prison without acknowledging how severe their criminal offences were. Clinically insane prisoners were poorly mistreated and often did not get the treatment they deserved.

3. Appalling Conditions ●Men, women and children were all placed in the same jails, no matter the type of crime committed. ●There was no thought of how to pair inmates with mentally insane. This often resulted in incidents of murder or injury caused by an insane inmate. ●People did not have much sympathy for those deemed “crazy”. They were often mistreated in regular prisons, abused and neglected. They were forced to be held in cages, closets, stalls or pens. They were chained, sometimes naked, and beaten into obedience with rods. Dietary needs were not met, food was poorly made.

4. Leaders in the Reform ●Dorothea Dix- Main reformer in the movement, she was small and timid, yet her determination and dedication brought her audience’s attention to the awful treatment of the insane. ●Dr. John Galt- He worked at a mental institute starting at 22 years old, the first to encourage de-institutionalisation. He rarely used restraints on his patients, instead using calming medication and therapeutic activities. Introduced moral management therapy to his patients. ●Elizabeth Cochrane-Was a journalist by the pen name “Nellie Bly”. She went undercover to an asylum, pretending to be clinically insane, and going through hardships to expose the truth about how poorly mentally ill patients were treated. ●Samuel Gridley Howe-Founded Perkins Institute for the blind. Thought the blind should no longer be seen as “doomed to inequality”. Also founded a school for the mentally retarded in 1848, and deaf children in 1867.

5. Dorothea Dix’s outrage "I have come to present to you the strong claims of suffering humanity, I come as the advocate of the helpless, forgotten, insane men and women held in cages, closets, cellars, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience!" “In Halifax County, a maniac was confined in the jail, shut up in the dungeon, and chained there. The jail was set on fire by the other prisoners: the keeper, as he told me, heard frantic shrieks and cries of the madman, and “might have saved him as well as not, but his noise was a common thing, he was used to it, and thought nothing out of the way was the case”. The alarm of the fire was finally spread; the jailer hastened to the prison: it was now too late; every effort (and no exertions were spared), to save the agonized creature, was unavailing. He perished in agony, and amidst tortures no pen can describe”. -Dorothea Dix

6. dorothea dix’s goals ●Dorothea dix wanted the mentally ill to be treated and taken care of, instead of being thought of and treated like murderers and hardened criminals. ●She wanted the mentally ill to be in a separate insane asylums than the criminals, where they couldn’t harm others or be harmed. ●dix’s report of how the mentally ill were treated and their conditions had the lawmakers voting to create public asylums for the mentally ill.

7. Setbacks and consequences Dorothea Dix petitioned in 1843 to the Massachusetts Legislature with horrific tales of how the insane were neglected. Her audience was left in shock and the result of their debating gave way to many establishments of hospitals dedicated to help the ill across the US and to Europe. When she petitioned to Congress in 1854 for a land grant that would fund asylums for the indigent insane. She was rejected three times and almost got it on the fourth try, but it was vetoed by President Franklin Pierce. Dr. John Galt was the first to encourage deinstitutionalization. He wrote “A large number of insane, instead of rusting out their lives in the confines of some vast asylum, should be placed...in the neighboring community”. Nobody agreed to what he had to say, and the Hospital’s Court of Directors prevented him to accomplish his plans to deinstitutionalization his patients three times. Because these early attempts at reform were shot down, it took a lot longer for people to realize how poorly mentally ill people were treated, and kept them in harms way for much longer. Elizabeth Cochrane, AKA Nellie Bly, went undercover for ten days to an insane asylum as a patient, and revealed all of their horrible treatments. When she wrote about it later in “Behind Asylum Bars” and “Inside The Mad-House”, which created an uproar in New York. Investigations were initiated and funds were provided to change the care of mentally ill patients.

8. Solutions proposed ●President Fillmore supported Dorothea dix and he granted the expansion of hospital that would benefit the navy and the army veterans. ●Earlier in 1841 dix took an attempted to reform. she took her finding and presented it the legislature. Many didn’t believe in what she said, so dix persuaded a group of people who was willing to help her make her stand. ●Solution to the movement was to separate the mentally ill from the prison and put them in a different facility.

9. implications ●Social and Religious implications- Most people believe that the mentally ill were possessed by the Devil. ●The earliest attempts at mental health reform were inspired by the American ideal of a shining city on a hill. Americans were setting an example to the rest of the world by being accepting of all religions, and now paying attention to people of all disabilities and not discriminating others for what they can’t control.

10. Related Events Salem Witch Trials- In 1692, more than 200 people were accused of witchcraft. Many of the Christians believed in the Devil’s magic. They thought it could harm others for return loyalty. This relates with the mental health reform because mentally ill people were thought to be possessed by witchcraft and the devil.

11. Accomplishments ●Dorothea dix and others changed the way the people thought of the mentally ill and back then, it was a very serious problem. ●There were 123 mental hospitals by 1880 in the U.S.

12. An Ongoing Reform After all the funds for psychiatric wards and better care for mentally ill patients, it didn’t stop. New mental health acts keep coming up, with new concerns. The National Mental Health Act of 1946 was meant to provide grants and fellowships for training mental health professionals, and fund research relating to the topic of the causes, diagnosis, and treatment of neuropsychiatric disorders. Adding on to that was the Mental Health Study Act of 1955 called for a nationwide analysis and reevaluation of the human and economic problems of mental health, and authorized the Public Health Service to provide grants for the study. America goes on to create the Mental Health Centers Construction Act of 1963, and in 1971, Mental Health America produced a film, Only Human, which aired on more than 150 television stations, to improve public understanding of the mental illness and public acceptance of people with disorders. More recently, Mental Health America succeeded in getting the Mental Health Parity Act signed into law in 2008.

13. Chronology 1841- dorothea dix visited the cambridge jail 1843- dix gave the Massachusetts state legislature a detailed report of the conditions of the mentally ill (later wins the court). 1848- dix proposes a bill asking that 5 million acres be used to build mental institutions. 1854- THe bill passed by both the senate and the House but was vetoed by president Pierce.

14. Historians perspective ●LaDonna Ghareeb- Dorothea dix instigated extensive legislative change. She changed institutional practices across the U.S. She affected the training of institutions and the construction of hospitals. ●Jenn Bump- the mental health reform started a new chapter in the treatment of those living with mental illness. dix established a mental hospital relocating the ill. the movement changed the institutions of hospitals.

15. Personal Reflection The topic of help for the mentally impaired and asylum reform is very important to me. I have known friends who have gone to mental asylums and psychiatric help, and without the mental health reform happening, they wouldn’t have the same rights as the common citizen. I would be abhorred to find out that anyone should be treated like those prisoners were in the 19th century. I found the conditions the mentally ill patients were kept in to be horrid, that they were chained to walls and beaten into fearful obedience when it is so easy nowadays to treat patients with medication and therapy. So many people were lost because of how they were neglected, the horrible things that happened to them is no better than slavery, in my opinion. At least slaves could try and protest and fight back, these mentally ill patients were not in the right mind to do anything about their poor treatment. -Emily The topic on how the mentally ill were put in mental asylums doesn’t mean anything personal to me, however, I am very interested in the topic. The condition the mentally ill were put in during the 19th century was really horrible. I was appalled with the way they were chained to wall, beaten when they misbehaved and how they were put in pens, closets, cages, and stalls. It is very inhuman and cruel. -Nicole