Annotated Bibliography

Primary Sources

Article

"Dorothea Dix: Report on the Insane (1843)." American Government, ABC-CLIO, 2019, americangovernment.abc-clio.com/Search/Display/210306. Accessed 13 Sept. 2019.

After surveying the conditions of every jail and poorhouse in Massachusetts, Dorothea Dix delivered a formal address to the Massachusetts legislature, relaying her findings. In this way, she advocated for the reform of the treatment of the mentally ill. This document reports what she had divulged to the government: the egregious circumstances, the acts of abuse, and an experience of a memorable victim. This speech provoked a great impact on the prison and mental health reform: It led to the approval of the refinement Worcester State Lunatic Hospital. This event started to educate the US government the conditions and the happenings in poorly financed institutions housing the mentally ill. Such an address to the government proves Dix was a prominent figure in the progression of mental establishments and treatment. This article was applied on the “Dix” page.

Dorothea Lynde Dix collection, Maine Women Writers Collection, University of New England, Portland, Maine

We found this particular resource on DigitalUNE of the University of New England; “Dorothea ​ Lynde Dix : A Paper Read Before the Worcester Society of Antiquity” by Alfred Seelye Roe. ​ This pamphlet introduces Dix’s experience in Worcester prior to her career of reformative work for mental illness, including a letter written by Dr. John W. Ward, the superintendent of the Asylum for the Insane at Trenton, New Jersey, concerning the end of Dix’s life as she passed away in the Asylum for the Insane at Trenton. It covers Dix’s family relationships, her profession as a teacher, and her role as a Superintendent of Nurses in the employ of the United States government. Biographer Roe attempted to gather as much information as possible on Dix through individuals she associated herself with such as acquaintances and family members. It was read to the Worcester Society of Antiquity on November 20, 1888. Ultimately, this was a unique outlook on Dix’s life and gave us a true sense of what the person behind various advancements in mental health was like.

Dorothea Lynde Dix, Memorial Soliciting a State Hospital for the Protection and Cure of the Insane, Submitted to the General Assembly of North Carolina, November, 1848, pp. 8–9, 14–15, 16–17, 26–28, 39–41.

ANCHOR (A North Carolina History Resource) is an online textbook in which we derived this article from. It prefaced with information on America in the 18th century, a time in which a prevalent belief was that social rank was a reflection of God, and the 19th century, the era of the birth of psychiatric care in which the mentally ill were confined in hospitals as opposed to

receiving treatment. In the 19th century, it was socially unacceptable for a woman to publicly debate topics such as business and government. The responsibility of caring for the mentally ill were placed on women as well, as women were viewed as “natural” nurturers. At this point in history, the mentally ill were thought to have deliberately abandoned themselves to sin or to have been possessed by demons. Dix’s campaign marked a great change in the way Americans viewed the mentally ill. Her “memorial” to the North Carolina General Assembly, Dorothea Dix lays out her arguments for building a state hospital for the mentally ill. This resource provided us insight on how Dix broke barriers for both women and the mentally ill.

Memorial Soliciting a State Hospital for the Protection and Cure of the Insane, Submitted to the General Assembly of North Carolina. November, 1848. [House of Commons Document, No. 2.]

After Massachusetts, Dorothea Dix continued to survey the conditions of prisons and poor-houses to advocate for the improvement of mental health. In 1848, she submitted a proposal for North Carolina to construct mental institutions for their state. North Carolina was concerned of the expensive costs of mental asylums. She addressed the legislators of North Carolina, providing charts and figures of the cost effectiveness of the construction of a mental asylum. She assured that she was not requesting for personal gain, but to “appear as an advocate of those who cannot plead their own cause”. Dix also emphasized that it was the responsibility of those in power to assist the “unfortunate”. Her last sentence of her 48-page memorial was, “Gentlemen, the sum of the plea of your Memoralist is embodied in the solicitation for an adequate appropriation for the construction of a Hospital for the remedial treatment of the Insane in the State of North Carolina.” This resource was significant to our project because it truly exhibited how Dix was knowledgeable in mental health, passionate to represent the mentally ill when they are unable to represent themselves on a federal level, and demonstrates how her religion influenced her ideology.

Schoeneman, Thomas J. “The Role of Mental Illness in the European Witch Hunts of the Sixteenth and Seventeenth Centuries: An Assessment.” Journal of the History of the Behavioral Sciences, vol. 13

Schoeneman, with a PhD in the Department of Psychology at the Lewis and Clark College, divulges information on sin and mental illness in the Middle Ages. From medieval sources, Shoeneman recognizes indications of truth within medieval authors’ beliefs concerning the origins of mental illness such as alcoholism, grief, and overwork as well as how, under many circumstances, religious beliefs such as sin and wrongdoing were also considered to be the cause. Such information was utilized in the timeline of our website, located on the “Breaking Barriers” page.

Franklin Pierce, “Veto Message, May 3, 1854,” in James D. Richardson, A Compilation of the Messages and Papers of the Presidents, 1789-1897 (Washington: Published by the Authority of Congress, 1898), V: 247-256.

Through her testimonials to the Massachusetts Legislature, Dorothea Dix aimed to provide and allocate ten million acres of land for refined mental health institutions. It seemed that she would be successful in her endeavor as the Bill for the Benefit of the Indigent Insane was approved by Congress. However, President Franklin Pierce, an outspoken critic of federal involvement in state and local issues, vetoed the bill. His main reasoning, in summary, is that States will view Congress as a charity and become reliant on federal support. With this veto, Pierce set forth guidelines for the federal role as a philanthropic agent until well into the twentieth century. This was an immense loss for Dix but it was also a major turning point in her career. The veto pushed her to achieve reformative actions in other countries and states. There is a quote from President Pierce is on the “Triumphs” page.

Book

Bly, Nellie. Ten Days in a Mad-House: or, Nellie Bly's Experience on Blackwell's ​ Island: Feigning Insanity in Order to Reveal Asylum Horrors. N.L. Munro, 1887. ​ In order to investigate New York’s mental institution, Blackwell’s Island Asylum, Bly checked herself into a boarding house for women and feigned insanity. She was the first to go undercover in the facility. There, she discovered that the doctors were incompotens, the patient were being abused, it housed sane, misunderstood foreign women, and the overall living conditions were horrible. When she was let out, she wrote articles of her experience that would later be turned into a book, advocating for further funding of the asylum. This was an excellent, true to life source of information for the circumstances of asylums of that era. We were able to gain a deeper understanding of what Dix similarly surveyed in Massachusetts’ asylums.

Image

1800s Hospital. 1800. ​

This hospital shows both staff and patients in a large room for care and treatment. There are patients of all ages in beds. This photograph is on the “Stigma” page.

A Postcard Depicting the Mississippi State Insane Asylum circa 1915. 1915. ​

Dorothea Dix supported the foundation of the Mississippi State Insane Asylum. The asylum housed about 35,000 patients from 1855 to 1935 and remains open today. This image is on the “Triumphs” page because this facility was one of the many Dix helped open throughout her career.

An Engraving from the 1860s Showing a Wing of the Bethlem Royal Hospital in England. ​

The engraving depicts the Bethlem Royal Hospital in England, which is now the Bethlem Museum of the Mind. There are many women pictured in the hallway, sitting on chairs and benches. The engraving is on the “Stigma” page.

Anonymous. St. Catherine of Siena Besieged by Demons. 1500. ​​​​​​​ ​

During the Middle Ages, anorexia mirabilis, also known as holy anorexia, was prominent for Catholic nuns and religious women. St. Catherine of Siena suffered from this. Church eventually saw anorexia mirabilis as heretical and dangerous. This painting is on the “Stigma” page.

A private duty nurse attending to a patient, Neshanic, NJ, 1950s. Pictures of Nursing: The Zwerdling Postcard Collection. National Library of Medicine

By the 1950’s, many psychiatric asylums have been shut down. A new era of nursing homes and medication for the mentally ill arise, along with a new system of mental care. This image was used in our timeline, as it compared conditions of asylums during Dorothea Dix to a century after her.

Bly, Nellie. Popular Mode of Curing Insanity! Lizzie Bommer Punishing Miss Hodson per ​ Suspicion of Taking Her Key.

Nellie Bly’s Ten Days in a Madhouse includes many illustrations of what Bly had witnessed ​ ​ during her investigative experience in the Blackwell Insane Asylum. In mental asylums, classic 1800s methods of curing patients included beating over the head, kicking, pulling hair, and drenching in water. The drawing is on the “I Tell What I Have Seen” page.

Bosch , Hieronymus. The Extraction of the Stone of Madness. 1516. ​ ​

Displayed at Museo del Prado in Madrid, Cutting the Stone, also called The Extraction of the Stone of Madness or The Cure of Folly, was painted by Dutch/Netherlandish painter Hieronymus Bosch. Bosch is known for capturing religious concepts and narratives. It depicts a performance of trepanation. This painting is on the “Stigma” page.

Callet, C. Samuel Tuke. ​ ​

While on her mental health break to England, Dix met Samuel Tuke, a leader in British asylum reform. Tuke was one of the British reformers who introduced her to his work with mental health advocacy, as that was a movement that occurred in Britain during her stay. This portrait of Tuke is on the “Dix” page.

Continuous Bath Attendant Shown Monitoring Temperature and Water Flow. ​

Hydrotherapy was a prominent method in the 19th century for mental illness, especially in mental asylums. The treatment was meant to calm the nerves. This image depicts patients in a tub of cold water, watched over by a staff member of the asylum. It is on the “I Tell What I Have Seen” page.

Cooke, Jerry. Female Patient in the Ohio Insane Asylum. ​ ​

This photograph depicts a despairing young girl on a bench in the Ohio Insane Asylum. This demonstrates the desolate conditions of asylums constructed for mentally ill patients but lacked proper treatment for mental illness. This image is on the “Thesis” page.

Cooke, Jerry. Female Patients Preparing Food in the Ohio Insane Asylum. 1946. ​ ​

A treatment for the mentally ill involved engaging patients with tasks such as sewing or preparing food. Women of all ages are seen in a rather dreary room. This photograph is on the “Stigma” page.

Cooke, Jerry. Women in an Ohio Insane Asylum. ​ ​

This image exhibits numerous sorrowful women ranging from all ages sitting on benches in the Ohio Insane Asylum. Cooke captures this era’s mental asylums’ dismal state. This photograph is on the “Thesis” page.

Cooke, Mary Delaney. Patients Sit inside Ohio's Cleveland State Mental Hospital in 1946. ​ 1946.

The image exhibits dismal circumstances of Ohio's Cleveland State Mental Hospital. There are many women ranging from all ages sitting on benches and chairs. This image is on the “Fleeting and Forever” page.

Corbis. Blackwell’s Island Asylum. ​ ​

Nellie Bly investigated the Blackwell’s Island Asylum undercover. She discovered horrible treatment towards patients from the staff and reported information on the mental asylum. This image of the asylum in New York is on the “I Tell What I Have Seen” page.

Crowded Dining on Blackwell’s Island, circa 1896. 1896. ​

Provided by Viewing NYC, the photograph of a packed dining area for men of the Blackwell’s Island Asylum packed. The asylum was poorly resourced in proportion to the amount of patients. We put this image on “Breaking Barriers” because Dorothea Dix was fighting for providing mentally ill patients with sufficient conditions within facilities.

Danvers State Hospital, Massachusetts. ​

The Danvers State Hospital is a hospital that Dorothea Dix assisted in the development with her ideas of humane treatment towards the mentally ill. The Danvers State Hospital took into account the concept that architecture assists with mental illness treatment. This image is on the “I Tell What I Have Seen” page.

Dix, George L. Ward No.3, East Cambridge, Massachusetts, USA. Cambridge, 1854. ​ ​

This drawing of a map of East Cambridge in Massachusetts reveals where Dorothea Dix had witnessed the inadequate conditions of the East Cambridge Jail. It gives a sense of location when

describing where Dix was inspired to begin her reformative movement. This image is on the “Dix” page.

DIX LETTER, 1850. 1969. ​

Dorothea Dix contacted President Millard Fillmore about her mental health reformative work. Fillmore was not in office when Dix’s bill for providing land to mentally ill individuals were vetoed. The photo is on the “Fleeting and Forever” page.

East Cambridge Jail. ​

The East Cambridge Jail was where Dorothea Dix witnessed inhumane treatment towards the mentally ill. Dix was able to get renovations for the East Cambridge Jail after she saw that there was no heating system for the prisoners. Her visit at the East Cambridge Jail was a significant moment in her career. This image of the East Cambridge Jail is on the “Dix” page.

Goya, Francisco. The Madhouse. ​ ​

The Madhouse, an oil-on-panel painting by Spanish romantic painter and printmaker Francisco Goya, depicts an early 1800s psychiatric institution. Goya’s works criticize the social and political problems of his era. This painting is on the “I Tell What I Have Seen” page.

Grant, James. “Disturbed Patients in a London Lunatic Asylum or Psychiatric Hospital.” Sketches in London, Hulton Archive/Getty Images. ​

During her stay with the Rathbone family, Dorothea Dix was educated about the British lunacy reform movement. It inspired Dix to begin her career as an advocate for mental health. Barriers of stigma around mental illness in Britain were similar to America as represented by this illustration by James Grant. This resource is on the “Dix” page.

Gress, John. India, 42, Suffers from Manic Depression and Post-Traumatic Stress Disorder. ​ She Has Spent Almost All of Her Adult Life in Jails and Prisons. ​

Mentally ill individuals sometimes seek prisons to get medication; they commit a crime to get in. According to the New York Times, India said that she has “tried at various times to get psychiatric care but found it almost impossible”. This portrait of India’s side profile is on the “Fleeting and Forever” page.

Gress, John. The Cook County Jail Has Become a De Facto Mental Health Hospital, the ​ County's Sheriff Says. ​

This photograph is of the Cook County Jail. Sheriff Thomas Dart describes the Cook County Jail as a de facto mental health hospital. Dart stated, “We’ve systematically shut down all the mental health facilities, so the mentally ill have nowhere else to go.” This image is on the “Fleeting and Forever” page.

Gress, John. The Cook County Sheriff, Thomas Dart, Center, Talks with Inmates Russell, ​ Right, and Compton. Russell, 46, Has Been Diagnosed with Severe Depression.

Mental illness continues to be criminalized in today’s society and is continues to be a massive problem. Those with mental illness are imprisoned instead of being cared for at psychiatric hospitals. This image is on the “Fleeting and Forever” page.

Hogarth , William. An Illustration of the Bedlam Insane Asylum. ​ ​

This engraving by William Hogarth as we found in Charles Phelps Cushing’s collection of Getty Images, depicts psychiatric patients in the Bedlam Insane Asylum. The Bedlam Insane Asylum was seen as a freak show and visitors were allowed to view the afflicted individuals with beer and nuts on sale. This image is on the “Stigma” page.

A Vigil for Increasing Mental Health Care at Cook County Jail in 2014. 2014. ​

Mental health has been criminalized throughout history and it continues to be in modern times. Individuals with mental illness have been frequently placed in prisons instead of hospitals where they could receive proper treatment. This photograph shows that there are people at Cook County who protest against this, this is displayed on the “Fleeting and Forever” page.

Lundborg, A. P. Worcester State Asylum in Worcester, Massachusetts. Worcester, 1905. ​ ​

Dorothea Dix was able to gain funds for the Worcester State Asylum through her reformative work. This was a significant success in Dix’s career. The image of a postcard is on the “I Tell What I Have Seen” page.

Miss D.L. Dix. Washington, D.C., Aug. 1865. ​

This photograph from the Library of Congress shows Dorothea Dix holding a book and sitting in a room with a medical bag on the floor. It is placed on the “Resources” page as a callback to Dix’s portrait on the “Home” page.

“New York Lunatic Asylum New York Lunatic Asylum On Blackwell Island In 1868 Contemporary Colored Engraving.” Granger Collection, 1868.

The New York Lunatic Asylum opened in 1841 on Blackwell’s Island. It originally focused on approaching mental illness treatment with moral treatment. Patients would participate in recreational activities to lift their spirits. Unfortunately, the asylum divulged from the ideals of moral treatment as it overcrowded. This drawing is on the “Breaking Barriers” page and provides a glimpse of the happenings of mental asylums from the inside.

Person with Mental Illness Chained to Wall. ​

This drawing depicts an individual chained to a wall in a prison. This demonstrated the cruelty of the criminalization of individuals with mental illness. This image is on the “I Tell What I Have Seen” page.

Pierce, Bill. Mentally Handicapped Patients Sleep in Chairs at Willowbrook State School. ​ ​ Staten Island, New York, 1972.

This disheartening image of patients residing within the Willowbrook State School recalls a darker time in a facility originally to care for children with intellectual disabilities. World War II transformed it to be a U.S. Army hospital, the Halloran General Hospital, because of its spaciousness. It was until 1947 did the New York State Department of Mental Hygiene intervene and revert the hospital to its roots. Though it was far from Dorothea Dix’s time, we placed it on the “Dix” page because it highly resembled the inadequate and crowded conditions of mental hospitals.

Pierce, Bill. Young Patients Sleep, Curled up in Carts, in Building #29 at Willowbrook State ​ School. Staten Island, New York, Jan. 1972. ​ Willowbrook State School, a hospital for children with intellectual disabilities, had once been reorganized to be Halloran General Hospital. This forced patients to crowd together as exhibited in the photo as the maximum capacity was 4,000 people when there were 6,000 residents. Willowbrook was described as a “snake pit” and a “warehouse” for the mentally disabled. This image is on the “Dix” page because although she had not visited this hospital, it resembles the crowded and insufficiently run facilities in Massachusetts.

President Franklin Pierce. 1869. ​

President Franklin Pierce vetoed Dorothea Dix’s bill for providing land for mental health aid, this was a massive defeat for Dorothea Dix. This image is within the collection of the Library of Congress. This image is on the “Triumphs” page as a defeat that she faced.

The dining hall for African-American patients, circa 1915. National Archives and Records Administration/National Building Museum

After the initial negative reaction to Dorothea Dix’s actions, by the 1870’s, virtually every state in the United States had one or more asylums funded by state taxes. This image shows the conditions of mental asylums after her crusade for better rights for the mentally ill. This picture was utilized in the timeline.

The Indianapolis Hospital for the Insane. 1854. ​

The architecture for the Indianapolis Hospital for the Insane is based on Kirbride’s Plan for psychiatric hospital designs that would help the treatment process. One of the advocates for the therapeutic construction was Dorothea Dix. This image is on the “I Tell What I Have Seen” page.

The Porches of the 1890s Allison Buildings, Shown above in 1910, Were Later Enclosed to Provide More Space for Patient Beds.

Dorothea Dix’s work for mental health had great impacts on psychiatric hospitals like the Allison Buildings. She set standards for care for mental illness, she thought it necessary for the recovery of patients to be treated humanely. This image is on the “Triumphs” page.

The Twelfth Night Entertainment in Hanwell Lunatic Asylum. London, 1848. ​

Published in the Illustrated London News, the drawing shows a dance and a feast that took place in celebration of Twelfth Night in the Hanwell Lunatic Asylum. This particular asylum was progressive in its mindset and humane towards its patients. This image is on the “Dix” page.

Stadler, J. C., et al. “St Luke's Hospital, Cripplegate, London: the Interior of the Women's Ward, with Many Inmates and a Member of Staff.” Wellcome Library, 1809. ​ ​

The illustration displays a portion of the interior of St. Luke’s Hospital in London, the women’s ward. It is described by the Science Museum that “[s]ome patients are industriously working, others tear their hair out in torment and some are slouched in despair”. It is on the “I Tell What I Have Seen” page.

St. Elizabeths Nurses in the 1950s Study a Portrait of Dorothea Lynde Dix, a 19th Century Social Reformer. 1950. ​

Dorothea Dix was able to impact future psychiatric hospitals with her reformative work. For the St. Elizabeth’s Hospital, she made sure that it had heat, tall arched windows and screened

sleeping porches where patients could catch summer breezes. For this, Dix was commended and hospital by the hospital. This image is on the “Triumphs” page.

Streshinsky, Ted. A Guard at Vacaville State Prison Prepares a Prisoner for a Lobotomy. ​ ​

Lobotomy was a method of neurosurgical treatment for mental illness. Historically, forms of lobotomy were utilized because it was thought that it would release evil, but in more recent times, there are more proper and effective procedures. This image is on the “Thesis” page.

Ward in the Fergus Falls State Hospital. 1900. ​

The Fergus Falls State Hospital opened in 1890 and its architecture was based on the concept that architecture would support treatment for mental illness. Parts of patient treatment were exercise, farming, entertainment, reading, and sewing. This photograph was on the “I Tell What I Have Seen” page.

Waugh, Samuel Bell. Dorothea Lynde Dix. National Portrait Gallery, St. Elizabeth’s ​ ​ Hospital, 1868, Smithsonian Institution, Washington.

This is a painting of Dorthea Dix by prominent American portrait artist Samuel Bell Waugh. Waugh used oil on canvas and the portrait was gifted to the St. Elizabeth Hospital from the Smithosnian. The St. Elizabeth Hospital’s development was assisted and supported by Dix. This image is on the “Home” page.

Women Eating at Bellevue Hospital, Blackwell’s Island, circa 1896. 1896.

Provided by the Museum of the City of New York, the image depicts a dining area of the Bellevue Hospital crowded with women. Bellevue was an epicenter for treating disease of underserved groups as well as a psychiatric hospital. The hospital also lacked anesthesia and performed brutal procedures on patients. This photo is on “Breaking Barriers” as Dorothea Dix sought to standardize humane and effective treatments for the mentally ill.

Newspaper

“Out of an Insane Asylum.” The New York Times, 26 Mar. 1880. ​ ​ In 1880, the New York Times covered a mental illness patient, John Carrroll, and his journey of persevering through abuse. Carroll was sent by his family to the Dixmont Insane Asylum at Pittsburg, suffering the effects of brain fever. He was treated roughly when bathing and beat senseless when placed in his cell. When he raised concerns about taking medicine, he was once

again beaten and forced to take it. During the night, he took off his strait-jacket and when he was found out in the morning, he was beaten a third time, breaking his ribs and injuring his spine. After much compliance to the asylum’s staff, he was released but not before witnessing the near-death of an inmate. This segment provided a first-hand experience on how patients of mental asylums were abused which enabled us to understand how insufficient the care and treatment towards the mentally ill. This newspaper clipping was used in the portion of “Stigma” concerning mental asylums and the brutality enacted upon their patients.

Interview

Ho, Sophia Michelle and Kim, Sara Sol. “Interview with Marcia Pontoni.” 20 Jan. 2020.

Marcia Pontoni is a licensed clinical social worker at Kaiser’s Behavioral Health Department. With a master’s in social work, she has worked as an on-duty therapist for 14 years and has been managing the department and running educational programs on mental illnesses for the past five years. We talked to Pontoni by phone and recorded the interview with another phone. Pontoni provided excellent, in-depth explanation for each of the questions we inquired, relating how mental illnesses such as depression have significant influence on the modern day. She divulges that suicide rates have been extremely high and necessary treatment for diseases of the mind such as depression include therapy. She emphasized the need for psychiatrist, centers for mental health, and the acknowledgement of mental health from society. We gained insight on the steps currently being taken to progress treatment of mental health, her take on the importance of being informed on mental health and how one can educate themselves on mental health, how she thought treatment for mental health has changed over the years, and how she thought laws have affected mental health over the years.

Secondary Sources

Article

Bigelow, Ann Clymer. ""The Most Appalling Forms of Degradation": Dorothea Dix Speaks ​ ​ ​ Out for the Insane in Ohio Poorhouses." Ohio Valley History, vol. 18 no. 4, 2018, p. ​ ​ ​ 23-41. Project MUSE muse.jhu.edu/article/712032. ​ ​ ​ ​

On her tour of mental institutions and prisons throughout the states, Dorothea Dix arrived at a poorhouse in Muskingum County on August 18, 1844. She wrote a follow-up letter to county judge Nathaniel Ewing in an effort to reform the care of the mentally ill in Ohio’s poorhouses. She had witnessed horrible treatment of two women by the staff in an Ohio asylum. In Ohio, similarly to her surveys of Massachusetts’ facilities and New York’s facilities, “the best ordered Alms house furnishes no suitable accommodations or efficient care for the insane.” Dix’s aimed for the construction of almshouses in Ohio more than anything, fighting for the sake of human beings inhabitting poorhouses. After her 1844 Ohio tour ended, she wrote to a friend that if she failed to convince Ohio to construct a State Hospital, “[she] shall feel amply rewarded by what I

am able to effect in prisons and almshouses.” Her reformative actions followed a routine: She voiced horror at what she saw and write a report or directly intervene. This particular article was very helpful as it enabled us to understand how Dix reformed mental health care and how passionately she is able to take initiative.

Field, Peter S. “Less than Meets the Eye: The Strange Career of Dorothea Dix.” Reviews in ​ American History, vol. 27, no. 3, 1999, pp. 389–396. JSTOR, ​ ​ ​ www.jstor.org/stable/30031077.

In Field’s journal article, Dix thoroughly explained the motives of Dorothea Dix when she took reformative action for the mentally ill. He declared her heart to be pristine; she was “[p]ossessed of an indomitable will” and “dedicated virtually her entire adult life” to take a stand against abuse and neglect of mentally ill individuals in insufficient prisons and other institutions. Dix thought of her cause as a “divine mission”, sacrificing herself to the nation for the advancement of mental health treatment. Mistreatment of the mentally ill was derived from “people obsessed with ambition and greed.” Field commented on how Dix is often unrecognized for her achievements, overshadowed by figures such as Florence Nightingale. This article helped our project by enforcing that Dix had fiery compassion in her work and the intentions of her reform was genuine.

Harry McKown, "January 1849 — Dorothea Dix Hospital," This Month in North Carolina History, January 1849.

In the United States, the mentally ill were either treated at home or were kept in common jails or poorhouses, neglected and often abused. In the 1830s and 1840s, an important humanitarian reform movement was the promotion of a new way of thinking about and treating mental illness. By the late 1840s, all thirteen states had constructed State Hospitals for the mentally ill except North Carolina and Delaware. In North Carolina, it was expressed that the mentally ill should be considered in government but no bills were passed. Dorothea Dix took it upon herself to take action, following her pattern of gathering information about local facilities and then wrote to federal officials, the General Assembly. Though the government did not favor the initiative of spending, she was able to win support for reform. However, the bill failed and Dix’s dying request to James Dobbins, a leading Democrat in the House of Commons whose wife assisted through her illness, pass the bill. James Dobbins returned to the House and called for the reconsideration of the bill. On January 29, 1849, the bill became law and the construction of the new hospital in Raleigh began. Ultimately, this resource demonstrates Dix’s passion for her work as well as a short-term impact of her actions.

Kazano H. [Asylum: the Huge Psychiatric Hospital in the 19th century U.S]. Seishin Shinkeigaku Zasshi. 2012;114(10):1194-200. PubMed PMID: 23234200.

This article discusses the prevalence as well as the conditions of 19th century asylums in the United States. Asylums were not originally built for institutionalizing patients, but to act as sanctuaries for the protection of mental patients. At the same time, moral treatment a humane and effective treatment for mentally ill individuals, was introduced as well as the therapeutic

landscape method as developed by Dr. Thomas Kirkbride. Asylums were to embrace both of these techniques to assist mental patients but it fell out of favor towards the end of the 19th century; the hospitals had many uncured patients and caregivers became pessimistic about the efficacy of the treatments. Abuse and neglect of mental asylum patients was common and the environment at the asylums deteriorated. Conclusively, this resource was helpful in understanding the original intentions of mental asylums and how they later devolved into poor and deficient institutions. This information was used in “Stigma”, as it provided insight on how mental asylums came to be such inadequate establishments.

Lowe, Tony B. (2006) "Nineteenth Century Review of Mental Health Care for African Americans: A Legacy of Service and Policy Barriers," The Journal of Sociology & Social Welfare: Vol. 33 : Iss. 4 , Article 5.

Sponsored by the Western Michigan University, Lowe of the University of Georgia reviews treatment of mental health and the barriers involved with it during the 19th century. Lowe states that “[t]he cause and treatment of mental illness for African Americans were viewed differently from that of whites,” African Americans with mental illness were viewed with biological defect and social inferiority. Lowe presents a case study comparing the efforts of Pennsylvania and South Carolina to document developments from a political economy perspective. The results of the data suggests that prevailing social, political, and economic factors have contributed to inadequacies in mental health as it relates to race. This information was especially useful in our “Breaking Barriers” website page as it exhibits another barrier involved with mental health.

Nathaniel P. Weston. “The Evolution of Mental Health Administration and Treatment in Antebellum Louisiana.” Louisiana History: The Journal of the Louisiana Historical ​ Association, vol. 40, no. 3, 1999, pp. 305–326. JSTOR, www.jstor.org/stable/4233598. ​ ​ ​

Weston of the University of Washington writes of the conditions that shaped mental health treatment in antebellum Louisiana. The implementation of moral treatment was eventually used in mental asylums, its methods revolving around order and discipline. The construction of American asylums in the early 19th century as in response to the basic needs of the homeless, the poor, and the disorderly mentally ill. The concept of asylums revolved around the principles of decency under the belief that the mentally ill could be cured if provided with adequate conditions of institutions. A “temporary insane asylum for the indigent insane” was established in New Orleans. Inmates of the asylums were detained for violating racist and genered cultural norms as opposed to having mental illness. Ultimately, this article helped us recognize how mental asylums came to be ineffective in treating mental illnesses.

Parry, Manon S. “Dorothea Dix (1802–1887).” American Journal of Public Health, © ​ ​ American Journal of Public Health 2006, Apr. 2006, www.ncbi.nlm.nih.gov/pmc/articles/PMC1470530/.

Manon, an author who is with the History of Medicine Division of the National Library of Medicine, wrote an official government article overviewing her personal life to the effects of Dorothea Dix’s impact on the medical world. She brings great attention to how Dorothea Dix’s

own struggles may have helped her become a more passionate advocate for the mentally ill. Dorothea frequently experienced illness and had racing thoughts of suicide, which led to biographer David Gohaller suspecting that she had some form of depression during this time. With this information, one could conclude that Dorothea had a personal connection to what she was advocating for, which would explain her fierce determination and persistence.

Book

“CHAPTER I Asylum Reform Ideals: Personnel Matters.” The Rise of Mental Health ​ Nursing: a History of Psychiatric Care in Dutch Asylums, 1890-1920, by Geertje ​ Boschma, Amsterdam University Press, 2003, pp. 31–58.

Boschma, PhD professor of the University of British Columbia mentions how moral treatment, rooted from enegelical, utilitarian, and hygienist movements, was “the idea that the insane had an inmate capacity of self-control, reason, and a moral, ordered way of living that could be brought out if they were treated as ration human beings.” On the other hand, mental asylums that locked their patients in chains or kept their patients in cages went against the principles of moral treatment. An essential method of treatment within mental asylums was isolation, segregation to abolish existing psychological causes and societal influences. Confinement was thought to have a healing effect for it changed the environment and daily regimen which imposed regularity on a disordered state of existence. This information was useful in understanding the relationship between 19th century moral treatment and mental asylums.

“Dorothea Dix.” A Group of Famous Women: Stories of Their Lives, by Edith Horton, D.C. ​ ​ Heath and Co., 1914, pp. 61–72.

In Horton’s collection of information on various empowering women, Dorothea Dix’s early life and career in reformative action for the mentally ill was covered. Joseph Dix, Dorothea’s father, paid little regard for his family and required his family to assist in his own work. Dorothea went to live with her grandmother in Boston. She studied diligently during her time in Boston and returned to Worcester to open a small school for young children when she was fourteen years old. She eventually returned to Boston and studied further. When she was nineteen years old, she opened a boarding school. Dix managed two schools, took care of her two brothers, and took charge of her grandmother’s home. Dix found the time to publish Common Things, Hymns for ​ ​ ​ Children, and Evening Hours. Her filled schedule declined her health and she moved throughout ​ ​ ​ the states until she eventually went to England. When she returned to the states once more, she taught Sunday school at East Cambridge Jail where she witnessed prisoners in inadequate conditions. She took this case to the Court in East Cambridge and succeeded in granting the prisoners heat. She travelled throughout the United States and through newspapers and pulpits, she made the circumstances of poorhouses and jails known. In 1850, a significant bill she submitted was vetoed by President Franklin Pierce. She went on outside of the United States to continue her reformative work. She served in the Civil War and devoted fifteen years more to the welfare of the mentally ill before she retired in Trenton, New Jersey and passed. This segment of Horton’s book was helpful to our project as it covered Dix’s background and her short-term accomplishments; we were able to interpret her long-term impact as well.

Gollaher, David L. Voice for the Mad: The Life of Dorothea Dix. The Free Press, 1995. ​ ​ ​ This biography of Dorothea Dix by Gollaher, president of the California Health Care Institute, documents her crusade to help the impoverished mentally ill by lobbying legislatures and soliciting funds that ultimately created thirty state asylums. She succeeded in bringing national attention to the inadequacies of mental health treatment. Furthermore, Dix achieved much outside of mental health reform as well, she organized Union nurses during the Civil War. This resource introduced biases that Dix held such as her belief that slavery was not wrong and her predjuices against Roman Catholics. Ultimately, her work raised awareness to politicians and voters on mental health and her work was a vital step for America in the right direction for the future of mental health.

Hall, Peter Dobkin. “History Maker: Dorothea Dix.” American History: Observations & ​ Assessments from Early Settlement to Today, Master Books, 2012, pp. 135–135. ​

An excerpt from Peter Dobkin Hall, American author and historian, explains the veto of the Bill for the Benefit of the Indigent Insane in an American history book by James P. Stobaugh. It summarizes the goals of the bill, to set aside 10,000,000 acres of land for the mentally challenged with each state receiving 100,000 acres. This resource goes into depth about the reaction of Dix’s supporters to the veto as well as President Franklin Pierce’s reasoning for the veto. Dix and her supporters had high hopes for her bill and condemned the veto. Pierce justified his actions by declaring it outside the extent of federal power. Hall explains that Pierce “set forth guidelines for the federal role as a philanthropic agent until well into the twentieth century”.

Lieberman, Jeffrey A., and Ogi Ogas. Shrinks: the Untold Story of Psychiatry. Little, Brown Spark, 2016.

Liberman, an expert in the mental illness field, specializing in schizophrenia, thoroughly examines psychiatry throughout history, emphasizing its origin as well as its scientific elements discovered as time progressed. This book was especially helpful in recognizing societal perception of mental illness and reinforced the theme of barriers. This particular resource acknowledged the segregation between patients in mental asylums and those on the outside. Patients were considered social deviants being punished by divine forces. He states causes of some mental illnesses, debunking false claims that mental illness correlated with homosexuality, identifies several modern pioneers for mental health, links to the science of prescription to treating mental illness. We utilized this newfound information for writing the project’s portion of historical context and the long-term impact. During Liberman’s visit to Politics & Prose in Washington D.C., he discusses this book, revealing his motives. Many have claimed that mental illness was a way to receive attention and Liberman sought to set the record straight with his book.

Muckenhoupt, Margaret. Dorothea Dix Advocate for Mental Health Care. Oxford ​ ​ University Press, 2003.

Muckenhoupt documents Dorothea Dix’s journey with much detail and context, beginning at her early life in Worcester and then to Boston, continuing on to publish books and opening schools in Massachusetts. Her teaching career eventually led her to witness the faults of the East Cambridge Jail. Driven by her religious faith and what she had seen in the jail, she published the circumstances of the mentally ill in newspapers and spoke strongly to advance mental illness treatment. The book also provides information on moral treatment, a humane method of mental illness treatment. Dix surveyed all of Massachusetts and presented her works to the government. She requested the government for the allocation of land for the mentally ill but was vetoed by President Franklin Pierce. Dix travelled to England where she continued to advocate for the mentally ill and convinced the pope to improve conditions for Rome’s mentally ill patients. Dix came back to the states and served in the Civil War before returning to further work for the mentally ill. Overall, this resource was a helpful and necessary review of Dorothea Dix’s history and reformative career.

Tiffany, Francis. Life of Dorothea Dix. Hansebooks, 1890. ​ ​

Francis Tiffany was an author residing in Baltimore, Maryland. This book was helpful in covering the entirety of Dorothea Dix’s early life and career to a degree. Though it was thoroughly detailed, well-researched, and contained an abundance of quotes that enabled us to cut down our word count, we noticed some of their writing to be dramatised, leading us to believe that some information could be convoluted and misinterpreted as a result. Thus, we only utilized the book’s information on President Franklin Pierce’s veto. We found a helpful quote from Dorothea Dix about the initial Bill for the Benefit of the Indigent Insane which we placed on the “Triumphs” page.

Digital File (PDF)

McGovern, Constance M., "Mad doctors" : American psychiatrists, 1800-1860." (1976). Doctoral Dissertations 1896 - February 2014. 1350.

McGovern of the University of Massachusetts Amherst writes of careers in mental illness in 1800s and beyond, noting how what was at first unfamiliar became prevalent. Doctors in the antebellum period had increasing difficulties with medicine in mental illness. Antebellum physicians sought opportunities in stable and profitable practices, though it was unseen by the public as public reliance diminished, the patent medicine industry was commercialized, and medical school graduates multiplied. Psychiatric medicine was only practiced within asylum walls. McGovern goes into the origins of asylums from the Europeans and how it was diffused back to America. By the early 1840s, a group of psychiatrists who established professional independence in their career called themselves “mad doctors”. They founded the Association of Medical Superintendents of American Institutions for the Insane (later renamed American Psychiatric Association) in 1844. It matured into an elite and powerful professional organization, dictating policies for organization administration, and treatment of mental illness to state

legislatures and charitable organizations which supported asylums. In the 19th century, the Association failed to incorporate discoveries of advancing science. Ultimately, we learned of a different side of mental health reform assisted with many graphs and it enabled us to understand 1800s advancements and support for mental health.

Meyers, Barbara. “The Spirit of Dorothea Dix: Unitarians, Universalists and the Mentally Ill.” 2002.

In addition to other figures of the past striving for proper treatment for the mentally ill, Meyers stated that Dorothea Dix was “the most foremost crusader for the mentally ill in the United States in the mid-1800s.” Despite facing prejudice towards women, her ambition and hard work accomplished much progression for mental health. Her sense of religious purpose of life drove her to devote her life to reform. Meyers provided a brief historical overview of the treatment of the mentally ill in North America. Dix found that the local almshouses and jails in which the mentally ill inhabited were negligent and often had abusive staff. The mentally ill were not treated like human beings, justified by prevailing orthodox religious opinions. Meyers proclaims that deinstitualization from the time of Dix’s crusade comes full circle with today. This resource enabled us to understand the outlook of mental illness during the 18th and 19th century, how stigma concerning mental illness formed.

Roberts, Albert R. and Kurtz, Linda Farms (1987) "Historical Perspectives on the Care and Treatment of the Mentally Ill," The Journal of Sociology & Social Welfare: Vol. 14 : Iss. 4 , Article 5.

This PDF examined the history of mental illness and its treatment over the centuries, revealing that the mentally ill have been subject to abuse, confinement, and isolations. Reformers such as Dorothea Dix had advocated for mental health, yet, modern times’ care for mental illness resemble the 19th century. Some continue to hold the ideology that mental illness is a form of religious punishment or possession by evil spirits. It reports on historical occurrences such as the banishment to ships of fools, mental asylums and institutions as well as more current occurrences such as the National Committee for Mental Hygiene led by Clifford Beers and the Community Mental Health Centers. Ultimately, we were able to use this information in both ̈Stigma ̈ in regards to mental health in the 19th century and ̈The Fleeting and Forever” for modern reform.

Smark, Ciorstan J. “Dorothea Dix: A Social Researcher and Reformer.” University of Wollongong Australia , 25 Nov. 2005.

Smark of the University of Wollongong wrote of Dorothea Dix’s reformative career. In her life, she had four professions—a teacher, an author, a reformer, and a nurse. In the 19th century, there were standards that degraded women and the mentally ill. Dix was able to persevere through and get through to the government and throughout that nation that the mentally ill should be treated and cared for properly. Her reformative work was through first-hand research of prisons, lobbying, and passionate advocacy. Dix also had talents in advancing nursing during the Civil War. Though she experienced much hardship, her successes are celebrated in this archived

report. Conclusively, this digitized paper helped us because it was very detailed, included many dates correlating with occurrences, and contained various quotes from reliable sources.

Torrey, E. Fuller, et al. “More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States.” Treatment Advocacy Center, May 2010.

Along with Executive Director Torrey, Sheriff Kennard, Sheriff Don Eslinger, Professor Lamb, and Executive Director Pavle contributed to the compilation of this digitized report. Though its research may be somewhat outdated, its information is relevant to how Dorothea Dix’s work applies to recent times. According to 2004-2005 data not previously published, there are more than three times more seriously mentally ill patients in jails and prisons than hospitals in the United States. The report states that “America’s jails have become our new mental hospitals.” The report mentions how Dix led a movement of advocating for proper treatment for the mentally ill as opposed to punishment. Deinstitutionalization began in the 1950s, drawing support from fiscal conservatives. Varying states varied in severity of deinstitualization and data exhibits the lack of psychiatric beds. This is an issue because the mentally ill inmates are “frequent flyers” (repeated offenders), jailing mentally ill inmates cost more, mentally ill inmates stay longer, mentally ill inmates are major management problems, mentally ill inmates are more likely to commit suicide, and mentally ill inmates are sometimes abused. The report goes on to provide possible solutions for deinstitutionalization including the use of outpatient treatment, the use of mental health courts, to conduct unannounced surveys, to shift funds, to fix the federal funding system, and to reform the treatment laws. We used this knowledge in our page, “The Fleeting and Forever”, emphasizing the connection of Dix’s advocacy to the current state of mental health. Ultimately, this report was very informative in how the United States has had a repeated issue of punishing the mentally ill and how it has detrimental effects on modern society.

Interview

Borson, Bob. “Dr. Jeffrey A. Lieberman at Politics & Prose.” 29 Mar. 2015.

At Politics & Prose at Washington D.C., Bob Borson interviews Dr. Jeffery Liberman on his book, Shrinks: the Untold Story of Psychiatry. Liberman reveals his intentions behind his ​ ​ book—to erase the stigma about mental illness. He acknowledges how individuals associated depression with parenting and mental illness with homosexuality, and how they campaigned this belief until they realized that there was no scientific evidence to back their statements. Liberman continues on to relay the modern reformers of mental illness he mentioned in his book, how they were pushing to learn about mental illnesses and improve upon treatment for mental illness. He comments how mental health treatment is only going to keep advancing from this point. Borson prompts Liberman to read a passage from his book about a time in college he took LSD and recognized how a drug can alter the mind to such an extent; from this epiphany, he also realized that drugs have the ability to help those with mental illnesses. Borson mentions how prescription for mental illness is a form of an art to which Liberman agrees, acknowledging that all treatment for health is an art. Liberman also answers questions about information from his book such as psychoanalytic theory from the audience. This interview gave us insight on how our current society viewed mental illness and how there are mental health reformers like Dorothea Dix who continue to strive for betterment.

Newspaper

Proctor, John Clagett. “St. Elizabeth's Has Notable History.” The Sunday Star, 4 Nov. 1934, ​ ​ pp. 6–7.

On the “Breaking Barriers” page, we used a clipping from the Sunday Star newspaper on Dorothea Dix. The full article is on the development of the St. Elizabeth’s Hospital, a facility in which Dix secured the first appropriation from Congress to start. We used this resource because it was a significant success for Dix’s reformative career. Dix was assigned to assist St. Elizabeth’s Interior Secretary by President Millard Fillmore. She also appointed Dr. Charles H. Nichols as the hospital's first superintendent. Dix and Nicholas based the hospital’s construction on the ideals of Thomas Kirkbride, also an activist for mental health. This resource was helpful because it demonstrated the influence of Dix’s advocacy.

“To Honor Miss Dix.” The Minneapolis Journal, 16 Dec. 1901, pp. 11–11. ​ ​

This Minneapolis Journal segment recalls Dorothea Dix’s reformative career as a memorial is built in her honor. We used a clipping on the “Breaking Barriers” page of this particular article because it explains one of Dix’s successes, accumulating $3,000,000 in funds for mental welfare purposes. The article covers Dix's difficult early life, notable accomplishments, and legacy. From this newspaper, we learned society’s earlier impacts to Dix’s work.

“Today in Illinois History.” The Day Book, 31 Mar. 1917. ​ ​

With this newspaper clipping on the “Breaking Barriers” page, we wanted to exhibit the influence of Dorothea Dix’s advocacy for adequate mental illness treatment in other states such as Illinois. Although it is shorter than the other two clippings, it demonstrates the public’s reaction to Dix’s cause. As the article claims her career in mental health to be honorable, we learn that the public became more accepting of mental illnesses as a result of her work.

Website

AAHN. “Dorothea L. Dix.” American Association for the History of Nursing, ​ ​ MemberClicks, www.aahn.org/dix.

In this website, Dorothea Dix is recognized for her accomplishments in reforming mental asylums and treatment for mental health. It briefly covers her background in Maine where she lived with her grandmother and where she taught a Sunday School class to women at the East Cambridge house of corrections. It summarizes how she petitioned states to provide funds for mental institutions. It continues to her service in the Civil War and to the end of her life. Overall, this resource was helpful as we fact-checked information we have already gathered with it.

“A Brief History of Psychiatry.” Psychology Today, Sussex Publishers, www.psychologytoday.com/us/blog/hide-and-seek/201206/brief-history-psychiatry.

Psychology Today briefly explains the history of psychiatry and how the view/perception of mental illness changed throughout the centuries. From the ancient Greek and Roman times, they were seen as people with “madness” or divine punishment/demonic possession. Throughout the Middle Ages, Renaissance, and Enlightenment, it slowly began to shift from mental disorders being caused by religion to psychological and social stressors.

“Asylum and Prison Reforms.” Antebellum Era Reform, WikiFoundry, 29 Oct. 2009, 10:27 ​ ​ AM, movementsinamerica9.wikifoundry.com/page/Asylum+and+Prison+Reforms.

This resource highlighted reformers of mental health including Dorothea Dix. as well as changes in the early 1800s as a result of Dix’s work. Dix and others campaigned successfully to seperate prisons and mental wards; Dix, a main force behind the spread of opposing punishment of mental illness and supporting treatment, helped to create mental institutions. She was vital in the development of mental hospitals in Illinois and North Carolina. This website included her success of giving more than 10,000,000 acres to future mental institutions as approved by Congress as well as how it was vetoed by President Pierce. From this information, we were able to understand Dix’s work, though some reformative actions may have not been able to be in effect, and recognize how she was especially important in the advocacy for mental health in regards to imprisonment.

Avina, Maranda. “Antebellum Era: Prison and Asylum Reform.” StMU History Media, St. ​ ​ Mary's University, 14 Oct. 2016, stmuhistorymedia.org/antebellum-era-prison-and-asylum-reform/.

The Antebellum Era marked the time before the Civil War and after the War of 1812, “called for self discovery and reformations that shaped American society” as Avina put it. The Antebellum Era was the first of four major reform periods in American history, the Prison and Asylum Reforms of the 1830s. Asylums were created for criminals and the mentally ill in response to the overcrowding of such individuals. Dorothea Dix was a particular crusader in this movement. Avina summarizes Dix’s life and goes in depth about her petition for psychiatric hospitals to work to help the mentally ill based on foundations of kindness. She continued to work for the improvement of mental facilities, her legacy impacting mental health today. This resource assisted our project as it provided us with information on the movement Dix was involved with and the successes of her career.

“Biography of Dorothea Dix.” Nursing Theory, 2016, ​ ​ www.nursing-theory.org/famous-nurses/Dorothea-Dix.php.

This website writes of Dorothea Dix’s career as a teacher and an author before becoming encouraged to seek advancement for the treatment of the mentally ill, especially the institutions in which they inhabited. She researched throughout Massachusetts and eventually requested funds from the Massachusetts legislature. She succeeded with the request and, for over ten years, travelled throughout the states as well as Europe “to provide quality mental health nursing while providing a therapeutic atmosphere for the curable insane and comfortable housing for the incurable.” The website contains insight on Dix’s legacy for nursing, stating that “her work still provided light to show the way.” This resource enabled us to understand that Dix sought to give the mentally ill care and treatment rather than to outcast them.

“Brief Biographical Sketch of Dorothea Dix.” Brief Biographical Sketch of Dorothea Dix | ​ Teach US History, www.teachushistory.org/node/385. ​

This resource covered Dix’s earlier background (up until 1841), including how her father was an alcoholic and how he abused Dix’s mother. It adds on how she began her religious life and continues to explain her success in reform, surveying Massachusetts and many other states after, collecting information, and petitioning legislatures in order to improve the treatment of mental health. Although she was not always successful, her work to abolish the faulty conditions of mental health institutes and the misconstrued stigma about mental illness stirred lasting impacts. This source was very useful in understanding the identity of Dix as well as she took steps forward in the treatment of mental illness we have in the modern day.

Britannica, The Editors of Encyclopaedia. “Dorothea Dix.” Encyclopædia Britannica, ​ ​ Encyclopædia Britannica, Inc., 13 July 2019, www.britannica.com/biography/Dorothea-Dix.

Born on April 5, 1802, Dorothea Dix was an educator, caregiver, and fierce advocate for those diagnosed with mental illnesses. Her passionate devotion towards the mentally ill led to “widespread reforms in the United States and abroad”. Dorothea Dix inspired many representatives from about 15 different states to establish state hospitals for those who needed it and her efforts affected the construction of about 32 new institutions in the states. She also improved the conditions of already existing hospitals by adding more room, reorganizing, and restaffing with more knowledgeable individuals.

Bumb, Jenn. “Dorothea Dix.” Dorothea Dix, ​ ​ faculty.webster.edu/woolflm/dorotheadix.html.

Jenn Bumb, a local writer, produced an article about Dorothea Dix’s life and how she is portrayed throughout history. The report mentions the possibility of Dorothea Dix’s achievements being neglected, as she is only mentioned within 10% of today’s general history books. Towards the end of her lifespan, her achievements were not commented on very much, as Dix herself preferred to have them “rest in silence”. Bumb elaborates on how this attribute of

Dix’s may have prevented her achievements from becoming more well-known, which would play an influential factor in the making of our project.

CBS News. “19th And 20th Century Psychiatry: 22 Rare Photos.” CBS News, CBS ​ ​ Interactive, 29 Sept. 2011, www.cbsnews.com/pictures/19th-and-20th-century-psychiatry-22-rare-photos/18/.

This website provided us with a series of imagery and information on treatment for mental illness and studies in mental health including phrenology, research in cranial capacity, measuring skulls, brain dissection, the utica crib, restraint chairs, dancing therapy, sound therapy from an opera singer, the implementation of electricity for psychiatric ailments in the late 1700s, diathermia (a precursor to electroconvulsive therapy) - deemed unsafe and unreliable by doctors, electroconvulsive therapy, fever therapy, and patient polygraph for examination. These photographs were useful in understanding the steps taken to advance mental health throughout history. The website was helpful as it directed us to a great amount of images with historical context to put on our own project.

“Central State Hospital.” IHB: Central State Hospital, ​ ​ www.in.gov/history/markers/4324.htm.

This website focuses on mental health of Indiana. It includes the content of Dorothea Dix’s memorials as well as her reformative work in Indiana. She surveyed Indiana similar to her tour in Massachusetts. From this website, we used a quote on the “Triumphs” page on the reason mental healthcare was poor during the 19th century. It saved us words on the word count and described the conditions of asylums housing mentally ill people as Dix sought to fix the state of treatment for mental illnesses.

Citronberg, Jessica. “TBT: Dorothea Dix Begins Her Crusade to Help Mentally Ill.” Boston Magazine, 28 Mar. 2018, 8:00 AM, ​ www.bostonmagazine.com/news/2018/03/29/dorothea-dix-tbt/.

This resource states that, in a century where women were forced under circumstances in which participation in politics was frowned upon, Dorothea Dix was able to gain political traction and start a revolution. After witnessing the horrors of East Cambridge Jail, she reviewed jails and poorhouses throughout the state housing the mentally ill. “She was tireless in her pursuit of prison reform.” In 1843, she submitted a pamphlet to the Massachusetts legislature urging for the support of the mentally ill. When the Civil War began, Dix accomplished much in nursing before continuing her advocacy work. Citronberg enabled us to understand how compassionately Dix fought for the reform of mental institutions.

Coy, Abigail, and Mayo Clinic College Of Medicine. “Mental Health in Colonial America.” The Hospitalist, 14 Sept. 2018, ​ www.the-hospitalist.org/hospitalist/article/123117/mental-health-colonial-america.

In colonial America, the conditions of mental health organizations, medication, and behavior towards mental health were dreadful as a result of society’s negative views revolving around it. Prior to the first mental health hospital in 1783, those with mental illness that “committed crimes, caused a nuisance or posed a potential threat of either” were jailed . This site provides how various took into consideration the imprisonment of innocents with a mental illness and how it sparked an advancement in treatment medically and socially. The site told of those who reflected upon the welfare of those with a mental illness and the actions they took that led us to the advancements of mental health. It also shed light on how cruelly society treated those with a mental illness; this particular website was excellent in revealing the perspectives of varying individuals of that time behaved/took action toward those with a mental illness and overall background information for events occurring prior to Dorothea Dix’s support and assistance of the ordeal.

Desrochers, Alyssa. “Dorothea Dix: Mental Health Reformer and Civil War Nurse.” Smithsonian Institution Archives, 29 Mar. 2012, ​ siarchives.si.edu/blog/dorothea-dix-mental-health-reformer-and-civil-war-nurse.

Desrochers, in honor of Women’s History Month, summarized Dix’s early life and continued to explain her visits of prisons throughout Massachusetts and her successful petition for improvement. In 1848, she requested that Congress set aside lands across the country for facilities for the mentally ill. Dix then travelled throughout the states and parts of Europe, evaluating prisons and mental hospitals and advocating for better treatment for the mentally ill. During the Civil War, she volunteered her services and directed a body of nurses to minister to injured Union soldiers. She was a strict captain but was efficient and effective. Her work in mental health instigated legislative deliberations for future years. In 1852, Congress established the Government Hospital for the Insane in DC. This resource was helpful in understanding her work in both mental health as well as in the Civil War.

“Dix, Dorothea.” National Women's Hall of Fame, ​ ​ www.womenofthehall.org/inductee/dorothea-dix/.

Though brief, this website is helpful, providing a summary on Dix’s life and achievements. It accentuates the influence of her advocacy and the weight of her reformative actions as she strived for better mental health treatment. We were able to utilize this site to connect the various pieces of information about Dix together, ensuring that we had the events that followed her life were correct and ensuring that other sources were credible.

“Dix, Dorothea (1802-1887).” Harvard Square Library, 30 Mar. 2017, ​ ​ www.harvardsquarelibrary.org/biographies/dorothea-dix/.

An important piece of information we have learned from this website is the fact that she met with other Unitarian reformers: Horace Mann, Charles Sumner, and Samuel Gridley Howe. Most resources we have found prior did not include the fact that these three led her to investigate poorhouses, jails, and almshouses throughout the states and Europe. Additionally, unique to most

other resources, this website mentioned that Dix was successful in convincing Queen Victoria and Parliament to support the mentally ill when she visited Scotland. Overall, this website had previously unknown information that was significant in understanding Dix’s motives as well as her impacts.

“Dix, Dorothea Lynde (1802-1887), Social Reformer - American National Biography.” (1802-1887), Social Reformer - American National Biography, 16 June 2017, ​ www.anb.org/view/10.1093/anb/9780198606697.001.0001/anb-9780198606697-e-1500 181.

This resource provided an in-depth analysis of Dix’s life, including her childhood, her career as a teacher, her experience with her mental illness, and the source of her motivation to begin her survey of Massachusetts’ mental institutions. The site incorporates quotes from her articles such as “Astonishing Tenacity of Life”. The resource continues to disclose details of her survey, eventually reaching a federal level, and the European continents she visited during her advocacy for improved mental health treatment. It follows her term in the Civil War as a nurse before resuming to work for reform for the mentally health treatment. The site taught us the impact of her work and her personal experiences, and we better understood her life as a whole.

“Dix, Dorothea Lynde." West's Encyclopedia of American Law. . Encyclopedia.com. 29 ​ ​ Jul. 2019 .” ​ ​

This resource covered the entirety of Dix’s life, beginning from her life with her alcoholic father to her advocacy for mental health to her service in the Civil War. Dix was required to stitch and paste thick religious tracts he wrote and sold during his travels by her father; her mother was depressed. She later moved and went on to use her income to support her family. Dix suffered from depression and chronic upper respiratory infections. The death of her mother and grandmother left Dix a large inheritance in which she used for travel. She met William Rathbone in England and was introduced to social welfare advocates. In 1841, she taught a Sunday school to a group of incarcerated women in the East Cambridge Jail in Massachusetts. Upon touring the jail, she found cells of horrifically poor condition. She surveyed every jail, poorhouse, and prison in Massachusetts and in 1843, she delivered a report to the Massachusetts state legislature and allocated funds to expand the State Mental Hospital at Worcester. She continued to England to further advocate for mental health. In 1861, at the beginning of the Civil War, she did a great deal in organizing women volunteers, establish hospitals, and raise funds. This website was very thorough in covering her life and enabled us to truly understand how she found her motives to be an activist in mental health.

“Dorothea Dix.” Angelpig.org, Network Solutions, www.angelpig.org/dorotheadix.html. ​ ​

This resource focuses on Dix’s efforts in reform for mental asylums. She dedicated herself to the study of the conditions of asylums, prisons, and almshouses across the states as well as Canada and Japan. She presented a “memorial” to the Legislature, requesting funds for a facility specially designed to treat the mentally ill, influencing legislation as well as expanding

knowledge on the mentally ill for the nation. Dix continued to break barriers in the Civil War by developing nursing standards. Dix had once said, “I have no particular love for my species but own to an exhaustless fund of compassion.” Overall, this website’s information was important because it made us realize that a barrier she broke was enlarging social consciousness on mental illness.

“Dorothea Dix.” Brooklyn Museum: Dorothea Dix, Elizabeth A. Sackler Center for ​ ​ Feminist Art, www.brooklynmuseum.org/eascfa/dinner_party/heritage_floor/dorothea_dix.

This website’s paragraph, though shorter than the other sources that we have, did an excellent job in summarizing Dix’s actions as a crusader of the 1800s. This was especially helpful in fact checking and making sure that the timeline in which she worked for reform. In case there was confusion in how or why Dix had accomplished certain occurrences, we knew that we could rely on this website to acknowledge basic information.

“Dorothea Dix.” Dorothea Dix, www.u-s-history.com/pages/h1092.html. ​ ​

In addition to providing information on Dorothea’s life including her childhood, it followed her career as she surveyed the conditions of Massachusetts’ prisons, poorhouses, and reformatories. It especially focused on federal action she took after gathering her research on the flaws of mental health facilities and their lack of hospitality and effective mental illness treatment. The website also covers how she travelled out of the United States to advocate for her cause of bettering overall mental health treatment. It included how Dix stood up for women when serving as a nurse in the Civil War. The source was very helpful for knowing Dix’s life story and accomplishments in her career.

“Dorothea Dix.” EHISTORY, Ohio State University, ​ ​ ehistory.osu.edu/biographies/dorothea-dix.

Before she was a social reformer, Dorothea Dix was an educator. She operated her own girls school in Boston for over ten years. Her health suffered and she moved to England before returning two years later. She began teaching Sunday school in the East Cambridge House of Correction in Massachusetts. There, she learned that the mentally ill were incarcerated like criminals and treated cruelly. She sought to improve mental asylums to her state legislature and went on to fifteen states as well as Canada and Italy to similarly reform mental health. Dix also served in the Civil War. This website enabled us to grasp an understanding of her life in a short paragraph.

"Dorothea Dix." New World Encyclopedia, . 11 Oct 2017, 20:06 UTC. 28 Dec 2019, 05:09, ​ ​ www.newworldencyclopedia.org/p/index.php?title=Dorothea_Dix&oldid=1007232. ​

This website covered Dix’s life, work, legacy, and publications. A significant component of this website contained in its information was how Dix was pressured by societal standards of women of the 19th century to be more “ladylike”. Another component was the fact that Dix placed

priorities in her work, refusing to marry Edward Bangs, her second cousin, in the endeavor of her career. On the topic of her reformative actions for mental health, the website states, “The outcome of her lobbying was a bill to create, expand, and develop state mental hospitals.” In the 20th century, she was blamed for custodialism in the hospitals she had assisted in the founding when it was clear she embraced a holistic approach to care and treatment. When she travelled outside of the states, she travelled to France, Greece, Russia, Canada, and Japan to support hospitals for the mentally ill. Overall, this website had information we had not previously known and it demonstrates how strong of a character Dix was.

“Dorothea Dix.” Trans-Allegheny Lunatic Asylum, ​ ​ trans-alleghenylunaticasylum.com/main/history4.html.

This resource is similar to others we have included in this bibliography but a unique point in this website's information was the fact that Dix worked closely with Thomas Kirkbride. Thomas Kirkbride believed that the architecture of an asylum could assist with the healing process for mentally ill patients. The first state hospital for the mentally ill in Trenton, New Jersey applied Kirkbride’s method of treatment. This website enabled us to understand how Dix worked with other mental health reformers in her career.

“Dorothea Dix.” UUA.org, 21 July 2017, ​ ​ www.uua.org/re/tapestry/children/windows/session16/143973.shtml.

The Unitarian Universalist Association recognizes Dorothea Dix for being an extremely influential figure in our society and for becoming an important Unitarian, a Christian belief in that God is one person. This source describes her life timeline, from when she was born to how she became religious. It adds how Dix investigated conditions in prisons, filed reports, and testified before state legislatures to help others will mental conditions. She helped establish hundreds of mental asylums and helped push against conventional thoughts that all those with mental illnesses are “cursed” or “sick”.

“Dorothea Dix & Franklin Pierce.” NPR, NPR, ​ ​ www.npr.org/programs/disability/ba_shows.dir/work.dir/highlights/dixfrank.html.

A defeat in Dorothea Dix’s advocacy for mental health was President Franklin Pierce’s veto. In the 1850’s, the Congress debated the extent of the federal government’s involvement with providing services and support to the mentally disabled. President Pierce, an outspoken critic of federal involvement in state and local issues. Dix petitioned Congress to sell federal lands to states who would in turn sell the lands again and hold the proceeds to pay for the building and administration of state mental asylums. Pierce vetoed this, explaining that the bill would draw the federal government into an inappropriate and unconstitutional relationship with the nation’s needy. Another veto from President Pierce in her career involved her requested bill for the granting of 10,000,000 acres of land distributed amongst the states for the care of the mentally ill. According to Peter Dobkin Hall of Yale University, from this, Pierce “set forth guidelines for

the federal role as a philanthropic agent until well into the twentieth century.” This resource was very helpful in understanding some of Dix’s unsuccessful work in reform.

“Dorothea Dix And The Gendered Politics Of Advocacy.” Disability History Museum, NEC ​ ​ Foundation of America, www.disabilitymuseum.org/dhm/edu/lesson_details.html?id=2.

This website immensely helped us in grasping Dorothea Dix’s reformative actions and the relation to the theme Breaking Barriers. The website addresses the gendered side of her political stance, how she is able to “establish authority over moral issues and thereby attract powerful male allies to her cause.” She was able to make her voice heard for the betterment of the mentally ill in a time where women were not allowed to speak directly before legislative bodies. A good point from this resource was the fact that although some of her advocacy did not lead to federal change, she was able to influence mental health for future times by diffusing knowledge on the conditions of mental institutions.

“Dorothea Dix and the Mental Hygiene Movement.” Exploring Your Mind, 21 Nov. 2018, ​ ​ exploringyourmind.com/dorothea-dix-mental-hygiene-movement/.

According to this website, Dorothea Dix sought for making “decent psychological treatments available for everyone, including the homeless.” In the 18th century, people believed that the mentally ill had no judgement or reason; hence, they were treated like animals, locked up in asylums. An important point in this particular website was the fact that King George III was a factor in the changing of mental illness treatment, as he himself suffered from porphyria but was able to recover after being cared for. “In light of this treatment’s success, a budding social optimism emerged about the possibility of using therapeutic interventions for patients with mental problems. Moral treatment was born but declined as a consequence of the disproportionate increase in hospitalized patients. Dix conversed with other reformers on mental health and while visiting hospitals housing the mentally ill, she aimed to understand the patients’ mistreatment so she could spark change. The information on Dix’s goal helped us with our theme of Breaking Barriers.

“Dorothea Dix Begins Her Crusade.” John Brown Speaks in Concord, ​ ​ www.massmoments.org/moment-details/dorothea-dix-begins-her-crusade.html.

This website discloses Dix’s life before her reform work as well as her actions to improve the treatment of the mentally ill. It emphasizes her significance in the progression of society understanding mental illness and how it should be dealt with more humanely. It also includes various quotes and statistics that were helpful when learning of Dix’s accomplishments and overall legacy. Finally, within this source, it displays essential components of Dix’s Memorial to ​ the Massachusetts Legislature in 1843. Overall, it gave us a strong idea of Dix’s actions and ​ influence as a social reformer.

“Dorothea Dix Biography.” Shotgun's Home of the American Civil War, ​ ​ www.civilwarhome.com/dixbio.html.

This website focuses on Dorothea Dix’s service in the Civil War a s the Union’s Superintendent of Female Nurses. Prior to the Civil War, she spent more than 20 years working for improved treatment of mentally ill patients and for better prison conditions. She was put in charge of all women nurses working in army hospitals in 1861. Dix served without pay through the entire war. “She convinced skeptical military officials, unaccustomed to female nurses, that women could perform the work acceptably, and then recruited women.” This website helped us recognize the barrier of women stereotypes that she broke in addition to the stigma of mental health.

“Dorothea Dix: Crusader for Patients with Mental Illness : Nursing2019.” LWW, ​ ​ journals.lww.com/nursing/Fulltext/2019/01000/Dorothea_Dix__Crusader_for_patie nts_with_mental.14.aspx.

From a medical perspective, Dorothea Dix was a pioneer in women nursing. She was never formally trained as a nurse, yet she was an important part of “shaping the future of this profession”. In 1861, she was appointed superintendent of the female nurses in the Union Army and recruited about 3,214 women for a subdivision of female nurses. Prior to the Civil War, women were not seen as nurses on the battlefield. However, Dorothea Dix strived to become a trailblazer for women and was a woman working in what was considered at the time to be a man’s field.

“Dorothea Dix Hospital.” Asylum Projects, MediaWiki, 25 Nov. 2018, 3:23 PM, ​ ​ www.asylumprojects.org/index.php/Dorothea_Dix_Hospital.

This website analyzes Dorothea Dix’s reformative work in specifically North Carolina and includes its modern day impact on North Carolina. Facilities housing the mentally ill as well as conceptions of the mentally ill were primitive. Delaware and North Carolina were the only two states of the original thirteen which had no state hospital for the mentally ill. Dix toured North Carolina and submitted a report to the legislature on her findings. Her approach for a solution was idealistic, recommending “moderate employment, moderate exercise.” An important component of this website was how the interest in railroads in North Carolina led to its original neglect of the mentally ill. Dix was able to request her bill through her efforts but it was until she was in her deathbed did she manage to pass it with the help of James C. Dobbin of Fayetteville. Overall, this resource was useful for our project in recognizing Dix’s successful reformative work for North Carolina.

“Dorothea Dix – Notable Women in History Series.” Arcadia Publishing, ​ ​ ​ www.arcadiapublishing.com/Navigation/Community/Arcadia-and-THP-Blog/March-2017/ %E2%80%8BDorothea-Dix-%E2%80%93-Notable-Women-in-History-Series.

In honor of women’s history month, this website acknowledges Dorothea Dix’s work as an author, nurse of the Civil War, and mental health reformer. It covers information we have already known, allowing us to fact check our knowledge as well as provide us insight on how her reports of the conditions of institutions housing the mentally ill were so persuasive for the federal government. Her emotional appeal in reporting “shocking and disturbing” happenings within asylums enabled her to improve mental health treatment.

“Dorothea Dix Park History Initiative.” Community Histories Workshop, Center for Urban ​ ​ and Regional Studies, communityhistories.org/dix-park-history/.

Dorothea Dix continues to influence today as stated in this resource. A helpful component of this website was how it provided potential primary databases for further research. Additionally, Dorothea Dix Park in Raleigh and “Dix Hill” demonstrates Dix’s impact on North Carolina as a result of her reformative actions for mental health. She had pushed for the construction of the first mental asylum and the building of such structures in her honor show she was appreciated for her advocacy.

“Dorothea Dix Portrayed by Pat Jordan.” American Historical Theatre, ​ ​ www.ahtheatre.org/characters/dorothea-dix.

This website helped with proving that Dorothea Dix had great influence on the present though she advocated for the mentally ill in the 19th century. In the event as described on the website, Dix is portrayed as a teacher, an activist, and a nurse. The website included background information on Dix as a child of a sickly mother and an alcoholic father. At the age of twelve, she moved to her grandmother’s and was able to open a school at fourteen.

“Dorothea Dix Timeline.” SoftSchools.com, ​ ​ www.softschools.com/timelines/dorothea_dix_timeline/434/.

This educational website helped us to understand how the events of Dix’s life correlated with time. It included occurrences such as the opening of her school in Worcester, Massachusetts, her publication of Conversations on Common Things, her travels to England, the proposal of providing land for the menally ill, and her service in the Civil War. It was useful to have a visual to truly grasp the happenings of her life as well as how her advocacy for mental health was a significant part of her life.

“Dorothea Dix (U.S. National Park Service).” National Parks Service, U.S. Department of ​ ​ the Interior, www.nps.gov/people/dorothea-dix.htm.

Through the honorable efforts of Dorothea Dix, she managed to create a change in her society and crusaded for better hospital conditions and for those who are diagnosed with mental illness. She appointed thousands of nurses onto the battlefield for the Union Army and helped those on both sides of the Civil War, being known as the “Superintendent of Army Nurses”. The US National Park Service applauds her for taking a stand in a time period where women were not as recognized as men and for campaigning for fair and equal treatment.

“Dorothea L. Dix.” History's Women, historyswomen.com/social-reformers/dorothea-l-dix/. ​ ​ Dorothea Dix is described as a woman with “a will of steel” in this resource. During her earlier years, illness forced her to stop teaching but it led her to come to know many English reformers and take an interest in humanitarian causes. She saw disturbing conditions in the East Cambridge Jail and took it upon herself to undertake reform throughout the states and beyond. This website

helped us realize that Dix sacrificed her life for the sake of the mentally ill, demonstrating perseverance and strength when advocating for the improvement of treatment.

“Dorothea Lynde Dix.” geni_family_tree, 23 Aug. 2019, ​ ​ www.geni.com/people/Dorothea-Dix/6000000003311703116.

This website discloses details of Dorothea Dix’s life, beginning from her problematic childhood. She was in poor health but managed to make accomplishments in her teaching career. She met the Rathbone family, Quakers and prominent social reformers in England, and was exposed to the British lunacy reform movement. When she returned to America, she surveyed the conditions of mental institutions in Massachusetts. She presented her findings in front of the state legislature and was able to expand the state’s mental hospital in Worcester. Dix continued to advocate, travelling to New Hampshire, Louisiana, North Carolina, England, and Europe. Dix served in the Civil War as the Superintendent of Union Army Nurses. Dix died in 1887 but her revolutionizing actions in mental health remains present today.

“DOROTHEA LYNDE DIX (1802-1887).” Unitarian Church Quincy, Illinois, ​ ​ www.uuquincy.org/projects/stamps/7dorotheadix.htm.

This website focuses on Dorothea Dix’s religion, which we thought important because it played a major role in her ideology when advocating for the mentally ill. Additionally, in a series of “Unitarians and Universalists on Stamps”, the website provided imagery of Dix on stamps. The resource summarized her early life and emphasized how religion influenced her motive for reform. Dix followed a religious-based schedule in her early life, her beliefs focused on the formation of character with high morals and a religious faith based on a sense of duty.

“Dorothea Lynde Dix Facts.” Dorothea Lynde Dix Facts, LoveToKnow Corp., ​ ​ biography.yourdictionary.com/dorothea-lynde-dix.

This website assisted us in truly understanding how her background motivated her to dedicate her life to advocating for better treatment for the mentally ill. As a teacher, she was a “strict disciplinarian, a rigorous moralist, and a passionate explorer of many fields of knowledge”. Her morality and her desire to help those who need it are exhibited through her passionate actions of reform. In addition to her teaching career, the website also stated her reform for mental institutions, her very successful crusade in Europe, and her service as a Civil War nurse.

“Dorothea Lynde Dix - Further Readings.” JRank Articles, Law Library - American Law ​ ​ and Legal Information, law.jrank.org/pages/6225/Dix-Dorothea-Lynde.html.

This website acknowledges Dorothea Dix’s emphasis on ethical responsibilities and how it plays into her motives for reformative action. In addition, the website covers her entire life—how she dealt with a difficult childhood, led a busy teaching career, suffered from chronic illness, associated with other reformers in England, campaigned for the mentally ill, and served in the Civil War. She experienced much hardship through her reformative movement such as President

Franklin Pierce’s veto on a significant bill she proposed. This information was helpful as it was a clear, detailed summary of most everything we need to research.

“Dorothea Lynde Dix Superintendent Nurses Civil War Women.” American Civil War ​ History, americancivilwar.com/women/Dorothea_Dix.html. ​ This website explains Dix’s family life and her capability from a young age as she opened schools in Massachusetts. Dix sacrificed both marriage and her health in prioritizing her work. Dorothea was forced to close the school and travel to Europe when her health was extremely deteriorated. William Rathbone III nursed her back to health and in his household, Dix “learned new theories of caring for the insane, such as moral treatment, seclusion from family and society, less use of mechanical restraints, and useful tasks to keep the patients busy.” This resource was helpful in mentioning her conversing with the Rathbones because it further enabled us to understand her source of her ideology towards the treatment of the mentally ill. The website continued to provide information on the rest of her life and reformative action.

Eghigian, Greg. “A ‘Painful and Toilsome Tour’: Revisiting Dorothea Dix's Advocacy for the Mad.” Psychiatric Times, MJH Life Sciences, 24 Oct. 2013, ​ ​ www.psychiatrictimes.com/history-psychiatry/painful-and-toilsome-tour-revisiting-dorothe a-dixs-advocacy-mad.

Eghigian, upholding a PhD, lays down the life of Dorothea Dix as she undertook an ambitious trip, visiting every single jail and almshouse in Massachusetts. She was encouraged by Samuel gridley Howe to summarize “the results of your painful and toilsome tour”. She submitted her report to the legislature in 1843. This website’s significance was the fact that Dix’s Memorial is ​ ​ heavily influenced by her religion as a devout Unitraian; “Dix’s moral compass and style of expression were inspired by New England preaching and social reformism at the time”, “Dix’s practice of combining personal testimony with overarching moral conclusions were sermoical as well.” For her early life consisted of much involvement in religion, she was taught that concrete biblical examples and general religious principles should be used as a guide to life. Ultimately, this resource was helpful in understanding how she was able to write such a persuasive report to the government.

Fabian, Renée, et al. “The History of Inhumane Mental Health Treatments.” Talkspace, 28 ​ ​ Sept. 2018, www.talkspace.com/blog/history-inhumane-mental-health-treatments/.

This informative site by Renée, a Los Angeles-based journalist and editor, contained very necessary knowledge for us to progress with our project. We knew that asylums in the mid-1700s and henceforth (still in older eras) were insufficient facilities that often utilized cruel and unusual methods of mental illness treatment. What was so vital about this site was that it goes into depth not only about the methods themselves but also the motivation behind such torturous treatment. It gave us a great sense of how mental illness was viewed of that older period of time and how it was thought to be dealt with. The site continued to modern times as well, noting how treatment has become much more humane and science-based. Ultimately, we were able to gain a good deal of information concerning background information from this particular site, which will be

especially helpful when considering what Dix wanted to change about asylums for mental illness.

Famous Scientists. famousscientists.org. 20 Jun. 2016. Web. 1/25/2020

Philippe Pinel, a doctor that focused on mental health conditions, founded scientific psychiatry. He ignored the false stigmas on mental illness, only using what he learned himself to guide him. Similar to Dorothea Dix, he viewed those with mental illnesses as “normal” people of society and that “they should be understood as individuals”. Philippe advocated for better management and rights for mentally ill patients, having worked at an asylum in the past. This shows that others also agreed with Dorothea Dix’s actions and promoted the same ideas as her.

Floyd, Barbara. “Mental Health.” From Quackery to Bacteriology, University of Toledo ​ ​ Libraries, 1 July 2019, www.utoledo.edu/library/canaday/exhibits/quackery/quack5.html.

This resource revolved around moral treatment, a humane and civilized form of care for the mentally ill, during the 19th century America. In an era of ineffective treatments, moral treatments as created by Benjamin Rush was a progressive and optimistic technique that focused on developing an appropriate environment that would facilitate cure. Asylums were constructed in rural areas to remove patients from their homes and refresh them with a bucolic change in setting, offering exercise, work, education, and religion instruction, stressing healthy, clean living. Mentally ill individuals were viewed as “unfortunate fellow beings” as opposed to inhuman. After the Civil War, moral treatment declined in favorability because of financial issues and overcrowding problems. It was also feared that moral treatment was responsible for the rise in dangerous spiritualist movements. By the 1880s, the conditions of mental asylums had deteriorated. Overall, this resource was helpful in truly understanding the intentions of moral treatment.

Garcia, Alexander, et al. “A Legacy of Reform: Dorothea Dix (1802–1887).” States of ​ Incarceration, ​ statesofincarceration.org/story/legacy-reform-dorothea-dix-1802-1887.

Alexander Garcia along with Amy Hildebrand, Austin Kiesewetter, Jill Walker, and Scott Zwierzchowski described Dorothea Dix’s advocacy for mental health. In 1847, she disclosed the conditions of Sangamon County Jail in Illinois. She had witnessed appalling dungeons at the jail, housing a mentally ill man as opposed to a violent offender. Dix brought to the public that the mentally ill should be separated from the criminally responsible. Her “activism was instrumental to the foundation of Illinois’ first mental hospital.” This resource is important because it connects Dix’s work to modern times. Budget cuts had emerged between 2009 and 2012, leading to the closing of numerous psychiatric treatment facilities and agencies throughout Illinois. Deinstitualization has increased and by 2012, “more than half of new inmates admitted to the Cook County Jail in Chicago had a mental health diagnosis.”

Goldsmith, Thomas, and Rose Hoban. “Dorothea Dix Hospital - Interactive History Timeline.” North Carolina Health News, North Carolina Press Association, 11 Oct. ​ ​ 2016, www.northcarolinahealthnews.org/2016/10/11/dorothea-dix-hospital-interactive-history-ti meline/.

The Raleigh psychiatric facility has much history before its demolition. This interactive timeline begins from Dorothea Dix’s advocacy for mental health from 1824-1848. She travelled to Europe, adding to her knowledge about the mistreatment of mentally ill patients in asylums. She delved more into the reform of prisons and asylums with her grandmother’s inheritance. In 1848, Dix made a presentation to the North Carolina legislature, proposing a state hospital. It continued on to the North Carolina Legislature as it was pushed to act in 1848, a hospital was established in 1849, the hospital opened and grew from 1849-1902, as the hospital grew but demand grew faster from 1902-1959, a fire destroyed the building in 1926, the hospital reached its largest extent from 1930-1974, the North Carolina State University took over portions of Dix property from 1984-1997, the Dix population fell and closure neared from 1999-2006, from 2006-2016, the decision to sell property and move patients was made, and in 2015, the Dix property was sold to Raleigh for use as a park. In conclusion, this information was useful to understand the impact of Dix’s work in North Carolina.

Hannah. “Dorothea Dix.” History of American Women, 19 Aug. 2018, ​ ​ www.womenhistoryblog.com/2012/10/dorothea-dix.html.

Dorothea Dix, an influencer, educator, and social-reformer passionately strived to make a difference in the field of which she had extreme passion for: just treatment of the mentally ill. Through a long and perilous process of lobbying the U.S. Congress and through state legislatures, Dorothea Dix eventually helped establish the first generation of hospitals for those with mental illnesses. The New Jersey Mental State Hospital at Morris Plains was the first hospital to be built with Dix’s vigorous efforts.

Harbor, Stark. “Dorothea Dix.” National Museum of Civil War Medicine, 14 Mar. 2016, ​ ​ www.civilwarmed.org/dorothea-dix/.

Although this resource does not concern her work in mental health, we thought it necessary to learn what Dix was like as a person outside of her advocacy. This website enabled us to understand her significance during the Civil War as the Superintendent of Army Nurses. Dix worked to improve the welfare of patients despite sparking controversy. She introduced the idea of permitting women to enter the predominately-male profession of nursing, increasing the number of available nurses while the men were fighting. She laid out strict guidelines for the recruitment of female Union nurses. Additionally, Dix convinced the government to supply the nurses with food, transportation, housing, and ultimately to pay them forty cents a day for their work. She resigned her position in 1865 to return to advocating for the mentally ill.

Hayes, Brittany. “Making Their Voices Heard.” US History Scene, 10 Apr. 2015, ​ ​ ushistoryscene.com/article/mental-health-reform/. Accessed 23 Dec. 2019.

Though both male and females were affected harshly by mental illness and societal judgement, mental fragility was emphasized on women. Mental asylums became prevalent in Antebellum America as a specialized care for less wealthy individuals. Many asylums were underfunded, overcrowded, unwarranted of commitment, and abusive. The mentally ill were often stigmatized to be criminals. The concept of moral treatment varied in use within mental asylums depending on the beliefs of those in charge. Hayes highlighted the women who led advances in the mental health reformative movement, including Dorothea Dix. Hayes included Dix’s life story and how she greatly influenced the betterment of mental health treatment. The website continued to explain other women who have helped the cause for reform. Overall, the information from this particular source helped us in our “Dix” page, concerning Dix and her advocacy.

History.com Editors. “Dorothea Lynde Dix.” History.com, A&E Television Networks, 9 ​ ​ Nov. 2009, www.history.com/topics/womens-history/dorothea-lynde-dix.

The original article being published in 2009, this modern article allowed for a more present-day view of Dorothea Dix’s impact and influence on America and our society. According to this source, she was a passionate advocate for employing females in the nursing department and also guided the Asylum Movement that later led to the establishment of many hospitals for the mentally ill. Although many questioned her capabilities as she was a woman, she strived for others to look past one’s gender. When people doubted her, she found a way to prove others wrong.

“History of Mental Health Treatment.” Dual Diagnosis, www.dualdiagnosis.org/mental-health-and-addiction/history/.

The Foundations Recovery Network thoroughly explain how mental health treatment was handled throughout the ages and how much times have changed since then. It mentions how Dorothea Dix made a variety of changes to how the mental ill were treated with the new concept of mental asylums/hospitals for the mentally ill. This information was especially important during the making of our project because it highlighted how much of an impact Dorothea Dix made on the mental health field and the drastic change that happened because of her fierce advocation.

“History of Psychiatric Hospitals.” • Nursing, History, and Health Care • Penn Nursing, ​ ​ www.nursing.upenn.edu/nhhc/nurses-institutions-caring/history-of-psychiatric-hospitals/.

The University of Pennsylvania School of Nursing describes the history of psychiatric hospitals throughout the years, beginning with the early 18th century to conditions of mental institutions today. They briefly mention Dorothea Dix and her impactful actions on mental asylums at the time, describing her as the “most prominent voice and most visible presence” in her campaign for better conditions for the mentally ill. This source was extremely useful in our timeline, as it depicted the history of psychiatric hospitals and how they developed throughout the centuries.

Holtzman, Ellen. “A Home Away from Home.” Monitor on Psychology, American ​ ​ Psychological Association, Mar. 2012, www.apa.org/monitor/2012/03/asylums.

Dr. Holtzman focuses on the private well-funded asylums of the 19th century in which only the higher-class could afford along with the origins of asylums in general. Prior to the rise of asylums, mental illness were cared for by family members. It was not until the start of the Industrial Age did many fear individuals with mental illness were a threat to public safety. In response, public psychiatric asylums and private asylums in people’s own homes (“a home away from home” were opened. Private asylums offered treatments such as hydrotherapy, electrical stimulation, and rest. In the height of private hospitals’ popularity (1890-1918), some physicians adopted a psychological understanding of mental illness, believing in the subconscious. Boris Sidis was an important figure in the advancement of psychotherapy. Public hospitals were overcrowded and dirty with poorly paid, frequently abusive staff. However, to attend a private asylum was much too costly for the lower-class, it was more reserved for the wealthy. For a number of years, small private asylums were successful. After World War I, psychotherapy overtook somatic treatments and became the standard of America’s mental health treatment. Ultimately, this resource provided helpful insight on wealthier asylums and psychotherapy.

Hussung, Tricia. “A History of Mental Illness Treatment: Obsolete Practices.” Concordia ​ University, St. Paul Online, 14 Oct. 2016, ​ online.csp.edu/blog/psychology/history-of-mental-illness-treatment.

This academic website was helpful in understanding mental illness treatments of the past, including those that were ineffective and unnecessary cruel. We applied the information we learned on isolation and asylums in the “Stigma” page, acknowledging how its psychiatric methods originated from medieval times and how unfunded mental asylums were inadequate institutions for the mentally ill. It reinforced our theme of barriers, insinuating that mental asylums put up barriers between patients within the asylum and society. In some cases, those placed in mental asylums did not have a case of mental illness but were considered outcasts. This enabled us to truly understand how mental illness was recognized in the 17th century. Dorothea Dix came into the scene in the 19th century, leading a movement to break the barriers of mental health. This resource also delved into mental health treatment today, how effective, safe treatments had developed as people learned to acknowledge and research mental illness.

Jones, Robert. “DOROTHEA DIX - HEROIC ADVOCATE FOR THE MENTALLY ILL.” Infinite Fire, 8 May 2016, ​ infinitefire.org/info/dorothea-dix-champion-for-the-mentally-ill/.

Jones divulges modern statistics—there are an estimated 450 million individuals with some form of mental illness, in the United States alone, mood disorders affect 21 million individuals, and more. Jones includes information about how cultures of the past viewed mental illness as a form of religious punishment or demonic possession. People with mental illness were misdiagnosed, mistreated, and marginalized. Dorothea Dix sought the exposure of treating the mentally ill like human beings with morals, crusading throughout the states as well as Europe. In Scotland, her findings resulted in the creation of the Scottish Lunacy Commission and she convinced Pope

Pius IX to construct a hospital for the mentally ill. Her legacy helped to push mental health treatment “forward, raise awareness, and remind us that mental patients are just as deserving our kindness and humanity as any other group of patients.” This website was helpful because it provided us information on how she put a crack in a barrier that would be continually broken as time progressed.

Kristof, Nicholas. “Inside a Mental Hospital Called Jail.” The New York Times, The New ​ ​ York Times, 8 Feb. 2014, www.nytimes.com/2014/02/09/opinion/sunday/inside-a-mental-hospital-called-jail.html.

In Chicago, thousands of people suffering from manias, psychoses, and other disorders are in jails; the only way to get treatment is to be arrested. Kristof points out how the United States resorts to imprisoning individuals with mental illness instead of health care. According to a 2006 Justice Department study, more than half of prisoners in the United States have a mental health problem. Amongst female inmates, almost three-quarters have a mental disorders. Cook County sheriff, Thomas Dart, claims that this system “criminaliz[es] mental illness”, that it is abhorrent, seenseless, and an expensive way to treat mental illness. The Justice Department says that mentally ill inmates are often preyed upon while incarcerated, or discipline because of trouble following rules. Kristof claims that “we as a society have, in effect, returned to the 1800s.” Ardell Hall, superintendent of a women’s unit at the jail, states, “Some people come here to get medication. They commit a crime to get in.” Taxpayers spend up to $300 or $400 a day in order to support mentally ill inmates. Sheriff Dart puts it, “We’ve systematically shut down all the mental health facilities, so the mentlaly ill have nowhere else to go. We’ve become the de facto mental hospital.” Kristof’s article enabled us to see how the United States treatment of health seems to have devolved two centuries back. This information was used in “The Fleeting and Forever” page of our website.

Kuroski, John. “44 Haunting Photos Taken Inside Mental Asylums Of Decades Past.” All ​ That's Interesting, 8 May 2017, allthatsinteresting.com/mental-asylums#31. ​ This website provides a gallery of photographs of the inside of mental asylums of the 19th and 20th century. It was a helpful resource as it captioned all of the images and we were able to utilize them on our own website; from these photographs, we understood how poor the conditions of the mental asylums of earlier times truly were. The government designated the mentally ill as actual patients in need of treatment in the Lunacy Act of 1854 and it was until the middle of the 19th century did the United States establish government oversight and committees over asylums to investigate abuses. The growth of psychiatry as discipline meant more diagnoses and patients put into facilities that were already overcrowded as well as more doctors developing more procedures — increasingly radical treatments were introduced such as electroshock therapy and lobotomy.

Larson, Zeb. “America's Long-Suffering Mental Health System.” Origins, Apr. 2018, ​ ​ origins.osu.edu/article/americas-long-suffering-mental-health-system.

Historian Larson traces how society’s response to the mentally ill has correlated to faith in its cure and trying to spend as least as possible for the mental health cause. Mental illness has frequently played a role in mass shootings and violence. However, there are little to no solutions. Larson delves into the effects of mental illness on quality of life and significant health outcomes. Larson points out how America criminalizes mental illness, providing the statistic that at least a fifth of all prisoners in the United States have a mental illness of some kind. Larson notes a study in which the Human Rights Watch revealed that prison guards routinely abuse mentally ill prisoners, which we thought resembled the times of the 19th century mental asylums of Dorothea Dix’s time. More are sent to prison as a result of the small number of mental health institutions. Larson provides multiple factors that have contributed to the long-impacting issue of society’s insufficient dealing of mental illness as well as very helpful images. We gained a deeper understanding of the modern treatment of mental illness and utilized such information in our “The Fleeting and Forever” page.

Lewis, Jone Johnson. "Quotes of Dorothea Dix." ThoughtCo, Oct. 28, 2019, thoughtco.com/dorothea-dix-quotes-3530064.

This website was helpful for our project for it enabled us to use many of Dorothea Dix’s quote to emphasize her motivations and beliefs in mental health. For National History Day projects, especially for the website category, quotes are critical in assisting the audience or user to understand the topic to a further degree. The selected quotes from Dix expressed her passion for her advocacy in improving treatment for the mentally ill and was a vital component of our own website.

“MAKE THE DEVIANT UNDEVIANT.” Parallels In Time | A History of Developmental ​ Disabilities | Part One, Minnesota Governor's Council on Developmental Disabilities, ​ mn.gov/mnddc/parallels/four/4b/1.html.

In a series of “The Rise of the Institutions 1800-1950”, this website covers Dix’s life, focusing on her request of the government to set aside ten million acres of land throughout the nation to accommodate the mentally ill. It was passed by both houses of Congress but vetoed by President Pierce. Though she did not succeed, this reformative action exhibits how Dix led the nation for future advancements in mental health treatment. There was also an audio clip implemented in this website, which we included in our own project on the “I Tell What I Have Seen” page.

“Mental Health and Illness.” Brought to Life: Exploring the History of Medicine, Science ​ ​ Museum, broughttolife.sciencemuseum.org.uk/broughttolife/themes/menalhealthandillness.

This website outlined the interpretations of treatment and causes of mental illness, expert patients viewing mental illness as biomedical issues, some viewing it as interpersonal matters, some viewing it as spirit possession and sin. In The European Middle Ages, Christians believed that people were possessed by demonic forces, which needed to be ritually exorcised by priests. Christianity’s influence on mental health care remained dominant for centuries. Asylums and moral treatment were treatments circa 1800s. By the early 1900s, many asylums were overcrowded and became testing grounds for controversial and dangerous treatments such as

electroconvulsive therapy and lobotomy. Physicians, social reformers and former asylum patients sought to reduce the stigma surrounding mental illness. In the 1970s, the antipsychiatry movement removed asylums as it had become inadequate. Optimists in the 1980s and 1990s hailed new technologies included specially targeted drugs like SSRIs, brain scanning techniques such as magnetic resonance imaging (MRI), more consistent disease definitions in the Diagnostic and Statistical Manual (DSM). Psychiatry became based around objective science. Ultimately, this resource was helpful in understanding stigmatized mental health and how it advanced as history progressed.

Malburne, Meredith. “Dorothea Dix's Advocacy for the Mentally Ill in North Carolina.” Documenting the American South, docsouth.unc.edu/highlights/dix.html. ​ One of the states outside of Massachusetts Dorothea Dix reviewed the prisons and mental institutions of was North Carolina. For North Carolina, the mid-19th century marked an era of change in mental health. North Carolina refused to build asylums despite other states’ constructions because North Carolina considered the costs to be too high. Dix addressed the North Carolina General Assembly in her 1848 Memorial Soliciting a State Hospital for the ​ Protection and Cure of the Insane, persuading the legislators to provide a proper institution for ​ the mentally ill. Dix brought up points including that imprisoning the mentally ill individuals was unjust, jails and poor-houses were unfit for the mentally ill, families caring for mentally ill in their own homes were ineffective. She explained how it would be cost effective for North Carolina to develop a mental asylum. Her efforts led to the construction of the Asylum for the Insane of North Carolina in 1854. Ultimately, this website was very helpful in showing very specifically her advocacy in mental health.

“Mental Illness.” Social Welfare History Project, VCU Libraries, 16 Oct. 2017, ​ ​ socialwelfare.library.vcu.edu/issues/mental-illness/.

This website provides a series of articles with further links concerning the issues of mental illness and the treatment of mental illness, including writing relating to moral treatment and he defective classes. The articles include information on after care in New York State of 1906, Management of Almshouses in New England, Brigham, Amriah, Massachusetts report on public charities of 1876, the Middletown State Homeopathic Hospital in New York of 1891, care of the “filthy cases of the insane” in 1885, moral treatment, care for mental illness in New York from 1736-1912, the New York State Care System “for the insane” completion in 1896, New York State charities in 1873, John Chapin, Poor House Conditions in Albany County, New York, defective classes in 1891, the Scientific Charity Movement and Charity Organization Societies, deportation of “the insane aliens” in 1907, the State Board of Charities of New York from 1878-1884, State Care of the mentally ill in New York in 1901, the duty of the states toward their “insane poor” in 1874, “Three Years in a Mad House” in 1851, Massachusetts’ first annual report of the Trustees of State Lunatic Hospital in 1833, training schools and civilian public service in 1944, Franklin Pierce’s 1854 veto, treatment of mental illness in 1876, Willard Asylum for the Insane in 1900, Dr. Charles S. Hoyt, an increase of mental illness in 1895, mental

illness in the Middle States in 1876, “Life in the Asylum” in 1855, and the Opal with “Listening to Patients”. Many of these topics are related to Dorothea Dix’s work.

“Mental Health Treatment: Then and Now.” Introduction to Psychology, Lumen, ​ ​ courses.lumenlearning.com/wmopen-psychology/chapter/introduction-to-mental-health/.

The stigma revolving around mental illness was religion-based, people believing that it was the possession of demons, witchcraft, or an angry god. People were forced to take part in exorcisms, were imprisoned, or executed. Asylums were constructed to institute the mentally ill where patients received cruel treatment. Crusaders such as Dorothea Dix in the 19th century sought reform for mental health, lobbying various state legislatures and the U.S. Congress for change. Starting in 1954 and gaining popularity in the 1960s, antipsychotic medications were introduced and the process of deinstitutionalization began. In current times, there are community health centers across the nation. Instead of asylums, there are psychiatric hospitals run by state governments and local community hospitals focused on short-term care. Overall, this website was helpful in understanding how mental health has progressed through history.

MHAHC. “History of the Mental Health Movement via Time Travel.” Mental Health ​ America of Hendricks County, 2010, www.mhahc.com/historymhmov.htm. ​ This resource was helpful in providing dates as it correlates to important events in mental health history. This timeline was significant in our research as it both provides context to Dorothea Dix’s work and her role in reformative mental health as well as how mental health continued to advance with her legacy. The timeline began in 1662, when Boston established the first almshouse using private funds. In the late 1600s, mental illness was heavily misunderstood as demonic possession and a form of witchcraft. The timeline ends in the 1990s with advertisements that portray mental illness as a treatable case and as a physical problem.

“Module 2: A Brief History of Mental Illness and the U.S. Mental Health Care System.” Unite For Sight, www.uniteforsight.org/mental-health/module2#_ftn2. ​

This website by Unite For Sight, a non-profit organization for human resources, lays down the foundations for the treatment of mental illnesses as well as the societal views of the era. Religion played a part in how mental illness was perceived, as some cultures thought it as religious punishment from demonic possession. This information was helpful in understanding the historical situation of mental health. The site also provides how Dorothea Dix played a vital role for the progression of adequate treatment of mental health in the 1840s. It continued to explain how society decided to treat mental illness, ranging from deinstitualization in the mid-1950s to transinstitutionalization later. Mental Health America and the National Committee for Mental Hygiene were established as well as acts that developed sufficient treatment of mental illness. This website was useful in grasping the state of societal conception of mental illness before and after Dix, and how specifically the US was able to advance in mental health.

Myers, Christopher. “Life in a 19th Century Mental Institution Was Basically Torture.” Ranker, ​

www.ranker.com/list/life-in-19th-century-mental-institutions-and-insane-asylums/christop her-myers.

The 19th century was an era of reform in mental health, changes in the philosophy of care for mental illness evolving and the construction of mental asylums shooting in growth. Mental institutions frequently fell short of their goals, conditions becoming severely insufficient. Myers includes the fact that it was often almost impossible to leave the mental institution and treatments in asylums included spinning one in a chair until they vomit, one would most likely be abused by the staff, cold bath treatments, one being strapped in a tranquilizing chair, and one being forced into a straitjacket. Women were especially vulnerable to being committed as the tendency to label women as “hysterical” was rooted in the 19th century mindset. Overall, this website was particularly useful as it outlined the inadequacies of early mental asylums in simple terms and provided much imagery.

Neal, MaryLovesJustice. “Dorothea Dix Pleads for a State Mental Hospital.” Dorothea Dix ​ Pleads for a State Mental Hospital, 1 Jan. 1970, ​ dogjusticeformentallyill.blogspot.com/2014/02/dorothea-dix-pleads-for-stat mental.html.

This source contained numerous statistics revolving around the amount of people she had an impact on, during her time and also long after her death. In this site, it includes a personal letter that Dorothea Dix wrote to the General Assembly of North Carolina pleading for a state mental hospital. In her letter, she firmly believes that putting the mentally ill in prisons and such is not justifiable, and that she “pleads” to have state mental hospitals for the poor.

Nelson, Ken. "Biography: Dorothea Dix for Kids." Ducksters, Technological Solutions, Inc. ​ ​ (TSI), www.ducksters.com/history/civil_war/dorothea_dix.php. Accessed 26 December 2019.

In the beginning stages of our project, when we were unsure of Dorothea Dix, this website was very helpful in recognizing the basics of her career in mental health and her background. This website also mentioned how she served in the Civil War where she helped recruit, organize, and train thousands of women nurses as well as explain her legacy. Later in our project, this resource was good to fact check the information we have collected from other websites.

NPR Staff. “America's Asylums In Photographs.” NPR, 4 Sept. 2011, 12:44 PM, ​ ​ www.npr.org/sections/pictureshow/2011/09/04/140146150/americas-asylums-in-photograps ?ft=1&f=97635953.

This website exhibits photographs by Christopher Payne from his book titled Asylum: Inside The ​ Closed World Of State Mental Hospitals. In the 19th century, the conditions of mental asylums ​ were inadequate. Asylums were self-sufficient; patients produced their own food and generated their own electricity. In the beginning of the 19th century, moral treatment was implemented into asylums, following the belief that if one was put into a different environment and put to work, their behavior would change. Payne’s photographs preserve an era of the past where mental

hospitals were very different from what they are now, it shows how far mental health has come from that point.

Norwood, Arlisha R. “Dorothea Dix.” National Women's History Museum, ​ ​ www.womenshistory.org/education-resources/biographies/dorothea-dix.

The National Women’s History Museum recognizes Dorothea Dix as a woman who consistently broke barriers in the medical department. During her time, women nurses were openly mocked and looked down upon from male doctors. Once the Civil War began, Dorothea was a firm activist in which she pushed for training and better opportunities for women nurses. Throughout the war, she appointed more than 3000 (about 15%) of the Union army’s nurses. She was also well known for treating both Union and Confederate soldiers which gained her recognition and respect from many people.

Pike, Kathleen M. “What about Dorothea Dix?” Columbia University Global Mental ​ Health Programs, Columbia University, 10 Aug. 2018, ​ www.cugmhp.org/five-on-friday/what-about-dorothea-dix/.

Pike, a professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University, connects Dix’s life mission to the modern world and clearly establishes how her life mission remains relevant. Pike prefaces that she would have loved to have Dix at a dinner conversation she had with Calvin Acker, indicating that Dix’s ideals are significant despite the amount of time that has passed since its formulation. Pike proceeded to explain Dix’s accomplishments and individual motivations. This website was very useful as we utilized its information especially with Dix’s long-term impact and short-term impact.

“Prison and Asylum Reform.” Ushistory.org, Independence Hall Association, ​ ​ www.ushistory.org/us/26d.asp.

This resource covers Dorothea Dix’s career of advocating for the mentally ill. She confronted the Massachusetts Legislature and brought attention to the deficient conditions of mental institutions. In 1841, she presented her findings of abuse and poor funding from her tour of prisons, workhouses, almshouses, and private houses. She requested for state-supported care for mental illness and went on to help establish five hospitals in America, pleaded for human rights to Queen Victoria and the Pope. There were other advocates for mental health of this era including Dr. John Galt at Eastern Lunatic Asylum, Francis Lieber, and Samuel Gridley Howe. Ultimately, this website was helpful because it summarized Dix’s reformative actions and introduced others’ as well.

Reddi, Vasantha. “Dorothea Lynde Dix (1802 - 1887).” Biography of Dorothea Lynde Dix, ​ ​ 2005, www.truthaboutnursing.org/press/pioneers/dix.html.

Reddi covers Dix’s life’s early beginnings, her time serving as a nurse in the Civil War, and her work for mental health reform. Not only was this site helpful for factual information, providing summaries of each segment of her life, it also provided further resources on Dix in the

bibliography. There are images, websites, and digital articles that we used to accommodate our research and vary the type and the perspectives of resources.

Rotov, Michael. “NEW JERSEY OPINION; DOROTHEA L. DIX: AN EARLY ADVOCATE FOR WORLD'S MENTALLY ILL.” The New York Times, The New ​ ​ York Times, 12 July 1987, www.nytimes.com/1987/07/12/nyregion/new-jersey-opinion-dorothea-l-dix-an-early-advoca te-for-world-s-mentally-ill.html.

Rotov wrote of Dorothea Dix’s life as an author, a teacher, a humanitarian, and a crusader. She visited the states as well as outside of the United States. She dedicated her life to her reformative work. Dix spent six years of her life at the Trenton Asylum, at Trenton Psychiatric Hospital she was disabled to travel any further. But her life prior to the decline of her health, she was a passionate advocate for the improvement for mental institutions jails, and poorhouses.

Slautterback, Catharina. “Dorothea Lynde Dix, 1845.” Boston Athenæum, 2006, ​ ​ www.bostonathenaeum.org/about/publications/selections-acquired-tastes/dorothea-lynde-d ix-1845.

This website includes a portrait of Dorothea Dix and describes her career as a humanitarian activist. The information on the website on her work in reformative mental health was nothing new as many other websites we have found have stated the same thing. What was unique about this resource was how it went into detail on the portrait. It suggests that she visited the studio of artist Seth Cheney but she disliked posing for her portrait, not wanting to be “flattered or caricatured”. Cheney himself was liberal and progressive, embracing reformative issues during the 1840s, naturally contented to draw Dix’s portrait. Overall, this resource provided us with an interesting outlook on Dix as a person.

Song, Arim. “Dorothea Dix.” The MY HERO Project, NopCommerce, 9 Jan. 2019, 10:15 ​ ​ PM, myhero.com/dorothea-dix.

Dorothea Dix stood up and spoke for the freedoms of those in need, the mentally ill who have been mistreated and neglected put in poorly conditioned facilities. She began her journey in Massachusetts and accomplished much in her reformative work as she continued to travel around the world, including England, Ireland, and Scotland. Though she did go through some obstructions as well when she was faced with rejection after request land for asylums from the government. During the Civil War, she was able to recruit female nurses and provided work opportunities for females, determined to not allow gender discrimnation from hindering her work. She used her grandmother’s inheritance for charity and reform, putting much effort towards improving treatment for the mentally ill. This information demonstrated Dix’s altruistic nature.

Stamberg, Susan. “'Architecture Of An Asylum' Tracks History Of U.S. Treatment Of Mental Illness.” WOSU Radio, WOSU Public Media, 6 July 2017, ​ ​

radio.wosu.org/post/architecture-asylum-tracks-history-us-treatment-mental-illn ess#stream/0.

Susan Stamberg, American journalist and special correspondent for NPR, wrote of St. Elizabeth’s Hospital on the WOSU Public Media website. We utilized information on Dorothea Dix’s impact in the development of St. Elizabeth’s on the “Triumphs” page. Dix was involved in planning the calming, healing architecture of the hospital as a form of moral treatment. St. Elizabeth’s was a facility built upon Dix’s ideals for mental illness treatment. Although it was successful at first, like most asylums in the United States, it overcrowded and deteriorated. The website also includes an interview with Stamberg on Dix’s career as an activist for mental welfare and focused on one of her goals, to use architecture to help mentally ill people.

Stetka, Bret S., and John Watson. “Odd and Outlandish Psychiatric Treatments Through History.” Medscape, 13 Apr. 2016, ​ ​ www.medscape.com/features/slideshow/odd-psychiatric-treatments#page=15.

On this website, Medical Director Stetka and Watson composed mental health treatments of the past in the form of a slideshow. This slideshow revealed both effective and ineffective treatments as time progressed. It enabled us to understand specific misconceptions about mental illness of each designated era and how society chose to view mental illness. Treatments often reflected varying harmful ideologies such as misogyny and racism, mental illness labelled on certain groups. In the past, those with religious beliefs had a negative opinion on mental illness, believing it to be divine punishment or demonic possession. Overall, this resource was useful in our page “Stigma” as it provided historical background on misunderstandings about mental health and different treatments for mental illnesses.

Toler, Pamela. “Dorothea Dix Volunteers.” Wonders & Marvels, 31 Jan. 2016, ​ ​ www.wondersandmarvels.com/2016/01/dorothea-dix-volunteers.html.

This website focuses on “Dragon Dix”, Dorothea Dix’s nickname during the Civil War as a result of her disciplinary and strict conduct. Dix was mentally tough and worked with powerful politicians. Her proposal of forming an “army of nurses” was well-received at the White House. Dix appointed more than three thousand nurses and had significant impacts on the Civil War. This resource helped our project by enabling us to understand Dix’s other work and it demonstrated how she Dix was skilled at politics, had strong connections, and was very persuasive.

Viney, Wayne. “Dorothea Dix.” Dictionary of Unitarian & Universalist Biography, 2003, ​ ​ uudb.org/articles/dorotheadix.html.

This website was an excellent resource in enabling us to truly understand Dix as a person. It provides her written works, studies, and experience as a teacher. It reveals her motives and

morals that concerned her decisions and overall drive to reform mental illness treatment. Not just stopping at Massachusetts, she travelled to other states and other countries to impact them similarly. Though her accomplishments may not seem greatly influential (such as her success in convincing Pope Pius to improve the conditions of a hospital in Rome), the movement she led was absolutely essential in the progression of mental health. The site also includes primary quotes as well as her service in the Civil War, criticism of her work, and her humble retirement. Ultimately, this was an eye-opening source for what her perspective was and how society perceived her efforts at that point in time.

Warder, Graham. “Dix, Dorthea Lynde.” Social Welfare History Project, VCU Libraries, ​ ​ 13 Mar. 2018, socialwelfare.library.vcu.edu/people/dix-dorthea-lynde/.

From Keene State College, Dr. Warder discloses Dix’s early background as a teacher for girls and later a follower of Unitarianism. Acknowledging her religion gives us insight on how she viewed things; Unitarianism, “stressed reason and the role of wealthy people setting examples for those they saw as social inferiors”. Warder additionally provided her social network including Ralph Waldo Emerson. From this information, Warder enabled us to understand how her mindset was shaped. The site continued to state how she developed a passion for advocating for the mentally ill and how she decided to act. It shed light on how her identity as a woman in the mid-1800s affected her career. Overall, this website was extremely helpful in how Dix’s identity was a major component in her work in improving treatment towards the mentally ill.

Whiteman, Honor. “Dorothea Dix: Redefining Mental Illness.” Medical News Today, ​ ​ MediLexicon International, 5 May 2017, www.medicalnewstoday.com/articles/317321.php.

During the 19th century, there was a common belief of that mental health disorders were not treatable conditions. Dorothea Dix opposed these perceptions and sought out to redefine mental illness for the better. Not only did Dorothea experience depression, but her father was an alcoholic and her mother suffered with a mental illness. Shem then took her own experience with dealing with mental illness as inspiration to make a difference in this field. Despite many of her ideas and protests being shut down, between 1843 and 1880 she helped to establish 32 new mental illness hospitals throughout the US.

“Women's History Month: Dorothea Dix.” PDG Rehabilitation Services, 5 Dec. 2018, ​ ​ www.pdgrehab.com/womens-history-month-dorothea-dix/.

Dorothea Dix was acknowledged in this website as a pioneer in behavioral health. Mental illness was severely misunderstood in her time; the treatments in the first United States mental institution in Williamsburg, Virginia (founded in 1773) “included solitary confinement, conditioned fear of the doctor, powerful but minimally effective drugs, bleeding, shackles, and plunge baths”. The hospitals that followed were not much better. Dix was a witness to the cruelty of mental institutions. She associated herself with other reformers and became encouraged to take action. She visited mental hospitals, wrote, and published. She advocated for human rights in front of senators and legislators, leading to new bills and reforms in multiple

states. The website states that “[w]ithout Dix’s revolutionary efforts, however, a large part of the population wouldn’t have received the care and support they deserved and we would be far behind the level of integrated care available to many now.” With this resource, we understood the events of her life and overall career as well as how she influenced today.

Woodruff, Lynne. “Prison Reform: The Origin of Contemporary Jail Standards.” Lexipol, ​ ​ 22 Feb. 2017, www.lexipol.com/resources/blog/prison-reform-origin-contemporary-jail-standards/.

In a part of the series “Understanding Our Roots: A Brief History of Prisons”, Lynne focuses on correctional history, specifically the prison reform movement. By the end of the 18th century, authorities had begun to use imprisonment as punishment, influenced by the Catholic Church, which believed that sinners could be led to recognize their errors and change their behavior. Many prisons were run for profit and abused the inmates. Reform of prisons began, reformative concepts involving mental illness within asylums; segregation, confinement, and overcrowding increased mental illness. Ultimately, this website was helpful in understanding the correlation to early prison inadequacies and mental health.

Yoo, Jina, et al. “Dorothea Dix.” Pioneers of Nursing: 1850-1880, ​ ​ sites.google.com/site/pioneersofnursing18501880/dorothea-dix.

The 19th century had much different views of mental illness than the 21st century. Dorothea Dix of the 19th century was one of the many social reformers taking part in the movement of improving care and treatment for the mentally ill, more specifically in the conditions of mental institutions. In the 19th century, it was thought that a solution to reduce the great amount of mentally ill in society was imprisonment. The societal view of mental illness was often negative. This website enabled us to learn that Dorothea Dix stood up for the mentally ill, raising awareness through writing memorials, and laid the foundation of the mental health care system in America.