By Joseph Collins, Staff Writer 

mental-illness-art-a3ce9bb6a9a7cdbc1Mental illness is one of the most important and widespread healthcare problems facing the world today. At present, an estimated 450 million people around the globe are struggling with some form of mental illness. In the United States alone, mood disorders affect 21 million people, social phobia afflicts 15 million people, and 8 million people suffer from post-traumatic stress disorder. According to the World Health Organization (WHO), approximately 25% of the global population will suffer from a mental disorder at some point during their lives. And yet, despite its prevalence, mental illness remains poorly understood and generally under-treated— as it has been for most of human history.

asylum1In the past, many cultures viewed mental illness as a form of religious punishment or demonic possession. Even in societies with advanced scientific knowledge, mental illness was treated with superstition and placed in the realm of religious speculation. As a result, people who suffered from mental disorders were generally misdiagnosed, mistreated, and frequently marginalized. Often, the mentally ill were blamed for their own condition and judged as morally inadequate. In many ways, this attitude still persists to this day.

“There is a lot of stigma around mental illness, There are still a lot of people who believe it is character rather than something physiological. They believe if you really wanted to fix this you could do it. I don’t think mental illness is very well understood,” said Peter Cappelli, a professor at University of Pennsylvania’s Wharton School.

7892305Nevertheless, while our understanding of mental illness still has a long way to go, we have recently made big strides in their treatment of the mentally ill—largely due to the efforts of social reformers and mental health advocates. One of the most important mental health activists in recent history was Dorothea Dix—a woman who dedicated more than 40 years of her life fighting for the rights of the mentally ill. Thanks to her efforts, there are now a wide range of institutions and federal laws in the US that ensure that people struggling with mental disorders are treated with civility, compassion, and dignity.

As we celebrate Mental Health Month, Infinite Fire is proud to profile Dorothea Dix, a pioneer in fighting for human rights for the mentally ill.


Hampden, Maine

Born on April 4, 1802, Dorothea Lynde Dix grew up in a poor, dysfunctional household in the rural town of Hampden, Maine. She was the first child of three born to Joseph Dix and Mary Bigelow, who were both chronic alcoholics.  When she was twelve, Dorothea fled her home to get away from her parents – especially her father, who was physically abusive. Initially, Dorothea went to live with her wealthy grandmother in Boston, Massachusetts, where she was raised in a strict, puritanical atmosphere. Later, she moved in with an aunt in Worcester, Massachusetts, where she began teaching school at the young age of 14.

One of the original Dix schools

In 1819, at the age of just 17, Dorothea returned to Boston and founded two schools for girls, one of which was a charity school where girls from poor families could attend for free. She soon began teaching some of the poorer children at their home. But due to health issues (undiagnosed), Dix was forced to give up teaching for a while. Instead she started writing text books, including her most famous, Conversations on Common Things edia for children.  After the success of that book, Dix devoted herself to writing, working mostly on religious texts and children’s books.  Once her health improved, however, she went back to teaching and opened a model school for girls in 1831, which she ran for 5 years. Unfortunately her health problems returned in 1836, and she was forced to leave the teaching profession once again.

William Rathbone

Hoping to find a cure to her ailment, Dix travelled to England, where she was introduced to the Rathbone family, a group of Quakers dedicated to helping others.  The Rathbones invited Dix to stay at their ancestral mansion in Liverpool, where they helped to nurse her back to health. During her stay, Dorothea learned that the Rathbones were prominent social reformers.  They were especially passionate about changing the way society treated the mentally ill. The Rathbones emphasized the need to move away from a confinement/punishment model and towards a more humane style of therapy. Dorothea’s interactions with the Rathbone family had a profound influence on her, and she took what she learned back with her to the United States, where she eventually launched her own movement on behalf of the mentally ill.


MTE5NDg0MDU0OTQ3MDA1OTY3In 1841, Dorothea Dix returned to America and immediately took a position teaching Sunday school at a woman’s prison in East Cambridge, Massachusetts. However, she was appalled at how the prisoners were treated, especially the mentally ill, who had no heat in their living quarters.  Dix went to court to secure better living conditions for them, and she won major concessions from the prison, including heat for the mentally ill.

chainedtowallInspired by her success, Dix began to investigate how the mentally ill were treated at prisons and poorhouses throughout the entire state of Massachusetts.  What she found was wide-spread abuse, prompting her to write a fiery report to the state legislature.  “I proceed, Gentlemen, briefly to call your attention to the present state of insane persons confined within this Commonwealth, in cages, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience.”  Her report brought about some important changes, including a larger state budget for the mental hospital in Worcester and a shift in policy toward more humane treatment. 

dorotheadixBut at this point, Dorothea Dix was only beginning her battle.  Encouraged by her early victories, Dix began touring the whole country, calling for improved mental health facilities in New York, New Jersey, Pennsylvania, Indiana, Illinois, Kentucky, Tennessee, Missouri, Maryland, Louisiana, Alabama, and South and North Carolina.   Dix was determined to make sure that everyone who struggled with mental health disorders would have clean and safe facilities to live in. She also fought to ensure that patients would receive more humane, compassionate, and medically-informed care. With her passion and conviction, Dix was personally responsible not only for improving existing health hospitals, but for the creation of the first mental health hospitals in many states.

The culmination of her hard work was the Bill for the Benefit of the Indigent Insane. This groundbreaking legislation set aside 12.2 million acres of federal land for those struggling with disabilities. Under the law, 10 million acres were to be used for the benefit of the mentally ill, while the remainder was set aside for the blind, deaf, and mute.  However, although the bill was passed by both houses, it was vetoed by President Franklin Pierce in 1854, who felt social welfare was the responsibility of the state, not the Federal government.

Pope Pius IX

Upset over her defeat, Dix went back to Europe to spend time with the Rathbone’s and start revising her plans for the future. During her time there, Dix carried out investigations of mental health facilities in Scotland, which revealed that country’s own abuses of the mentally ill. Her findings resulted in the creation of the Scottish Lunacy Commission, which helped to reform how mental patients were treated in the UK.  Inspired once more, Dix began traveling throughout Europe, comparing the different mental health systems available. During her travels, Dix even met with Pope Pius the IX, who ordered the building of a new hospital for the mentally ill after hearing her report about abuse and substandard living conditions.

In 1856, at the age of 54, Dix returned to the United States to continue advocating for the infirm and the needy.


Civil War nurses

When the Civil War broke out in 1861, Dorothea Dix volunteered to serve her country by helping the injured. Not long afterwards, she was made Superintendent of Nurses. In this capacity, she was responsible for setting up field hospitals and first-aid stations, recruiting nurses, managing supplies and setting up training programs.   Dix performed her duties with great passion, treating the wounded from both sides of the conflict. 

civilwarnursesBut Dix’s experience during the war was not a very good one.  She often fired nurses she did not personally hire or train, which didn’t sit well with many at the hospitals she managed, including many of the doctors.  Furthermore, many of the nurses thought she was rigid and had no social skills, and they often avoided her.  By the time Dix left her post in 1865, she walked away feeling that her experience as a Civil War nurse was a failure. After a short time, she returned to the cause that she cared about most: advocating for the mentally ill and the disabled.


NJ State Hospital (Asylum) – Trenton, NJ

In the late 1860s, Dix traveled throughout the South, assessing the damage caused by the war to asylums and hospitals.  Sadly however, her travels were interrupted in 1870, when she contracted malaria and was forced to abandon her tour.  Nevertheless, she continued to write and lobby for social reform, despite her illness.  But over the years, as Malaria took its toll, Dix became an invalid, and, in 1881, she moved into one of the hospitals she helped set up many years ago—the New Jersey State Hospital, in Trenton, New Jersey.  She was given a private room of her own for as long as she lived, and was looked after with compassion by the staff.

Six years later, on July 17th 1887, Dorothea Dix died at the age of 85, and was buried in Mount Auburn Cemetery in Cambridge, Massachusetts. 

dorothea_dixFor her dedication to helping others Dix has been awarded several honors, including being elected “President for Life” by the Army Nurses Association for her volunteer work during the Civil War.   The U.S. Postal Service commemorated Dix with a postal stamp in 1983.  A U.S. Naval ship and a crater on Venus were named after Dix in her honor, and the Mental Health Institute in Bangor, Maine, was renamed the Dorothea Dix Psychiatric Center in 2006.

Teacher, author and social reformer, Dorothea Dix spent the better part of her life serving others and fighting to make sure that people with mental disorders are treated with dignity and respect. Her hard work and determination helped create dozens of new and improved institutions in the United States, Canada and across Europe.  With her compassion and commitment, Dix helped to change people’s dixperception of the mentally ill, initiating a new era of sympathy and humane care. Although we still have a long way to go – in terms of eliminating stigma and judgment – Dorothea Dix helped to push us forward, raise awareness, and remind us that mental patients are just as deserving of our kindness and humanity as any other group of patients. As such, she will forever be remembered as giant of her time and transformational figure in the field of mental health.