“Now the expressed sentiment is universal – that all must be fully and permanently provided for whether curable, or not promising recovery.”
“It is late to express my sense of yr. courteous consideration for assuring the accomplishment of my object in visiting Buffalo recently, but the constantly crowding [?] occupations incident upon quick succeeding journies [sic.] and close Hospital visits have hindered all correspondence. You will accept this needed apology for my short-coming acknowledgement. I hope you will sometimes reach the department for the Insane which is connected with the Poor-House believing that the fact of yr. personal notice will quicken attention and modify care for those poor people – not that there is any disposition manifest with the Superintendents & care-takers to neglect their duties, but it was quite evident that these duties were not fully understood. You may think that I might spare all suggestions now, in view of the very large powers and the very large number of associated visitors lately appointed – and here you may be only judging correctly – it is but just to hope large benefits will early result through the exercise of a full authority, as now delegated.
I have found in the Institutions in Northern Ohio, Michigan, Wisconsin, and Minnesota very marked improvement in the exercise of both professional and custodial care of Patients in the State Institutions for the Insane: and a much wider and more intelligent interest in making adequate provision for all classes of these unfortunate sufferers than was evidenced a few years since: now the expressed sentiment is universal – that all must be fully and permanently provided for whether curable, or not promising recovery.
Will you present my acknowledgement to Mr. Putnam and recollect that I hold my brief sojourn in Buffalo in gratified remembrance…”
Dix was the author of several books, governess for the family of famed Unitarian minister William Ellery Channing and the proprietor of several Boston schools. Her poor mental health, however, interfered with her professional life, leading to a nervous breakdown in 1836 for which she travelled to Europe to recuperate. There she met and was influenced by a number of British social reformers, including Quakers Elizabeth Fry and Samuel Tuke, closely observing their campaign for increased care for the mentally ill, the so-called “Lunacy Reform.”
Upon her return to the United States in 1840, Dix conducted an investigation of the mental health system, such as it was, in Massachusetts and issued a report to its legislature which voted to expand the state mental health hospital. Using the same methodology, she helped improve mental healthcare in numerous states and was instrumental in the founding of some of the first state mental hospitals including those in Pennsylvania, New Jersey, North Carolina, and Illinois, leading to the expansion of such facilities in scores of other states. Over the course of several decades, Dix was “a leading figure in those national and international movements that challenged the idea that people with mental disturbances could not be cured or helped. She also was a staunch critic of cruel and neglectful practices toward the mentally ill, such as caging, incarceration without clothing, and painful physical restraint,” (“Dorothea Dix 1802-1887,” American Journal of Public Health, Parry). Her work on behalf of the mentally ill in America culminated with the 1854 passage of the Bill for the Benefit of the Indigent Insane, passed by both houses of Congress, and would have used federal land grants to help establish asylums. However, the measure was vetoed by President Franklin Pierce who maintained that social welfare projects were the responsibility of the state and not federal government.
In response to this defeat, Dix devoted herself to the cause of the mentally ill abroad, specifically in Scotland, Canada and the Channel Islands until she was appointed Superintendent of Army Nurses at the outbreak of the Civil War, ensuring that female nurses were allowed in combat hospitals and that Union and Confederate wounded were treated with equal care. After the war, she resumed her campaigns on behalf of the mentally ill as well as the disabled.