Dorothea Dix

Dorothea Dix was born in Hampden, Maine, in 1802. Poorly cared for by her parents, she moved to Boston in 1814 to live with her wealthy grandmother. Dix began teaching at an early age and established an elementary school in her grandmother’s mansion in 1821. Alongside her teaching, she published numerous books for young readers and was active in Boston’s religious and intellectual circles.

Amid ongoing struggles with depression and respiratory illness, Dix traveled to England in 1836 for a period of convalescence. As a guest of the philanthropist William Rathbone, Dix met prominent English social reformers of the day, including Samuel Tuke, a Quaker proponent of “moral treatment.” A then-innovative approach to mental health care, moral treatment emphasized kindness and patience, rather than physical punishment and control. Dix observed this model of care in practice when she visited the York Retreat, a mental health facility founded by Tuke’s grandfather.

Following her return to Boston, Dix volunteered to teach Sunday school to women in the East Cambridge Jail. There she discovered people who had been deemed “insane” confined as criminals under brutal conditions – undernourished, living in filthy cells, often in chains.

Taking up mental health reform as her life’s mission, Dix investigated the treatment of people with psychiatric conditions in prisons, almshouses and asylums across Massachusetts, documenting her findings in unflinching detail. In 1843 she submitted a written testimony of her observations to the state legislature, appealing for their attention to “the strong claims of suffering humanity.”

Having spurred legislative action in Massachusetts, Dix took her campaign across the country. In keeping with the principles of moral treatment, she argued that people with mental illness would benefit from clean, spacious surroundings, structured daily activities, intellectual engagement and bucolic scenery. By the time of her death in 1881, Dix had influenced the establishment of 15 state mental hospitals and 17 privately funded asylums, as well as the improvement of many other facilities.

Contemporary biographers have criticized Dix for her failure to support the abolitionist and women’s rights movements of her day. While Dix’s progressivism was notably limited, she must be remembered nonetheless for the role her generosity, compassion and advocacy played in transforming attitudes and treatments for mental illness in the U.S. and beyond.

Contributor: Erin Brown