Dorothea Dix — the Hidden World of the Asylum

Dark History takes a trip into the history of mental illness care and Dorothea Dix’s whistleblowing.

In the early 1800s, individuals with mental illness in the US were often housed in isolated rooms or neglected areas. People thought to be unstable were often kept in jails, cellars, poorhouses, or private dwellings. Many lived in jails, while others remained locked in darkness for years.

Then Dorothea Dix arrived.

Dix started her efforts in the 1840s, following a visit to a Cambridge jail. There, she discovered individuals with mental illnesses confined alongside criminals, subjected to cold, neglect, and violence. Not all of them had broken the law. They were imprisoned because there were no alternatives, not because they were guilty.

What Dix observed extended beyond a single building. She embarked on state-to-state travel to see the conditions for herself. Each town she went through presented her with the same situation. Individuals experiencing mental health conditions were confined with chains or locked away in jails. They were left unclothed in cold rooms during the winter.

She provided a straightforward account of her observations and presented them to the state legislatures. She documented hardships in formal appeals that were difficult for authorities to ignore.

Due to her endeavors, public hospitals for mental health care were built or expanded. She helped to shape the development of over thirty organizations nationwide over many decades. She subsequently organized comparable initiatives in Europe.

These organizations were established with a clear objective. They would opt for rehabilitation instead of punishment. Patients would live in organized settings created for healing, not imprisonment.

The problem, however, was that the expansion of asylums outpaced available resources. The population grew beyond what was expected. Several hospitals, initially established as reform initiatives, lapsed into the very neglect that Dix had worked to combat. Facilities intended for care became overwhelmed systems that failed to serve their residents.

Dix herself acknowledged this conflict. Reform could build institutions, but there was no assurance regarding their operation decades down the line.

Her work remains part of a larger story about mental health care. Prior to her public awareness campaigns, the plight of people with mental illness was not a widespread concern. Hidden away in prisons and back rooms, their suffering was kept from public view.

Dix brought that suffering into focus.

The organizations she founded weren’t able to fix all the issues. Some developed failures of their own. However, her actions initiated a significant change. Situations that were once private were openly documented and debated.

Dorothea Dix did not end the dark history of the asylum. She exposed it.

Deven VanKirk was raised in the Midwest and has lived all over the eastern half of the US. He’s been a horror fan for as long as he can remember. He enjoys hiking and camping, when he’s not reading or writing. Currently he resides in Florida with his wife, son, and two dogs.

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