When I Suffer, So Do They: A Shared Experience

Dorothea Dix is one of the most interesting and inspiring women of the 19th Century. She worked tirelessly to improve the living conditions of the indigent mentally ill population. From the age of 19 when she opened her first charity school for children in poverty, until her last tour of the hospitals she’d established throughout New England at the age of 79, she made sure that her life had meaning and lived by no one’s rules but her own. This kind of independence was uncommon for women in the 1800s.

She continued to break barriers and used her wit and intelligence to petition the United States government to take on the mentally ill as wards of the state, a ground-breaking concept for the period. One of her more famous quotes, “If I am cold, they are cold; if I am weary, they are distressed; if I am alone, they are abandoned.”, adequately sums up her life’s mission.

Although the term “social worker” wasn’t around during Dorothea’s time, I think it is a good representation of the broad scope of work that can be done in the social work profession.

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In her early years in Boston, she worked in school social work. She was an advocate for both young women having equal educational access and for income inequality in education. Between the years of 1816-1836, she opened a series of schools run out of the houses of the relative she was staying with at the time, mostly her wealthy grandmother, Dorothy Dix, her namesake.

In 1821 she was permitted to open her first charity school for young women called Hope School, (Herstek, 2001, p.27). Throughout the next few years she published a few works, mostly on lessons in morality. Her first published book in 1824, Conversations on common things; or, guide to knowledge: with questions, was very popular. It had been reprinted 60 times by the time the Civil War started, (Parry, 2006). While her strong drive and motivation allowed her to achieve her success it had also began to wear her down and the development of her chronic illness and depression would cause her to travel to Europe for relief. There she would meet some fellow social reformers, Philippe Pinel, a French prison reformer and William Tuke, responsible for building the York Retreat for Mentally Ill, who would change her views on how the mentally ill could and should be treated, (Wood, 2017).These views, along with the empathy she possessed from overcoming her own battle with mental illness, drove Dorothea into starting her own crusade for the wellbeing of the less fortunate when she returned to Boston in 1827.

Her middle years were spent advocating for the mentally ill and their basic human needs and rights. She was what you would now call a mental health social worker but on the macro level, not on the micro level or case by case basis. She worked within the halls of government in Washington D.C. to get her policy reforms adopted and was one of the very first female lobbyists. She traveled throughout New England and gathered data on the current guidelines for the treatment of the mentally ill kept in prisons, almshouses and asylums. What she found inside was horrifying. It was believed that the insane couldn’t feel cold, therefore many were kept chained and naked in unsanitary conditions. She saw providing compassionate care as a critical necessity. Responsible for helping to establish 128 state run mental hospitals, including one federal Army and Navy hospital for the insane, she also changed the way the mentally ill were viewed, (Herstek, 2001, p.98-99). She used the term moral treatment often in her memorials to legislature. “These pamphlets were the only means by which a woman could participate in political life in America. Women were barred from voting, could not hold office, and did not present such testimonials before the legislature- a male representative had to read the text aloud.” (Parry, 2006) Dorothea felt that it was the responsibility of the government to provide for those who couldn’t provide for themselves, in a humane and moral setting and despite being a woman with little legal rights, she was able to get several states on board with her reforms. “I refer to idiots and insane persons, dwelling in circumstances not only adverse to their own physical and moral improvement, but productive of extreme disadvantages to all other persons brought into association with them. I applied myself diligently to trace the causes of these evil and sought to supply remedies.” (Dix,1843)

It wasn’t until Dorothea was nearing her 60s that she provided one of her most memorable achievements as a medical social worker and was give then title of the Superintendent of Union Army Nurses. She volunteered her time to train and organize the distribution of nurses during the Civil War. It was uncommon for there to be female nurses during this time, and it took advocating to get the Army officials to change policy. She even set up a list of qualifications that female nurses had to meet before they could receive training including age restrictions, good overall health, matronly character, superior education and strong habits in cleanliness. These guidelines eased the concerns about women caring for men and helped fill the shortage for quality nurses during the war, “Without trying, she empowered women by providing them with important, life changing work.” (Herstek, 2001, p.84-92). The famous author Louisa May Alcott was one of the nurses who trained under Dorothea and her accounts during the war greatly influenced her writings, (Wood, 2017).

Dorothea did not live an easy life. She was plagued with depression and chronic illness for many of her years. It is because of the illnesses, not despite them, that she was able to compel others to match her compassion and do something about the world we choose to live in. She wasn’t afraid to expose the cruelness and suffering she saw. I had never heard of this amazing woman before taking this class, but the moment I heard her story, I knew there was a connection. Her cause is the same cause that has compelled me to go back to college. I see the suffering of the homeless, I have been inside shelters and addiction treatment facilities and I know that there is something that can be done to better the quality of life.

Access to long term care for the mentally ill would solve a large portion of the homeless crisis. I meet so many people living on the streets who don’t have the capacity to take care of themselves, hence why they are there. One man I encountered had fetal alcohol syndrome and his mother had admitted to him her faults along with teaching him how to survive without her, as she knew no one would treat him with the same compassion she had towards her son. He was taught how to find places that would serve food, like soup kitchens and places that provided clothing so that he would always know how to at least get fed and clothed. He proudly explained how his disability was paid out in the following order, 1: rent so that he always had shelter 2: utilities so he always had heat and warmth 3: food if money was left over. My compassion towards these individuals drives me to want to learn how to write grants and lobby for changes within legislature, much like Dorothea did. I appreciate her approach, she observed, collected data and then presented the cold hard facts. This is the roots for evidence-based practice that we use today.