Miss Dorothea Dix (1802 – 1887): Teacher, Nurse, Social Reformer and Advocate for the Mentally Ill

by Dr. Graham Warder, Keene State College

Dorothea Dix was born on April 4, 1802 in the frontier town of Hampden, Maine. Her father was poor, a drifter, and probably an alcoholic. He was also a Methodist minister and thus preached to the common folk. Dorothea had a troubled childhood and later portrayed herself as an orphan. She may have been concealing her upbringing out of embarrassment. At twelve, she moved to Boston to live with her wealthy grandmother. She became a teacher for girls, wrote and published moral tales for children, and came under the influence of Unitarianism, the religion of Boston’s wealthy elite who had rejected Congregationalism in the early 1800s. Unitarianism was a softer faith than the one in which she had been raised. Unitarians, for example, were less likely to emphasize sinfulness, hell, and damnation than either Methodists or Congregationalists. It was more likely to stress reason and the role of wealthy people in setting examples for those they saw as social inferiors. 

In Boston, Dix developed a powerful network of allies, including the Rev. William Ellery Channing, for whose children Dix served as a nanny. Channing was the American leader of a revitalized Unitarianism that promoted all sorts of social reforms. He favored an active humanitarian outlook. Because of her connections with Channing, Dix become acquainted with and deeply respected by Boston’s Brahmin leaders — Ralph Waldo Emerson, Horace Mann, Charles Sumner, and Samuel Gridley Howe, important allies in her later career as a professional reformer.

Dix came of age during a period of tremendous change. Like many Americans of the 1820s and 1830s, she was influenced by the religious upheavals of the Second Great Awakening, the revivalism sweeping the nation. She also witnessed the social and economic upheavals of the Market Revolution, the spread of a growing commercial economy into what had been isolated rural backwaters. Like so many contemporaries, Dix experimented with religion. Her spiritual wanderings led her away from the emotional backcountry religiosity of her father to the more rational ideology and assumptions of moral stewardship embraced by Boston’s Unitarians. She shifted from the fire-and-brimstone sensibilities of Methodism to something much cooler and more elitist and genteel. In other words, her soul and psyche journeyed from “fire” to “ice.” Her journey also took her from the nomadic poverty and marginality of her father’s life to the opulent success and intellectual wealth of Boston’s high society — the people who came to be known as the Brahmins.

Both theology and class led people like Dix to express concern for the unfortunate. But upon what group of unfortunates would she focus her energies? Dix did not truly discover her life’s work until she was almost forty years old. She did not become a leader in the asylum movement until she herself experienced a debilitating bout of depression and physical illness in 1836. Then Dix traveled to England and stayed for five years. While there she learned of reforms in the treatment of insanity. She met Samuel Tuke, the superintendent of the York Retreat and a leader in British asylum reform. He was the grandson of William Tuke, an early proponent of “moral treatment” for mental disorders. Moral treatment asserted that people with mentally illnesses could be nurtured back to rationality in “home-like” settings.

Dix returned to Massachusetts and in 1841 began teaching Sunday school to women at the East Cambridge jail. There she observed firsthand that many inmates had a psychiatric disability and suffered from abuse and neglect. Appalled by the conditions she witnessed at the jail, she embarked on a career as a sort of early investigative reporter, at a time when no such career existed. Thereafter, reforming the care of the insane became her passion and purpose in life.

Dix had found her calling, a mission to which she could devote her talents. She traveled throughout Massachusetts examining jails and almshouses to collect the evidence needed to create an argument for better care.

In January, 1843, Dix presented her petition before the state legislature. The immediate goal was to secure funding to increase the size of the State Hospital for the Insane in Worcester. In Gothic vividness, Dix declared, “I proceed, gentlemen, briefly to call your attention to the present state of insane persons confined within this Commonwealth, in cages, closets, cellars, stalls, pens! Chained, naked, beaten with rods, and lashed into obedience…” In her petition, hers is the only voice. In her calls for sympathy, we see things through her eyes alone. She holds a monopoly on perspective. Her petition was also a powerful indictment against the cruel and irresponsible practices of jail wardens and almshouse keepers.

Dix’s efforts took her outside the accepted cultural norms of behavior for women. In 1843, women could not vote, and respectable women were expected to remain within the private “sphere,” the world of children, morality, piety, and home. Women had moral authority but no political power. Dix became an effective and active political lobbyist at the state and federal levels of government, and she assumed a public role very rare for a woman of her generation. But her activities were also carefully limited. Dix wrote, but men spoke. In presenting evidence in support of asylum reform, Dorothea Dix directly addressed neither the Massachusetts Legislature, the United States Senate, nor the House of Representatives. She instead relied on powerful male allies to speak for her.

Despite voices raised in local newspapers questioning Dix’s account, her emotionally powerful memorials were successful. In her first appeal (many others would follow), the Massachusetts legislature granted a large increase in funding for the Worcester institution. In the long career ahead, Dix would travel throughout the country to lobby for the construction of asylums by the states and even the federal government. She played a direct role in the establishment of 32 state institutions for the care of the mentally ill.

During the Civil War, Dix was placed in charge of all female nurses in Union military hospitals and aspired to be the American Florence Nightingale. She believed that women, not men, were superior caretakers, but she also demanded that all nurses be plain-looking and at least thirty years of age.

Dix never married. She spent her last years in declining health, residing as a guest at the visitors’ quarters of the New Jersey State Hospital in Trenton, an institution her lobbying had helped to build. She died there in 1887.

Selected Bibiolography

Dain, Norman, Concepts of Insanity in the United States, 1789-1865 (New Brunswick: Rutgers University Press, 1964).

Gollaher,David, Voice for the Mad: The Life of Dorothea Dix (New York: Free Press, 1995).

Grob, Gerald N., The Mad Among Us: A History of the Care of America’s Mentally Ill (New York: The Free Press, 1994).

Republished from: Graham Warder, “Miss Dorothea Dix,” Disability History Museum, http://www.disabilitymuseum.org/dhm/edu/essay.html?id=35 (October 27, 2014).

How to Cite this Article (APA Format): Warder, G. (n.d.). Miss Dorothea Dix (1802 – 1887): Teacher, nurse, social reformer and advocate for the mentally ill.  Social Welfare History Project. Retrieved [date accessed] from https://socialwelfare.library.vcu.edu/people/dix-dorthea-lynde/

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