Dorothea Dix (1802–1887) was the prominent reformer responsible for major changes in the care and treatment of the mentally ill. Dix spent her early career as a teacher and, in 1841, was invited to start a Sunday school class at the East Cambridge House of Correction in Massachusetts. There, she witnessed appalling and inhumane treatment of mentally ill individuals. They were incarcerated with criminals and left without clothing or heat. Some were chained to the walls and beaten. Dix began a two-year tour of Massachusetts prisons and found similar conditions throughout the state. In 1843, she submitted a report of her findings to the state legislature and lobbied successfully for a bill to provide better care for the mentally ill at Worcester State Hospital. Dix spent the next decade touring American prisons and lobbying for reform, which resulted in legislation in fifteen states. She also worked on mental health reform issues in Europe. During the Civil War she served as chief superintendent of nurses for the Union Army. After the war she continued her mental health advocacy until her retirement in 1881.

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