What It Was Like to Be a Mental Patient In the 1900s
“Locked Away: The Forgotten Souls of America’s 1900 Asylums”
They called them lunatic asylums, but in truth, they were graveyards for the living.
Cold iron beds. Screaming hallways. Children and adults locked behind bolted doors. The stench of disinfectant and fear. And the echo of something worse — the knowledge that no one inside had any real chance of ever leaving.
This is not a story about medicine.
This is a story about what happens when a society decides that the easiest solution… is to throw people away.
And in 1900 America, thousands were thrown away.
1. THE DOORS THAT ONLY LOCKED ONE WAY
If you stepped inside a U.S. mental hospital in the early 1900s, the first thing you would hear wasn’t conversation.
It was metal.
Metal doors slamming.
Metal keys turning in locks.
Metal bars rattling on windows that would never open again.
Most of the patients inside didn’t choose to be there.
Most didn’t even know why they’d been brought there.
The law allowed families — angry husbands, embarrassed parents, tired caretakers — to sign a single piece of paper and have someone committed for years, sometimes decades, with no trial, no defense, and no hope.
Elizabeth Packard knew this better than anyone.
She had committed no crime.
She hadn’t hurt anyone.
She didn’t even raise her voice.
Her only “sin” was that she dared to disagree with her husband’s religious beliefs.
And for that, she spent three years locked inside an asylum, treated not as a patient but as a burden.
She slept behind bars.
She ate food crawling with rot.
She watched helpless women dragged by their hair into solitary confinement.
And every night, as she lay on a hard cot listening to the screams coming from down the hall, she wondered the same thing:
How many of us don’t belong here?
And how many will never get out?
She had no idea the answer was thousands.
2. CHILDREN OF THE BARRED WINDOWS
The horror didn’t stop with adults.
Between 1854 and 1900, asylums across America admitted hundreds of children — some as young as six years old. Boys and girls, confused, terrified, pulled away from their families and thrown into locked dormitories with violent adult patients.
One boy, Henry Frazier, was sent to an asylum in New Orleans because his mother said he was “uncontrollable.”
Her evidence?
He played with himself until he fell asleep.
That alone was enough.
Night after night, Henry slept in a room of strangers who screamed until dawn.
He watched attendants restrain people three times his size.
He felt fear wrap around him like a second skin.
Doctors made no exception for his age.
He received the same treatments, the same punishments, the same terrifying “therapies” used on adults.
Many children admitted never saw their families again.
Some died.
Some simply vanished into the records.
And the world outside kept turning, unaware that behind those ivy-covered walls and elegant Victorian architecture, childhoods were being erased one scream at a time.
3. THE UNDERCOVER WOMAN WHO DARED TO TELL THE TRUTH
Most Americans never saw what happened inside. And hospitals wanted it that way.
But in 1887, one woman forced the doors open.
Her name was Nellie Bly, a young journalist with fire in her veins and fearlessness in her bones.
She pretended to be insane — stopped sleeping, ate nothing, spoke to no one — until officials committed her to the notorious Blackwell’s Island Insane Asylum.
What she found inside would shake the world.
Women shivering on stone floors.
Patients slapped, shoved, starved.
Doctors yanking their hair.
Nurses screaming insults into their faces.
Bly slept in a room with ten other women.
Bars on every window.
Locks on every door.
Metal everywhere — cold, cruel, inescapable metal.
She imagined what would happen if a fire broke out.
She knew the answer:
They would all die.
Because no matter how loud they screamed,
no one outside would hear them.
And no one inside would unlock the doors.
She was finally released after ten days — only because she had an editor waiting outside.
But the women she left behind?
They had no one.
4. THE TORTURES THEY CALLED “TREATMENT”
Medical knowledge was primitive.
Understanding of mental health was nearly nonexistent.
So the “treatments” offered in 1900 were not medicine.
They were torment.
Patients were spun in machines at high speeds until they vomited.
Others were strapped into harnesses and swung for hours to “shake the madness out.”
Some were burned with hot irons to “restore the senses.”
Some were dunked into freezing baths until they turned blue.
But perhaps the most horrifying was the “malarial treatment.”
Doctors believed that injecting malaria into the bloodstream might “burn away” syphilis.
Yes — malaria.
Fever after fever, until the body was too weak to stand.
Half of the patients showed improvement.
Fifteen percent died.
Yet hospitals continued the practice, not because it worked — but because they were desperate.
And sometimes, desperation breeds cruelty.
5. A NIGHT IN THE WARDS
Let us step inside the Oregon State Hospital in the year 1900.
It is night.
Patients lie in narrow iron beds.
Mattresses thin as paper.
Sheets stiff with over-washing.
No privacy, no silence, no comfort.
A new patient arrives.
Exhausted.
Terrified.
Still wearing the clothes he came in.
A man in a white apron walks up and adjusts the blankets on his bed.
The patient whispers, “Are you an attendant?”
The man smiles faintly.
“No,” he says.
“I’m one of you.”
Down the hall, someone screams for hours.
Another begs for death.
Another repeats the same word all night:
Murder.
Murder.
Murder.
The new patient realizes something soul-crushing:
No one here is healing.
Everyone is surviving.
6. THE FOOD THAT BROKE THEIR SPIRITS
Meals were not nourishment.
They were punishment.
Tea and stale bread.
Rancid butter.
Five prunes.
Nellie Bly said the eating alone was enough to break a person’s mind.
And yet, there were pockets of hope — rare as they were.
Some institutions tried to create restaurant-like dining rooms.
Patients served other patients.
Fresh food was grown on asylum grounds.
But these were exceptions.
Most patients worked the fields, not for their mental health, but because hospitals needed cheap labor.
Hands that trembled with fear harvested vegetables they were never allowed to eat.
7. THE BEAUTIFUL BUILDINGS THAT HID THE PAIN
From the outside, asylums looked like heaven.
Manicured lawns.
Majestic stone architecture.
Balconies, fountains, gardens, winding paths beneath tall trees.
Tourists even visited them, strolling past patients as if they were part of an attraction.
But once you stepped inside, beauty dissolved.
Locked doors.
Barred windows.
A smell that clung to your clothes — sweat, bleach, and despair.
Reformers wanted peace.
But administrators wanted discipline.
And governments wanted people hidden, not healed.
The outside world saw serenity.
The inside world lived in suffering.
8. THE REASONS THEY CALLED “INSANITY”
Doctors in the 1900s believed insanity could come from nearly anything:
A fever.
A fall from a horse.
Too much whiskey.
Too little sleep.
Too much stress.
Not enough obedience.
One man was institutionalized because a malarial fever left him “deranged.”
Another because doctors said his brain had “softened” after a fall.
A woman was locked away because she drank too much whiskey.
A boy because he played too loudly.
A girl because she cried too often.
And some — perhaps the most heartbreaking — were committed simply because their families didn’t want them anymore.
For hospitals, admission meant money.
And a filled bed meant income.
Patients became products.
Souls became revenue.
Human beings became inventory.
9. LIVING PRISONS IN EVERY STATE
By the 1870s, nearly every U.S. state had built at least one asylum.
Oregon, for instance, had so many patients that it expanded to three buildings by the 1930s.
Thousands lived there.
Thousands died there.
And thousands more were forgotten.
Imagine lying in a locked room, unable to escape, listening to a stranger cry through the wall — not once, not twice, but every single night for years.
Imagine realizing that the only difference between patients and staff was who held the keys.
Imagine being told the only way out was to pretend you were sane.
One patient said, “Do exactly what the doctors say if you want to get out.”
He followed the rule.
He was released.
And then he died by his own hand.
10. THE QUESTION WE STILL CAN’T ANSWER
So what was it like to be a mental patient in 1900?
It was like being buried alive.
It was like shouting into a room with no echoes.
It was like being erased while still breathing.
It was like living in a place where treatment meant terror, and healing meant obedience.
It was not medicine.
It was survival.
And the hardest truth of all?
Many of the people locked inside weren’t insane.
They were inconvenient.
People society didn’t understand.
Didn’t want.
Didn’t know how to help.
And so it hid them.
Behind doors that only locked one way.
