Dorothea Dix A crusader for humane treatment of the mentally ill

It’s easy to drive right past the woodsy little roadside park in Hampden that marks the birthplace of Dorothea Dix. And perhaps that’s the way she’d want it. By all accounts, Dix was averse to publicity and during her lifetime turned down several opportunities to have her name attached to hospitals and other institutions.

But more than 120 years after her death in 1887, the name of Dorothea Dix is still associated with one of the most important social reform movements ever undertaken: the humane and therapeutic treatment of people with mental illness.

“She was absolutely seminal in promoting the humane treatment of the mentally ill,” said Carol Carothers, director of the Maine chapter of the National Alliance on Mental Illness. Carothers said Dix’s humanitarian influence still can be felt in the public debate over providing appropriate care to people with mental illness, both in residential facilities and in the communities where they live.

Dorothea Dix was born on April 4, 1802. Her father was an itinerant preacher and the family was poor. When she was 10 years old, she moved with her family to Worcester, Mass., to be near her paternal grandfather, a wealthy Boston physician named Elijah Dix. The elder Dix owned large tracts of Maine timberland, and in time the towns of Dixmont and Dixfield were established and still bear the family name.

Young Dolly, as she was called, eventually went to live with her grandparents in Boston and at the age of 14 opened her own school for girls. When her grandparents died, she inherited the family home and continued to work as an educator.

Her own formal education was not extensive, but Dix read widely, attended public lectures and performances, and developed close relationships with many knowledgeable and influential people of her time.

Although her religious training was grounded in the Methodist and Congregational churches, she was drawn to the Transcendentalist thinkers and eventually became a close friend of the renowned Unitarian minister William Ellery Channing and his family.

In 1836, Dix suffered a severe illness related to a chronic respiratory weakness and was unable to work for several years. She traveled to England and stayed in Liverpool with the family of William Rathbone, a Quaker philanthropist and a friend of Channing’s. While she was there, Dix was asked to teach a Sunday school class for women incarcerated at the East Cambridge Jail. The experience changed her life.

The jail was filthy and unheated, she wrote later. Men, women and children were locked up together. Most shocking, though, was the presence of mentally ill and mentally retarded people enduring the same deplorable conditions as hardened criminals.

Dix immediately petitioned local officials and succeeded in improving conditions somewhat at the jail, and she resolved to investigate the treatment of people with mental illness in her own country.

Upon her return to Massachusetts in 1842, Dix undertook the inspection of jails and poorhouses throughout the state. She took careful notes on each facility and the conditions of the inmates. She found people with mental illness kept in chains, unclean, poorly fed and exposed to the cold. Armed with a report of her findings, she persuaded the Massachusetts Legislature to fund a major expansion and improvements at the state mental hospital in Worcester.

Hundreds of people with mental illness were transferred from the cruel environment of the prisons to the more humane and therapeutic hospital setting. Dix advocated for secure surroundings and medical treatment, as well as access to books, music, recreation and meaningful work.

Dix expanded her efforts to a nationwide crusade. In state after state, she exposed the inhumane treatment of the mentally ill and inspired the establishment of more than 30 hospitals dedicated to their care.

During the Civil War, Dix was appointed the superintendent of Union Army nurses. Though her headstrong, outspoken character did not endear her to the nurses or doctors with whom she worked, she established a reputation for tending to wounded soldiers from both sides. After the war, she helped trace missing soldiers and assisted families in reuniting with their loved ones.

As the 19th century neared its close, waves of European immigrants arrived in the United States, straining social programs and budgets. The hospitals Dix had helped establish grew overcrowded and underfunded. Conditions for the mentally ill patients within their walls worsened, and in some cases came to resemble the deplorable environment of the prisons they had replaced.

Discouraged by these changes, Dix retired at the age of 79. She was reluctant to speak about her work and quashed several attempts to have hospitals or other facilities named in her honor. In the early 1880s she entered the Trenton Insane Asylum in New Jersey. She died there on July 17, 1887, and is buried in Mount Auburn Cemetery in Cambridge, Mass.

Late in the 20th century, the large residential hospitals Dix had helped build began releasing their patients, on the premise that adequate care could be provided by community clinics and patients could live more independently. The community model is now widely considered to be in crisis, with many mentally ill people not getting the care they need. Homelessness, poverty and criminal behaviors are, unfortunately, not uncommon.

Carothers of NAMI Maine said Dix would be dismayed to see people with mental illness living on the street or shut up in prisons and jails instead of getting the care they need.

“Conditions are going back to the way they were when she first became involved,” Carothers said.

In 1899, the small park in Hampden was established on the site of Dorothea Dix’s first home. Hundreds of area residents attended the dedication. Honorary trustees of the park included Clara Barton, mother of the Red Cross; author Sarah Orne Jewett; Gettysburg hero Gen. Joshua Chamberlain; Col. Augustus Hamlin, Vice President Hannibal Hamlin’s nephew; Julia Ward Howe, writer of “The Battle Hymn of the Republic”; and Susan B. Anthony, legendary leader of women’s suffrage.

In September 2005, the former Bangor Mental Health Institute was renamed the Dorothea Dix Psychiatric Center.

mhaskell@bangordailynews.net

990-8291

From the collection of the Maine Historical Society. This image and thousands of others spanning Maine history are on Maine Memory Network, www.mainememory.net, Maine’s digital museum developed by the Maine Historical Society.