Hand me a vacuum!

A few years ago, I met a woman who swore she was being attacked by aliens. She told me there were people trying to frame her for murder, so she had to keep running away. Another woman confided to me that her hairdryer was frying her brain cells, so she threw it away before it left her brain-less. She seemed genuinely frightened, but not as much as the man who told me the CIA was keeping him from running for president. He had spent over 10 years campaigning and was sure government agents were trying to kill him in case he won.

These were just some of the people I helped during my internship at St. Elizabeth's Hospital in Washington DC, in my sophomore year at American University. I was working for the Mental Health Division of the Public Defender Service, the arm of the government that provides free legal defense to people who can't afford their own. St. E's (as the hospital is referred to) is where all the mentally ill people from the District of Columbia end up if they have no health insurance. Have you ever seen a mentally ill person? Sometimes you find them on street corners, talking to themselves or imaginary people. Other times, they are sitting quietly outside a restaurant or a movie theater, rocking back and forth as if hypnotized. Do you ignore them? Cross the street? Look the other way?

People with mental illnesses, such as schizophrenia, manic-depression, and paranoia, need medical and psychological help. They need emotional support and sometimes, constant attention. As a society, we've come a long way in providing most of these needs. Places like St. E's shelter, clothe and feed people who would otherwise be left to fend for themselves-and die-on the streets.

For that, we have Dorothea Dix to thank. She has been called "the one woman in history to contribute more to the social progress of this country than any other, before or since." Haven't heard of her? Don't worry-you're not the only one. Many haven't either, which is a shame, since her life is truly an inspiration to all.

She was born in 1802, at a time when women had little or no rights. They couldn't vote, own property, have custody of their children, attend university, or divorce. And yet, despite these obstacles, she dedicated most of her life to fighting for the rights of the mentally ill.

Dorothea grew up in Worcester and Boston, Massachusetts. At the age of 15, she began teaching a private school for young girls, and until she was 39, she continued teaching and writing books. Then, in 1841, she volunteered to teach a Sunday-school class for women inmates at the East Cambridge Jail. She returned home that night so shocked at what she had seen that she could not sleep. What she had seen was the condition of four mentally ill people held in confinement. They were not criminals, yet they were kept in one dark, airless room, the walls of which were covered white with frost because it was not heated.

The (almost) universal belief of the time was that insane persons were born depraved and that nothing could be done about it, except to confine them as if they were wild and potentially dangerous animals. Many guards made extra money by charging visitors to see them, and some people would even prod them with sticks to get a few laughs!

Dorothea was determined to do something about this. She visited jails, almshouses and other places where the mentally ill were housed, taking careful notes and investigating as she met with jailers, caretakers and townspeople. She put together a document, which she delivered to the Massachusetts state legislature. She began her speech by saying: "I proceed, gentlemen, briefly to call your attention to the present state of insane persons within [the state], in cages, closets, cellars, stalls, pens -- chained naked. Beaten with rods, lashed into obedience."

She went on and on, giving examples of what she'd seen with her own eyes-a woman chained to a wall, living in a toilet; a youth with a heavy iron collar around his neck, also chained to a wall with six feet of great iron links. The politicians were stunned, and Massachusetts quickly passed a series of laws to improve conditions for the insane.

She didn't stop there. Dorothea continued on to Rhode Island, New Jersey and other states, delivering the same messages to lawmakers. During her first four years, she visited 18 prisons, 300 jails and more than 500 almshouses. She traveled over 10,000 miles by stage, steamboat and horseback. She then went to Europe, inspecting jails and almshouses in more than 10 countries and calling on these governments to improve conditions for the mentally ill. In all, she played a major role in founding 32 mental hospitals, 15 schools for the feeble minded, a school for the blind and numerous training facilities for nurses! At the age of 80, she checked herself into a room at a state hospital in Trenton, NJ (the first hospital she helped open). She died there, six years later, largely unknown.

I think about Dorothea and I think about St. Elizabeth's (which she also helped found in 1855). My job there was to interview the people who had been brought in involuntarily (that is, against their will) and explain to them that they had rights in case they wanted to try and leave. Every Tuesday and Thursday I made my way to southeast DC and spent the day in the wards of St. E's, talking to patients, doctors and nurses. I found the place to be very depressing -- patients were often so drugged they couldn't speak to me and the smell of urine was sometimes overpowering. The staff was overworked and severely underpaid and as such, not usually in a good mood. The lawyers I worked for (from the Public Defender Service) had too many cases to handle and were also overworked. Scarce resources meant that services, activities and personnel were routinely cut from the ever-shrinking budget.

It was clear to me that there was a problem.

Despite all of Dorothea's efforts, our society has yet to fully accept-and adequately care for-the mentally ill. Dorothea spent her entire life fighting for the rights of people who could not fight for themselves. She accomplished much to make a tremendous impact, and brought about sweeping social changes. The work she started is far from finished.

The bottom line is that people who suffer from mental illnesses are entitled to the same rights and privileges that other Americans take for granted. In the 1840s, Dorothea was the lone voice demanding justice, but her indignity is now felt by countless lawyers, psychologists, nurses and volunteers, who work (for little or no pay) in order to right these wrongs. They believe -- as I do -- that the mentally ill should get proper care, proper treatment and proper emotional and psychological support, even if they don't have insurance -- the same way we'd treat our relatives or best friends. Unfortunately, budgets get cut because we often forget about the people behind the walls of state hospitals. Out of sight, out of mind.

Well, not for me. Dorothea has inspired me with her courage, determination and will. As I look back at my time in St. E's -- and at all the people I met and helped -- I think of what I can do to make her life's work a reality. I won't cross the street, or look the other way, or ignore those who suffer from a mental illness. I will use my rights to make sure theirs aren't taken away. And I will lend my voice to those who can't speak up. Will you?

Daphne