The Rights of Mental Patients: An Early Crusader

Janet Coburn
3 min readJan 18, 2022

In 1887, investigative journalist Nellie Bly pretended to be insane so that she could report on the conditions in a New York asylum. The results of her sojourn there were the subject of her book Ten Days in a Madhouse and became the catalyst of increased funding for mental institutions.

Now there is a book that recounts an even earlier example of a woman who publicized the conditions in an insane asylum. It has a bearing on the rights of mental patients and involuntary commitment.

The legal rights of mental patients have been much discussed of late. Involuntary commitment is a particularly thorny subject. Some people decry it as a violation of civil rights. Others point to its usefulness in cases of extreme danger to self and others, but also in cases of anosognosia that do not quite meet that standard. “Assisted outpatient therapy” is one version of involuntary commitment that has many supporters. (See

Long before this became a matter of debate, and a couple of decades before Nellie Bly’s exposé, a woman crusaded for the rights of mental patients and against the practice of involuntary commitment. Of course, the involuntary commitment she decried was of married women by their husbands, and in 1860s Illinois, husbands were perfectly able to do that. The causes cited could be as varied as novel reading and masturbation (two separate categories). For Elizabeth Packard, the reason her husband gave was that she was insane because she disagreed with his religious opinions and dared to teach her opinions to others.

Karen Moore’s book The Woman They Could Not Silence recounts Packard’s story, in detail. Meticulously researched (as was Moore’s previous book, The Radium Girls), the nonfiction work is based on many primary sources, including Packard’s own writings (from when she was in the asylum and hid her papers, in one case inside her hat, as well as the book and pamphlets she published) and newspaper accounts of her crusade and her trial.

Packard’s trial was a result of a law she had promoted requiring a civil jury trial before a married woman could be committed, instead of on her husband’s word and the recommendation of an asylum doctor. Interestingly, immediately before the jury trials were mandated to begin, hundreds of married women were miraculously “cured” and released from the asylum where Packard had been held.

Once released from the asylum, three years after being committed, Packard became a tireless campaigner for the rights of the involuntarily committed and of married women (who at the time were not entitled to their own money or property, or even their own children). Packard also exposed the abuses that mental patients suffered at the hands of asylum staff, including isolation, beatings, and cold water baths (near-drowning) used as punishment. Another policy that she sought to have changed was withholding mail from mental patients. Packard had been prevented from reading supportive letters that her relatives had written.

Women dabbling in politics was not common, or approved of, at the time. Packard was able to influence lawmakers and other officials with a combination of her compelling speaking style, her eloquent presentation of her cause, and her remarkable tenacity. To say that she had an agenda is putting it mildly.

The prologue to The Woman They Could Not Silence begins, “If she screamed, she sealed her fate. She had to keep her rage locked up inside her, her feelings as tightly buttoned as her blouse,” and the book ends, “There was a world out there that needed reforming. And she was determined to do it.”

The Woman They Could Not Silence (subtitled One Woman, Her Incredible Fight for Freedom, and the Men Who Tried to Make Her Disappear) was selected by A Mighty Girl (, which serves as a clearinghouse for books, toys, and other products for adults and children, as one of their “Pick of the Day” recommended books for adults.

I highly recommend it too.



Janet Coburn

Author of Bipolar Me and Bipolar Us, Janet Coburn is a writer, editor, and blogger at and