Dorothea Lynde Dix

Inspired by her social conscience, Dorothea Dix launched a self-financed career aimed at improving the lives of the mentally ill. Her crusade to document squalid institutional living conditions and inhumane treatment built public awareness and redefined political thought, leading to more benevolent treatment practices.

"I encounter nothing which a determined will, created by the necessities of the cause I advocate, does not enable me to vanquish."

— Dorothea Lynde Dix

Born: April 4, 1802 Hampden, Maine
Died: July 18, 1887 Trenton, New Jersey

Social reformer, advocate for the mentally ill, teacher, scholar, and writer, Dorothea Lynde Dix is best known for her one-woman crusade for the humane treatment of the indigent insane. At a time when lunatic paupers were routinely confined in jails, poorhouses and prisons, chained, beaten, deprived of adequate food, clothes, shelter, sanitation and medical care, Dix devoted her life to establishing institutions for the impoverished mentally ill where they would be decently cared for. As a concerned private citizen, she used her own funds, her intelligence, her perseverance, her sense of mission and her personal charisma to travel to and survey hundreds of mental institutions across the United States and Europe. In her detailed reports, or "Memorials," which she presented to legislators, Dix forced her readers to see the mentally ill as human beings and identify with their plight.

Thirty-two mental hospitals in 20 states of this country, as well as several institutions overseas, were founded directly through the efforts of Dix. During the Civil War, she was appointed as the first Superintendent of United States Army Nurses and held that position until 1866. After the war, she returned to her work on behalf of the mentally ill.  Dix is also known for her quest for prison reform.

Dorothea Lynde Dix was the oldest of three children born to an itinerant Methodist preacher, Joseph Dix, and his wife, Mary Bigelow Dix. Dorothea Dix grew up in a one-room pine shack in the backwoods of Maine, impoverished, emotionally neglected and perhaps physically abused. Her father was reported to have been an active alcoholic. Her mother became an invalid and could not manage the household. Although Joseph Dix came from a wealthy Boston family, he was rejected by his parents for his inability to succeed at anything and for marrying a penniless woman of a far lower social class. When Dix was 12 years old, her family moved to Worcester, Massachusetts. Unable to face a life of continued poverty and abuse, Dix ran away to her grandmother's house in Boston, where she was taken in but found it difficult to get along with the rigid and autocratic Madam Dix. At the age of 14, she moved to her great-aunt's home in Worcester where, for the first time, she found emotional nurturing and acceptance.

Although the young Dix was sent to a private girls school in Boston for a short time, she essentially educated herself. She was especially interested in the sciences, literature and divinity. Determined not to be a burden on her family, she taught school for several years, both as a teenager in Worcester and later, as a young woman, in Boston, where she convinced her grandmother to provide space for a charity school for poor children on the grounds of the Dix family home. She worked tirelessly, despite recurring bouts of ill health.

In addition to teaching school, Dix wrote and published several books including a virtual children's encyclopedia, Conversations on Common Things (1824), which sold widely and had been reprinted in 60 editions by 1869; Hymns for Children, Selected and Altered (1825); Evening Hours (1825); Meditations for Private Hours (1828); an exhaustive volume on plants, A Garland of Flora; and several other fictional and devotional books.

Dix was a deeply religious woman, but free from religious bigotry and narrow-mindedness. Although brought up as a Methodist, she warmed to the liberal Christianity of early Unitarianism through her friendship with Unitarian minister Dr. William Ellery Channing, who taught a faith of love and social conscience. Inspired by Dr. Channing and others, Dix had a personal mission of "faith through works," which ultimately led to her self-financed career in social reform.

In 1836, Dix suffered a complete breakdown in physical and emotional health. On her doctor's orders, she went to England to convalesce. She spent a year there at the country estate of a Mr. and Mrs. William Rathbone, to whom she had been introduced by Dr. Channing. The Rathbones' home was a regular meeting place for Boston intelligentsia and liberal, cultured Englishmen. There, Dix met Dr. Samuel Tuke, son of William Tuke, the Quaker who in 1796 founded York Retreat, England's most progressive asylum for the insane. The Tukes believed that mental illness could be alleviated, even cured, by treating the insane with kindness and respect. York Retreat's philosophy and values formed the basis of Dix's subsequent crusade for the rights of the mentally ill.

While Dix was in England, first her mother, then her grandmother died and Dix returned to Boston in 1837. She had enough money saved from her teaching, her royalties, and inheritances from her grandparents to live comfortably. For the next few years she traveled through the Eastern United States, seeking the right philanthropic career for herself. Although she had many friends and admirers, she declined to marry or maintain a permanent home. She preferred to be an independent woman, emotionally and spiritually sustained by a sense of mission.

In the winter of 1841, Dix was asked by a friend to teach a Sunday School religious class for women at the East Cambridge House of Corrections in Massachusetts. At the jail, Dix was appalled to see that lunatics were incarcerated with criminals, and were deprived of heat and proper clothing. Her indignation catapulted her into a lifelong crusade on behalf of the mentally ill. Although mentally ill persons who had private means and concerned families were usually cared for at home, boarded with paid caretakers or sent to Massachusetts' one hospital for the insane, most mentally ill people had no funds.

These unfortunates were kept, regardless of age, sex or condition, in jails, prisons, almshouses and workhouses. Dix visited hundreds of such institutions to survey conditions, which she found shocking. Mentally ill inmates were routinely caged, beaten, chained, deprived of fresh air and sunlight, poorly fed, given no medical care, and were often found filthy, naked, physically weak, and lying in their own excrement. Dix took detailed notes, which she used as the basis for her "Memorials." These were carefully written, lengthy reports that she convinced her influential friends to present to legislators. Her goal was to establish hospitals for the care of the indigent insane.

After successfully convincing the legislature of Massachusetts that additional insane asylums were needed, Dix took her campaign to the remainder of New England and the Eastern and Southern states. After legislation passed to permit the construction of new insane asylums, as it did in most of the states that she covered, Dix was often consulted on site location and building design for the new facilities. When funds were lacking, she labored to raise them. She was repeatedly honored by state legislatures as well as individuals who came to believe, through her efforts, that the mentally ill were entitled to humane care. During this time, she also became a zealous advocate for prison reform. Her book, Remarks on Prisons and Prison Discipline, was written in 1845.

When Dorothea Dix began her surveys in 1841, there were 11 insane asylums in the United States. By the spring of 1848, she had traveled over 60,000 miles, surveyed thousands of institutions throughout the country, visited over 9,000 mentally ill, epileptic and mentally retarded people, seen the ground break for dozens of new hospitals and witnessed expansions to many existing facilities.

Dix then attempted the most important part of her quest. She attempted to convince the United States Congress to establish a perpetual fund for the care of the indigent insane, setting aside millions of acres of land for the purpose. Her "Memorial to the Congress of the United States" was presented to the U.S. Senate on June 27, 1848. Although the bill she promoted was eventually defeated, she continued to have bill after bill re-submitted to Congress. Finally, in 1853, her last bill passed both the Senate and the House of Representatives, but was vetoed by President Pierce. Severely disappointed, Dix left the United States to continue her crusade in Europe. During the next several years, she traveled in Europe, again surveying institutions where mentally ill persons were kept and advocating on their behalf when necessary. In 1856, she returned to the United States and continued her work in the Northeast and in Texas.

In 1861, the Civil War broke out. Dix went to Washington, DC and volunteered to organize an Army Nursing Corps of female volunteers. She was formally granted her commission as Superintendent of the United States Army Nurses, the first appointment of its kind ever made. Although then nearly 60 years old, Dix brought her inexhaustible zeal and sense of mission to this Herculean task. Although respected for her drive and hard work, Dix was also criticized for her rigid attitudes and inability to delegate responsibility. She held the post of Superintendent of Nurses until 1866. When the war was over, she returned to her work on behalf of the mentally ill. In 1881, Dix moved permanently into her apartment at the New Jersey State Hospital at Trenton, an institution that she had long called her "first-born child." She lived there until her death on July 17, 1887.