Education: Lesson Details


During the 1840s reformer Dorothea Dix spoke on behalf of impoverished people with mental disabilities confined in the poorhouses, jails, and asylums of Massachusetts. Dix’s efforts to expose the cruelties of confinement ultimately led to the passage of legislation expanding the state insane asylum in Worcester. She later replicated this lobbying effort in many other states. Dix played a pioneering role in American public life that today is performed by either the lobbyist/advocate or the investigative journalist.

In this lesson, students learn about a shift from local to state control of the care of people with cognitive and psychiatric disabilities in the first half of the nineteenth century. They read about the specific reforms Dix advocated and why she was so active in advocating for people with mental disabilities. They also examine the ways in which Dix’s personal biography intersected with her professional activities and how she came to crusade for “moral treatment,” considered by Dix and her allies a more humane and optimistic approach to treating insanity. Documents include the views of both her enemies and her supporters. Students explore this pioneering effort in disability advocacy as well as the hurdles in achieving permanent improvements in the lives of people with psychiatric and cognitive disabilities.

The lesson raises three themes in disability history -- duties and responsibilities, definitions of disability, and matters of voice. First, Dix’s reforms came at a time when state governments first became interested in the care of people with mental disabilities. Her petitions also fostered an increase in medical authority and novel forms of treatment. Second, Dix and her allies embraced a new definition of disability rooted in natural, as opposed to supernatural, causes. They rejected, for example, the earlier Puritan view of insanity as demonic possession. On the other hand, they still defined the duties of the nondisabled in religious terms. Third, Dix’s own voice dominated her approach to disability advocacy. Hers was not a grassroots movement. It was rather an elite alliance of religious, medical, and political leaders, spearheaded by one very committed woman. Neither the voices of people with disabilities nor those of their families were included. An exploration of her actions, motives, and accomplishments, “Dorothea Dix and Lunacy Reform in Massachusetts” fits well into any class that examines antebellum reform movements.

Questions To Consider

1. In the early nineteenth century, impoverished people with mental disabilities lived in jails and poorhouses. What were the living conditions of these people revealed by Dorothea Dix? What definitions of mental disability contributed to these conditions? And how did Dix challenge these views?

2. What was the relationship between Dix’s personal biography and her vision for changing how impoverished people with mental disabilities lived in Massachusetts?

3. How did people, both allies and opponents, respond to Dix’s investigative reports?

4. What does Dorothea Dix's proposed solutions to the problems she identified say about the world in which she lived?