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In the mid-1800s, American activist Dorothea Dix deployed her sizable inheritance to devote herself to these issues with a fierceness of purpose that hasn’t been matched since. She traveled more than thirty thousand miles across America in three years to reveal the brutalities wrought upon the mentally ill, describing “the saddest picture of human suffering and degradation,” a woman tearing off her own skin, a man forced to live in an animal stall, a woman confined to a belowground cage with no access to light, and people chained in place for years. Clearly, the American system hadn’t improved much on Europe’s old “familial” treatments. Dix, a tireless advocate, called upon the Massachusetts legislature to take on the “sacred cause” of caring for the mentally unwell during a time when women were unwelcome in politics. Her efforts helped found thirty-two new therapeutic asylums on the philosophy of moral treatment. Dorothea Dix died in 1887, the same year that our brave Nellie Bly went undercover on Blackwell Island, in essence continuing Dix’s legacy by exposing how little had truly changed.
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Susannah Cahalan (The Great Pretender: The Undercover Mission That Changed Our Understanding of Madness)