‘Ten Days in a Madhouse’

DSCN3340Wednesday 8th March was International Women’s Day and one woman I heard justifiably eulogised on the radio was journalist Nellie Bly. Born in 1864 in Cochran’s Mills, Pennsylvania, USA, she is best known for going around the world, in the style of the fictional Phileas Fogg, only eight days faster. But she also made a great contribution to investigative journalism, especially in the cause of those being treated for mental illness.

She first began writing for the Pittsburgh Dispatch in 1885, when she posed as a sweatshop worker to expose the poor conditions for working women. But, frustrated by the lack of opportunities for female journalists, she moved to New York in 1887 and began writing for the New York World. One of her first assignments was an investigation into the conditions in a notorious insane asylum on Blackwell’s Island ( now Roosevelt Island ), which she titled ‘Ten Days in a Madhouse’. This assignment exposed serious neglect, poor health care and physical abuse.

Posing as Nellie Moreno, a Cuban immigrant, she checked into a New York boarding house, where she refused to sleep, saying she was afraid of the other residents because they looked ‘crazy’, and then continually asked where her bags were. This fairly unextreme behaviour got her taken, first to court, and then to Blackwell’s. The asylum was supposed to be a state-of-the-art humane and moral institution but, when funding ran out, it’s good and progressive intentions did also. Nellie found ‘oblivious doctors’ and orderlies who ‘choked, beat and harassed patients’, often deliberately provoking them to get violent results. She also found the women were refused all reading materials or forms of entertainment and had to endure filthy rat-infested conditions, rancid food and forced, freezing cold baths. Many women there were completely unaffected by any mental health problems but were incarcerated simply because they were foreign so nobody understood them; others were there because they were poor, or because they had been unfaithful to their husbands. And the worst aspect of the asylum was the constant isolation and enforced inactivity…as Nellie Bly said:

“What, excepting torture, would produce insanity quicker than this treatment?…Take a perfectly sane and healthy woman, shut her up and make her sit from 6am to 8pm…do not allow her to talk or move…give her bad food and harsh treatment, and see how long it will take to make her insane…”

Nellie only spent 10 days there, a very short time, but she found it easy to understand how a lengthy stay there would be horrendous, and permanently damaging, physically and mentally. One of the women she met reported:

“…they tied my hands and feet, and, throwing a sheet over my head, twisted it tightly around my throat so I could not scream, and thus put me in a bathtub filled with cold water…”

And despite the fact that, from the moment Nellie actually entered the asylum, she acted completely sanely and rationally, no-one (except one very kind doctor) would believe, or even question the fact, that she should not be in there:

“Yet strangely to say, the more sanely I talked and acted, the crazier I was thought to be…”

Her writing on the subject caused New York Assistant District Attorney Vernon M. Davis to launch an investigation. When the Grand Jury visited, Blackwell’s clearly had received advance warning, so that the place had been cleaned up and the most badly treated women hidden from sight. However, Nellie’s story was believed, resulting in a number of changes, including a greater appropriation of funds for the care of mental health patients, more supervision of nurses and health care workers, and regulations to prevent overcrowding. Nellie wrote other such investigative pieces after this, specifically looking into conditions in prisons and factories.

Care and treatment for those with mental health problems may still be oppressive, unfair and often barbaric. But, like most things, it is all relative. And although Nelly Bly went on to be better known for travelling around the world, alone, in 72 days, her pioneering work in mental health reform, particularly for women, is well worth remembering.


The opinions expressed are those of the author and do not necessarily reflect those of Changes Bristol

Welfare reforms: who cares?

As many of our members know, only too well, Personal Independence Payment or PIP has never been an easy benefit to claim successfully. In fact, frontline welfare advisers recently told the work and pensions select committee that the PIP process was “inherently flawed”, resulting in thousands of wrong decisions and causing widespread harm and distress to claimants. According to the DWP’s own statistics, just 45% of new claims for personal independence payment have been successful where the claimant is not terminally ill. The success rate for DLA to PIP transfers is currently 69%.

People with mental health problems face many, many barriers to making PIP claims but it really seemed that things were taking a more positive turn when an Upper Tribunal recently ruled people who need support to make journeys because of overwhelming psychological distress should be eligible for the  mobility rate of PIP.  The tribunal decision ruled that claimants who need mobility help due to psychological issues should be entitled to the same help as people with physical issues.

However, the Government announced it would change the law rather than follow the court’s ruling. The Government didn’t want to pay the extra cost. And so, in an attempt to save £3.7bn, it introduced emergency legislation to overrule the tribunal decision. The changes to the law were introduced via a ‘statutory instrument’ which allows ministers to fast-track changes to existing laws without the need for a vote or to be subject to much scrutiny.

The Social Security Advisory Council (SSAC), who were not consulted about the new regulations before they were introduced because the government regarded the matter as too urgent, have held a meeting and written a letter to Penny Mordaunt, Minister for Disabled People, Health and Work attacking this controversial decision. 

In its report, the SSAC said it was “particularly concerned” that overturning the tribunal’s ruling will cause confusion. “It is not clear how tribunals, decision makers, or health care professionals conducting assessments will respond to changes in descriptors to exclude ‘psychological distress’,” it warned. The SSAC urged the DWP to consider “testing the proposed changes with health care professionals and decision makers to ensure the policy intent behind the regulation is clearly understood”. And it concluded: “The department should both (a) consult more widely with representative bodies and health care professionals; and (b) improve the estimate of likely impact before the changes are introduced.”

New guidelines issued for benefit assessors do appear to suggest that people whose mobility is limited due to mental health conditions are not entitled to receive the mobility component of PIP even if their mobility is limited to the same extent as someone with a physical impairment. 

This change in the law which came into force on 16 March could leave disabled people without vital financial support, according to mental health charity bosses. Thirty-two chief executives wrote to disabilities minister Penny Mordaunt, stating that they were “deeply concerned” by the proposed changes to disability benefits, but the changes went ahead anyway.

A letter sent to Penny Mordaunt from the Disability Benefits Consortium, said:

“We are deeply concerned by imminent changes to Personal Independence Payment which will leave at least 160,000 disabled people and those with long-term conditions without vital financial support….We believe this undermines the principle of the PIP assessment and its ability to fairly provide financial support, regardless of impairment or condition. Those with mental health issues, learning disabilities and autism face just as severe barriers and costs as those with other impairments – these changes fail to acknowledge this…We are also worried that the full scale and impact of these changes will not be understood before they come into effect.”

Phil Reynolds, co-chairman of the Disability Benefits Consortium and policy and campaigns adviser at Parkinson’s UK, said:

“Across the consortium, we have had our helpline and advice services inundated by calls about PIP since it was introduced…Instead of supporting disabled people, the benefits system seems increasingly rigged against them. The whole system needs urgent improvement, in order to accurately assess the support they need. Disabled people cannot afford to wait.”

There’s an argument floating around various internet forums that this change directly discriminates against people with mental health problems. After all, if a person cannot leave their home without copious amounts of support in place, should it really matter if the inability to travel independently stems from physical or mental roots? Or a mix of the two? Actually, the PIP application process really doesn’t cater for people who have both physical and mental disabilities. Pick a side people; you can’t have both! The more realistic among us are well aware that many people do have mental and physical health problems that have an inconvenient tendency to exacerbate each other. This is a really bad case of the whole equalling more than the sum of its parts as mental and physical health problems combine to produce an overall disability that is far, far more incapacitating than any of its individual components.

 It is now possible for two neighbours with similar or even identical levels of difficulty leaving their homes to attend a medical appointment to be treated completely differently by the very process that is theoretically in place to support them and that’s just not funny. It’s not funny that our current government promised that mental health would be given much greater parity with physical health but then backtracks and effectively says “Nah, the mentally ill can stay home, we’re only helping the ‘proper’ disabled get out and about.” It’s like we’re going backwards to the time when so many people ‘knew’ you could tell a disabled person from a non-disabled person by their wheelchair or lack thereof. In the words of Theresa May’s head of policy, George Freeman, personal independence payments  should go to “the really disabled people who need it” as opposed to those “taking pills at home, who suffer from anxiety”. Wow George. Way to put us in our place!

 In yet another twist, Labour peers used a rarely used ‘regret motion’ in the House of Lords demanding an urgent review of the new policy to determine the impact on people with mental health conditions. The government are supposed to carry out impact assessments whenever  they introduce changes like this but in recent years have kept ‘forgetting’ to do this when implementing their numerous welfare reforms. Unfortunately, the Lords “regret” will have no impact on the disabled people losing their benefits as it is simply a motion that criticises the government. The controversial changes to PIP were subject to an Emergency Debate on 29 March, but as it was left until the last day of parliament before the Easter break there was no time for a vote which means, under the terms of emergency legislation, that MPs will be out of time to demand a vote after the break.

The cumulative effect of the cuts on disabled people in Britain led to a UN investigation. After receiving evidence from disability organisations about an “alleged adverse impact” of government reforms on disabled people, the UN Committee on the Rights of Disabled Persons (CRPD) sent two committee members to investigate and identify any gaps in human rights protection for disabled people. The findings were that UK welfare reforms have led to “grave and systematic violations” of disabled people’s rights. Changes to housing benefits, criteria for parts of the Personal Independence Payment, a narrowing of social care criteria and the closure of the Independent Living Fund, all “hindered disabled people’s right to live independently and be included in the community”. The committee made 11 recommendations to the UK government, including calling for a complete impact assessment of reforms introduced since 2010, and introducing measures to fight “negative and discriminatory stereotypes”.

However, Work and Pensions Secretary Damian Green rejected the report’s findings and said the document demonstrated “an outdated view of disability which is patronising and offensive”. Patronising and offensive to who exactly? Weirdly, there don’t seem to be an awful lot of disabled people protesting that they were left feeling patronised and offended by the findings, for many it seemed like the first time an authority had actually taken the trouble to listen to them. Shadow work and pensions secretary Debbie Abrahams said: “The UN report confirms that, despite Theresa May’s warm words, this government is failing sick and disabled people.”


Disclaimer: Opinions are those of the author and do not necessarily reflect those of Changes Bristol.