Meet Dorothea Dix: Early Advocate for Mentally Ill Prisoners

It’s easy to lose your mind in prison. The insane world of forced routine accentuated by culture clashes, boredom, and the loss of personal freedoms can cause people to question their sanity. In February 2005, I wrote a quote from John Steinbeck’s Cannery Row in my personal journal. Sitting on my bunk on a cold and dark winter day, I was looking for a way to express my depressed mood. I was at a loss for words, so I quoted Steinbeck to express my mental state: “The world of man is fit now mainly for satire . . . but a ghastly satire of the insane—the rolling head and laughing tongue and glassy eyes.”

In my first post, There Are Crazy People in Prison, I talk about the mental health issues of an inmate I encountered who thought he was the emperor of Norway. The guy was not joking. I wrote that “the sovereign’s resolve about his rank did not welcome a joke or further questioning.” I feared for my personal safety if I challenged his beliefs. In 2003–2005, while I was incarcerated, it became clear to me that scores of other inmates had mental health problems that were not being addressed. Looking into the eyes of a person with chronic mental illness, no matter the diagnosis, is a pathway into his or her inner realm of disturbances. By observing a person, most of us can identify outward signs of depression, anxiety, and irrational thought patterns. Real life situations, the movies, the theater, and the media train us to read these signals all the time.

During my prison experience, I saw very little positive action by the administrators to address mental health problems. Men in delusional states were caged in phone booth–sized chain link holding structures so small that they could not sit down. I observed these detentions while waiting in regular holding cells to be processed through the prison system. Most of these caged men became delirious, loud, and blusterous: shouting, banging, cursing, begging, crying, and exhibiting anguish I had never experienced before. They were mostly ignored or told to shut up (with expletives included).

I knew the treatment of these men needed to be improved, but at the time I was powerless. I now know that major steps have been taken in the California prison system to address the problems of inmates who present with severe mental health problems. The road to this prison reform issue goes back a long way—back to the world of a remarkably courageous woman whose advocacy for mentally ill prisoners began in antebellum America.

Who Was Dorothea Dix?

(1802–1887) was born in the small town of Hampden, Maine. As a child, she was a zealous reader and a rapid learner. Dorothea lived in a time when anyone could teach children and establish his or her own school, which is what she did. At the age of fourteen, Dorothea opened a school for young children; at the age of nineteen, she moved to Boston where she continued teaching and began a formal school for older children in a cottage on her grandmother´s property. The school was named “the Hope,” and it served the poor children of Boston whose parents could not afford to provide their children with a formal education.

At age thirty-four, Dorothea toured the most advanced insane asylum in England, York Retreat, built in 1796. Here she found the principles of treatment that would later influence her movement in America. Dorothea witnessed, for the first time, the insane being taken care of with dignity and respect. She learned through this experience that recovery from mental illness could be achieved by those who were treated and cared for compassionately. This ideal followed Dorothea in her future advocacy for the mentally ill in prisons in Massachusetts, Rhode Island, New York, New Jersey, Pennsylvania, Indiana, Illinois, Kentucky, Missouri, Tennessee, Mississippi, Louisiana, North Carolina, and Maryland.

Before her visit to York Retreat, Dorothea had taught inmates at local jails in Massachusetts, where she became aware of the cruelties inflicted upon the insane. Those memories stayed with her and set her on a path of change.

Dorothea transformed from a teacher of students to a social reformer dedicated to changing conditions for people who could not help themselves. She was a champion for the mentally ill and the imprisoned, and her work continued in later years when she became a superintendent of nurses during the Civil War.

Work on Behalf of Mentally Ill Inmates

The Famous People website gives this synopsis of Dorothea’s work in Massachusetts on behalf of mentally ill inmates:

• In 1841, she took a job teaching inmates in an East Cambridge prison. She was shocked by what she saw there—the mentally unstable were kept with the hardened criminals, there was no heating, the place was stinking and the living conditions were horrible.
• Appalled by what she witnessed she went to the legislature of Massachusetts and demanded that the living conditions of the insane be reformed. She presented to the legislature a report she had made after researching on the horrible conditions the inmates were kept in.
• The report, called “Memorial” was presented by her supporter, Joseph Dodd, who was in the Senate, to the Legislature of New Jersey in 1845. Even though her demands for reforms found many supporters, there were also some critics who opposed it.
• Dix was not disheartened and continued writing letters and editorials and championed for the cause along with her supporters. Her unrelenting work finally bore fruit when the bill proposing reforms was finally passed in March 1845.

The Memorial listed case after case of the abuse of mentally ill prisoners in Massachusetts prisons. Here’s part of Dorothea’s passionate plea:

I come to present the strong claims of suffering humanity. I come to place before the Legislature of Massachusetts the condition of the miserable, the desolate, the outcast. I come as the advocate of helpless, forgotten, insane, and idiotic men and women; of beings sunk to a condition from which the most unconcerned would start with real horror; of beings wretched in our prisons, and more wretched in our almshouses [homes for the poor]. And I cannot suppose it needful to employ earnest persuasion, or stubborn argument, in order to arrest and fix attention upon a subject only the more strongly pressing in its claims because it is revolting and disgusting in its details.

In my next post, I will explore how the work of Dorothea Dix foreshadowed prison reform for the mentally ill in the California prison system. She is mentioned in a recent Stanford Law School’s Three Strikes project report entitled “When did prisons become acceptable mental heathcare facilities?” Learning about Dorothea’s work taught me about the many improvements that have been incorporated into the administration and care of the state’s mentally ill inmates since I left the California prison system.

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