Mental health and mental illness have been stigmatized over the past centuries as less than a chemical imbalance in the brain; it has been seen that ill people are simply “crazy” or just out of their minds. Nonetheless, mental illness is medically defined as an imbalance of chemicals in the brain yet people are treated as though they have gone crazy. Like any type of illness, mentally ill patients should be given great care and, if in hospitals, should be treated as if they have any other sickness, with good living conditions and respect from doctors and other staff members. Unfortunately, these simple standards of care are not found in every hospital, nationwide, and patients throughout the country are given inhumane treatment. Dorothea Dix, the first mental health advocate of the mid-1800s, observed these horrible conditions and worked to support mentally ill patients who were being treated like animals. Through her work, mental hospitals were created and it was required that patients were treated better, yet somehow, the treatment of such mentally ill people has seemed to retreat to the ways of the mid-1800s.

A former reporter for The Washington Post and New York Times bestselling author of Crazy, Pete Earley, explored the conditions and treatment of the mentally ill, similarly to Dorothea Dix. He explored part of the reason that the treatment and living conditions had deteriorated and gone back to the ways of the past: deinstitutionalization. This process began around 1955 when the federal government created programs that would allow state legislators to “find a way out,” so that they could put their responsibilities of and for the mentally ill onto the country’s new programs. Similar to many things in our country, money was a driving force in this era as lessening the number of patients in mental hospitals would save the states’ money. Over a 20 year period, 1960-1980, the number of patients in mental hospitals decreased by 20%. (Earley 71). As also explored by Anne E. Parsons, history professor at the University of North Carolina at Greensboro, in From Asylum to Prison: Deinstitutionalization and the Rise of Mass Incarceration After 1945, deinstitutionalization caused hospitals to discharge patients when they weren’t mentally stable enough to be turned onto the streets causing an increase in the homeless population and eventually an increase in the prison population as these mentally ill people were committing crimes since they had very minimal control over their actions. While the states believed that deinstitutionalization would benefit them financially, they would end up having to pay more for each prisoner than they would have had to for the state mental hospitals.

When Dix first began exploring and investigating the treatment of the mentally ill, her observations were filled with notes about the living conditions that they were given. The patients were put into small, enclosed, filthy, damp places, some made of stone, with iron frames, and with no source of light or ventilation. Dix’s discoveries were mentioned in The North Carolina Historical Review by Margaret Callender McCulloch; when she approached various legislatures with proposals to create hospitals and regulate treatment and living conditions expectations, they accepted based on her evidence (qtd. in Harrison & Gilbert 70). Even though they accepted these proposals and, very much so, improved the mental health system ordinance, there are still hospitals and prisons with such horrid conditions. As explored through and by Pete Earley in Crazy, mentally ill patients are kept in places with some of the living conditions of the mid 19th century. On the ninth floor of the Miami-Dade County jail, severely mentally ill patients are put into cells. Upon Earley’s first tour of the prison with Dr. Joseph Poitier, the jail’s chief psychiatrist, he was quickly taken aback by the completely disgusting scents and physical attributes of the ninth floor, “The air in the C wing stinks. It is a putrefied scent, a blending of urine, expectorant, perspiration, excrement, blood, flatulence, and dried and discarded jailhouse food. When the jail’s antiquated air conditioning breaks down during the summer, which it often does, some officers claim C wing’s pink walls actually sweat” (Earley 45). The mentally ill inmates live in this repulsive environment and are expected to be respectful and follow orders. Similarly to the patients and places that Dix observed, the mentally ill inmates are living in a beyond nauseating environment.

Another atrocity that Dix found in the treatment of the mentally ill is how they were physically abused and treated as if they were animals. Accompanying her notes in regards to the living condition issue, there were lots of notes highlighting the inhumane treatments that mentally ill patients were receiving. Within one of her many speeches, Plea for Humane Treatment of the Insane, she presents notes on over one dozen asylums and hospitals that she had visited; they all contain similar observations about how appalling the patients were being treated. One note from a hospital in Medford, Oregon, says, “One idiotic subject chained, and one in a closed stall for seventeen years” (Dix 3). Although treatment was regulated and history proved that inhumane treatment of any person was jail worthy, the mentally ill patients on the ninth floor in Miami experienced torture and abuse by correctional officers. One tactic that the officers used was something they referred to as “OC spray,” which was oleoresin capsicum, pepper, spray. When an inmate repeatedly refused to cooperate, they would occasionally use this spray to temporarily knock them unconscious (Earley 239). This was not nearly as horrible as the abuse would get for the patients; correctional officers would beat them, use leather restraints to immobilize and punish them, and more if they were not getting what they wanted.

In a non-physically abusive way, inmates on this floor, specifically in the suicide watch area, were forced to be completely naked at all times so that they had absolutely nothing that they could possibly use to harm or kill themselves. These prisoners were forced to be vulnerable as their entire naked body was not only visible to other prisoners and guards but also to passersby of the jail who could see in. A punished prisoner on the ninth floor was once seen completely naked and tied to a chair with a pool of her own urine below her (Earley 185). Like a wild animal, this patient was “did her business” on the floor because she had no other option and was forcibly restrained to that chair.

It has been almost two centuries since Dix began advocating for the right conditions and treatments of the mentally ill, yet we are still treating our nation’s most mentally ill patients as though they are animals and less than human. We made progress only to be pushed back into history but with more modern day tools. The horrible effects of deinstitutionalization must be stopped, somehow, someway, and patients must be treated with the utmost respect, attention, and care that they deserve; they are human just like anybody else.