It was an urban myth or more of a taboo, that the Women’s Lunatic Asylum on Blackwell Island was full of abuse and neglect. No one ever dare to confirm those speculations. Not until Elizabeth Cochran was brave enough and able to infiltrate herself in the asylum, as a research opportunity as a journalist. Not knowing if once inside she will be able to get out, or if anyone would have the power to help her out of the institution. Cochran documented the atrocious acts that were perpetrated on vulnerable human beings, sane or insane.
In 1887 that is when Cochran is admitted into the mental institution, she decides to change her identity, and becomes a Cuban immigrant, she goes by Nellie Moreno or Nellie Bly. For ten long days she was exposed to awful care treatment; she was exposed to all kinds of neglect, and was at risk of sexual abuse from the same doctors. Now a days doctors, nurses or anyone who happens to be in contact with a mental health patient, need to be a people person. They need to enjoy interaction with different personalities, need to learn how to deal with mood swings.
As soon as Bly arrived to the Blackwell Island, she dropped her act and just behaved as a normal person. It seemed that the saner she acted, the more insane doctors and nurses thought she was. Since doctors did not have proper training or knowledge about metal illnesses they were clueless on what they were dealing with. Simple civilians were the ones to take innocent people to the asylum, and those innocent ones where already categorized as insane, they did not have an opportunity to prove themselves wrong. According to the staff, anyone who ended up in the asylums was there for a reason, and everyone admitted was categorized as inane. An attempt to help patients was made, but the type of care that received was inhumane, and humiliating.
Methods of Diagnosis
Patients did not have any say so whether they were really insane or not. Many of those patients did not have a mental illness; according to society they just acted different. While Bly was experiencing life inside the Asylum, she had the opportunity to talk to different women that were there before her, and they had been there for a long time already. She noticed that many of those women were as sane as she was. That proved that the doctors were not qualified to be diagnosing patients with mental problems.
The doctors and nurses, or any staff was unqualified, and untrained to treat mental health patients. In the era of Nelly Bly, doctors did not have an idea on what they were dealing with when it came to mental health patients. The only thing they knew is that they were insane, but that was inaccurate most of the time. Women that were admitted to a mental health institution did not have a mental illness, the problem was that they were women and they did not share the same way of thinking like men did. Their methods of diagnosis were just based on the rhythm of the patients heart beat, their eye movement, if they were from a different country and did not speak the language. When Bly arrived at the mental institution she was not acting insane, and it is unbelievable that the doctors and nurses still believed that she was insane. That shows that they did not know the difference between a sane and an insane person.
Mental health conditions are mostly treated in a nonpsychiatric medical setting. (Davis, Moore, Meyers, Matthews & Zerth, 2016). Most of the time a mental condition can me treated at home with medication, and therapy. When someone is hospitalized is because they need to be monitored by professionals, their medications need adjustment depending on their improvement, or they are they are a threat to themselves and society.
The Diagnostic and Statistical Manual for Mental Disorders (DSM), and the International Classification of Diseases (ICD) are books used by doctors for the proper diagnosis of patients that might show signs of certain disorders. Since the release of these two books, major improvements have happened on the treatment of mental health patients. Now doctors have a set of guidelines and procedures in order to diagnose someone with the proper disorder. Before being admitted into a mental institution or prescribing medication, a patient needs to undergo many different tests in order to be sure if that patient should be diagnosed with a certain disorder.
Conditions of Living
The overall living conditions for the mental health patients were inhumane; animals had a better treatment than humans. If someone were not insane when they were admitted into Blackwell Asylum, they would go insane just by living in that place for a long period of time. Patients were forced to share the same cold-water bath with other patients, not knowing if those patients had any other health problems. Aside from having to share the same dirty water, patients also had to share the same dirty towels, which could lead to many skin diseases. Also patients sometimes went to sleep with wet hair, and freezing temperatures, which could also lead to patients getting extremely sick with no medication to treat that sickness.
Patients did not have proper feeding. The food had no taste, and it they served their food cold. Sometimes they were forced to starve, and went to bed without supper. Patients requested better food, but they were told that they did not have funds. The asylum was run by the donations from the public, they did have enough clothing, and better food to provide to their patients. Nurses and doctors made patients believe that they should not ask for more, that they should be thankful for what they had. Staff in that mental institution were the ones who gave a bad reputation to the asylum.
Patients were not able to have family members to visit them., the only people allowed inside the asylum to visit; were people who were looking for someone. When people were visiting, patients were taken to a designated area, and were given proper clothing. Staff did not want anyone to know about the real living conditions of the patients.
Ethics
Any woman who was committed to the Women’s Lunatic Asylum on Blackwell Island was left at the mercy of nurses with no morals, and doctors that did not have experience in mental health problems. Little to no clothing, and living in freezing temperatures. Patients were neglected, and abused every single day. Nothing of the practices used in that mental institution were even close to ethical. If now in this day a mental institution was to do what Blackwell Asylum did, they would be sued, directors, doctors, and nurses would go under investigation, and the possibility of going to prison.
Doctors way of treatment was experimental, since they did not have a clear diagnosis of what they were dealing with, they started experimenting on patients and see what happened. Those experiments were being performed on perfectly sane people. They did not have a set of rules or guidelines to follow in order to properly diagnose someone. It’s not that the doctors were not prepared; they did not know what was happening to the insane patients. Doctors did not have any family background, or any patient’s medical history in order to determine if the problem may be genetic or not. Staff attempted to treat their patients, but they did it in an unethical way. Patients were forced to undergo different methods, like ice-cold water baths.
Now in day when someone is being admitted to a mental health institution, patients have to undergo many different procedures to be diagnosed properly. Family background will be taken into consideration; patients’ daily life routine would be looked at and evaluated. Before someone is admitted, the use of medication and therapy is suggested. Once someone is admitted into a mental institution, proper care will be provided. Professional staff will be assigned depending on the patient’s situation; timely check ups will be schedule to ensure patients fast and safe recovery.
Conclusion
At this time of the century someone might choose to volunteer themselves into a mental institution, because they may be experiencing suicidal behavior, and they are aware of their situation, and they are willing to ask for help and seek treatment. There is also the involuntary hospitalization, which is the last option for help. Friends and family members might be behind in the hospitalization of someone, for different reasons like aggression, attempting of suicide, or substance use to mention a few.
Since the experience of Nelly Brown (Ten Days in a Mad House), there have been many improvements in the treatment and diagnosis of patients. The DSM and the ICD were invented, which have helped on the diagnosis of patients. There are areas that only focus on the treatment of mental health related problems. If someone needs to be committed to a mental institution, they need to undergo many psychiatric tests. Now patients have the option to be deinstitutionalized, where they might be placed with a family member or a halfway house were proper treatment will still be provided. They also have option to reintegrate themselves into society.
Staff at mental health institutions require higher training, and besides training they need to have empathy and be compassionate towards people who have a mental illness. Nurses and doctors need to be aware and have a certain level of experience in order to support patients without being overwhelmed with different situations the patients may experience.
Mental Institutions are required to have the best treatment for their patient’s fast recovery. Family members are allowed to visit their loved ones. Doctors and nurses are required to have the proper training to attend their patient’s needs. Aside from just being institutionalized patients receive different kinds of therapy now, and also engage in different activities in order to overcome their psychological problems.
Thanks to the exposure the asylum was part off, money was donated in order to improve the living conditions and the treatment of the patients.