Dorothea Dix: Redefining Mental Illness

In the course of the 19th century, psychological well being issues weren’t acknowledged as treatable circumstances. They have been perceived as an indication of insanity, warranting imprisonment in cruel circumstances. One lady got down to change such perceptions: Dorothea Lynde Dix.
Dorothea Dix was instrumental in altering perceptions of psychological sickness for the higher.
Picture credit score:
The Nationwide Library of Drugs

Born in Maine in 1802, Dix was instrumental within the institution of humane psychological healthcare companies in america.

Dix – a trainer and nurse in the course of the American Civil Warfare – tirelessly campaigned for the truthful remedy of sufferers with psychological well being issues, after being appalled by the circumstances through which they have been confined.

“I proceed, Gents, briefly to name your consideration to the current state of Insane Individuals confined inside this Commonwealth, in cages, stalls, pens! Chained, bare, crushed with rods, and lashed into obedience,” wrote Dix in a Memorial to the Legislature of Massachusetts in 1843.

Within the years that adopted, Dix traveled to a whole bunch of prisons and workhouses throughout the U.S., documenting the inhumane remedy that individuals with psychological sickness obtained and reporting her findings to state legislatures.

Her work not solely resulted within the institution of 32 psychological well being hospitals in a wealth of U.S. states, but it surely additionally helped to alter individuals’s perceptions of psychological sickness.

“By her work, she make clear the abuse and neglect of these with psychological sickness, which helped change perceptions and coverage approaches of state, nationwide, and worldwide leaders to determine extra humane remedy approaches,” Paolo del Vecchio, director of the Middle for Psychological Well being Companies on the Substance Abuse and Psychological Well being Companies Administration, informed Medical Information At this time.

For our fifth and remaining article in a sequence celebrating feminine function fashions in medication, we take a look at Dix’s unbelievable life and profession.

How did her steadfast lobbying for psychological healthcare reform greater than 200 years in the past assist to form at this time’s remedy for sufferers with psychological sickness? What challenges stay for psychological healthcare?

An sad childhood

Dix’s childhood was not a contented one; her father was an abusive alcoholic, and her mom struggled with psychological sickness. On the age of 12, Dix ran away from her residence in Maine to dwell along with her rich grandmother in Boston, MA.

Regardless of a scarcity of formal schooling, Dix was clearly a wise and bold lady, as she went on to determine a profession as a schoolteacher. In 1821, on the age of 19, she opened a faculty for younger women in her grandmother’s mansion.

Within the years that adopted, Dix penned plenty of kids’s books and quick tales and, in 1831, she opened a faculty for underprivileged kids, which she ran from her own residence.

Nonetheless, these achievements weren’t simple; Dix typically suffered from bouts of sickness, together with extreme cough and fatigue, which finally ended her profession as a trainer.

Archives recommend that her bodily sickness took its toll on her psychological well being, inflicting her to grow to be depressed. Her psychological sickness, nevertheless, would later grow to be a driving drive in her need to alter psychological healthcare within the U.S. for the higher.

Impressed by her personal psychological sickness

Within the mid-1830s, Dix traveled to Europe within the hope of discovering a remedy for her ongoing sickness.

Throughout her time in England, she met with social reformers Elizabeth Fry and Samuel Tuke. Fry had helped to go new laws in the UK to make the remedy of prisoners extra humane, whereas Tuke based England’s York Retreat for the mentally unwell.

[A female prisoner in the 1800s]
Dix was appalled by the remedy of sufferers with psychological sickness.

Proof means that Dix’s personal expertise of psychological sickness, in addition to the work of those social reformers, helped to encourage her to make modifications to psychological healthcare within the U.S.

“Maybe her personal struggles helped make her a extra compassionate advocate for individuals who had been recognized as mentally unstable or insane,” wrote historian Manon S. Parry in a paper revealed in 2006. “Definitely her unwell well being ended her instructing profession and introduced her into a brand new circle of contacts.”

In 1841, Dix volunteered to show a Sunday College for feminine inmates at a jail in East Cambridge, MA. Right here, she witnessed the struggling of ladies with psychological sickness. They have been chained to beds, starved, and abused – punished as in the event that they have been criminals.

Horrified by this maltreatment, Dix started visiting jails and workhouses throughout Massachusetts and documenting her findings.

The rise of psychological healthcare

In 1843, these findings have been introduced in a Memorial to the Legislature of Massachusetts.

As a part of the Memorial, Dix requested for the funds to introduce reform for the care of sufferers with psychological sickness in Massachusetts’ solely state psychological hospital – Worcester Insane Asylum. Her request was accredited.

“This memorial reveals how Dix labored throughout the conventions of her time to carve a job for herself in public life and draw consideration to the horrendous remedy of the mentally unwell in prisons, almshouses for the poor, and asylums,” writes Parry.

“Beliefs of femininity characterised girls as having a particular accountability to essentially the most weak members of society, and an ethical authority superior to males’s. On the identical time, girls have been speculated to be protected against photos and experiences of struggling and degradation.”

“Dix was in a position to make use of her vivid and upsetting descriptions to highly effective impact, damning the existence of those abuses and shaming political leaders into taking motion on her behalf, and on behalf of the ‘inmates’ of those establishments.”

Manon S. Parry

Following her success in Massachusetts, Dix took her marketing campaign for psychological healthcare reform to different states.

A major level in Dix’s campaign was the Invoice for the Advantage of the Indigent Insane, which was put earlier than Congress in 1854. The invoice proposed laws to supply federal land and funding for the event of recent psychological establishments.

Whereas the invoice was handed by each homes of Congress, it was vetoed by President Franklin Pierce, who acknowledged that the problem of social welfare must be the accountability of every particular person state, fairly than that of the federal authorities.

Although disenchanted by this choice, Dix continued to make progress at a state stage. Between 1843 and 1880, she helped to determine 32 new psychological hospitals throughout the U.S. – together with in New York, Indiana, Illinois, Rhode Island, and Tennessee – and she or he aided in enhancing the care of many extra.

From ‘lazy and nugatory’ to ‘sick and human’

When it comes at this time’s look after sufferers with psychological well being issues, we have now undoubtedly come a good distance for the reason that 1800s.

At this time, there are greater than 6,100 psychological well being outpatient services and greater than 800 psychiatric services within the U.S., in contrast with simply 123 psychological hospitals in 1880.

“Dix was considered one of our nation’s first champions for healthcare as a primary proper and that we have now a societal and public accountability to look after these weak residents amongst us,” del Vecchio informed MNT.

Moreover, she helped to alter the best way that sufferers with psychological sickness are perceived.

As psychiatrist Dr. Fuller Torrey, govt director of the Stanley Medical Analysis Institute, informed us, “She modified the notion from being lazy and nugatory to being sick and human.”

Nonetheless, there’s way more to be achieved within the area of psychological well being, and consultants imagine that we will study an important deal from inspirational figures equivalent to Dix.


‘We want extra champions like Dix’

In accordance with the Nationwide Alliance on Psychological Sickness, round 1 in 5 adults within the U.S. expertise some type of psychological well being dysfunction in any given 12 months.

The speed of psychological sickness is even larger for inmates in jail or jail – a report from the U.S. Division of Justice discovered that greater than half of those people have a psychological well being dysfunction.

Statistics present that round 56 % of sufferers with psychological sickness within the U.S. don’t obtain remedy.

There may be additionally a extreme scarcity of psychological well being professionals. In truth, Psychological Well being America report that in states with the bottom workforce, there is just one psychological well being skilled – together with psychiatrists, psychologists, and social staff – for each 1,000 individuals.

Stigma surrounding psychological sickness additionally stays an issue. The American Psychological Affiliation state that solely 25 % of adults with signs of psychological sickness imagine that individuals will likely be caring and sympathetic towards them.

Transferring ahead, del Vecchio believes that we will construct a greater world for individuals with psychological sickness by following in Dix’s footsteps.

“At this time, we want extra champions like Dorothea Dix to supply management to alter attitudes and insurance policies to allow all People with psychological sickness to get better and dwell full, productive lives in our communities.


Dix is a job mannequin to others who wish to reform how individuals with critical psychological sickness are handled. She gives an instance of how devoted people can assist change society for the higher.”

Paolo del Vecchio