Dorothea Dix and Franklin Pierce: The Battle for the Mentally Ill

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Before she led the Union Army nursing corps during the Civil War, New England’s Dorothea Dix led the most ambitious reform efforts for the care of the mentally ill ever attempted in the U.S.

Dix argued that a land grant system, similar to the one that created state universities, should be used to create mental hospitals across the country. And she very nearly succeeded, were it not for New Hampshire’s only U.S. president, Franklin Pierce, and his insistence on catering to southern slaveowners above all else.

These two New Englanders would not seem to be natural opponents on the issue, but they came to loggerheads nonetheless in the swirl of politics in the 1850s. Slavery and even a hint of abolitionism dominated the terms of virtually all debate.

Dorothea Dix

By any measure, Dorothea Dix led a remarkable life. Born in Hamden, Maine, to a semi-invalid mother and an alcoholic Methodist preacher for a father, she fled at the age of 12 to live with her wealthy grandmother in Boston and her great aunt in Worcester.

While her mother and father floated around New England, Dorothea Dix worked at teaching and writing. But soon after her grandmother’s death, she found her true calling as a social agitator. Following a trip to Europe, where she became acquainted with the reform movement to improve the conditions of the mentally ill, she brought the issue home with her.

The treatment of indigent mentally ill people in New England and throughout the country was abominable in the 1830s. Asylums barely existed and most often the mentally ill were housed in segregated quarters in jails or poorhouses. Lacking any training or understanding of mental illness, the jailers often treated their charges no better than animals.

Dorothea Dix struck upon a straightforward and effective means of change. She simply traveled the country touring the facilities and described what she saw. She seemed to understand government’s penchant for commissioning studies in lieu of taking action, and she appointed herself to study the conditions of the indigent mentally ill.

Pits, Pens, Outhouses

In state after state, beginning in Massachusetts, she documented mentally ill people living in underground pits, pens, outhouses and attics. She simply explained how they lived lacking clothes, heat and decent food.

Her reports shamed even the most recalcitrant legislatures into taking action, and in the 1840s insane asylums led by doctors began springing up throughout the country. Building on the techniques that had worked on a state level, Dorothea Dix took her case to Washington.

Sympathetic congressmen in 1848 provided her with an office in the capitol. There she launched a six-year effort to pass a law that would grant 10 million acres of federal lands to build asylums. The idea was relatively simple. The land would be used to construct hospitals on, or sold to raise money for the hospitals.

A stark depiction of the lives of the mentally ill created sympathy in Congress. After four attempts at passage, she finally won overwhelming support for the bill in 1854.

Congress at that time was preoccupied primarily with the question of slavery. One of the reasons Dix was able to procure passage of her proposal was that she was not an abolitionist. She believed African-Americans were inferior to whites, and found the New England abolition movement to be tedious. She supported the American Colonization Society, which wanted to send slaves to Africa.

Franklin Pierce

On the surface, she would seem like the ideological soulmate for New Hampshire-born President Franklin Pierce. Pierce was the northeasterner chosen by the Democrats to be their presidential candidate. His  Yankee background appealed to the North and his sympathy for slave owners appealed to the South. He was the perfect choice: While critical of slavery, he did nothing about it.

The Dix land grant bill nearly made it into law. Millard Fillmore, president until 1853, had spoken in favor of the concept. But the bill was successfully stifled during his presidency. Westerners did not like the law since it would sell some of their public lands to support asylums in other states. They managed to slow its approval.

But the real opposition came from southern politicians. Southern Democrats hung their arguments in favor of slavery on the concept of state’s rights. Critics of the Dix plan, notably Jefferson Davis, argued that the bill infringed on state’s rights. If it passed, nothing would prevent Congress from passing a similar law to free slaves. Then Congress could sell western lands to compensate slave owners and provide property for the freed slaves.

30 Asylums

Before his election as the president of the confederacy during the Civil War, Davis served in the U.S. Senate from Mississippi. He fought fiercely against the Dix bill. As Pierce’s Secretary of War, he could also agitate against the land grant bill.

Ultimately, Pierce sided with the southern slave interests, as he generally did, and vetoed the law. In the aftermath, Dorothea Dix returned to Europe to work on promoting the interests of the mentally ill there. She would later lead the Union Army’s nursing corps throughout the Civil War, where she generated controversy as well.

But at the end of her life, she could look on more than 30 insane asylums that her movement inspired as part of the first effort in the country to provide a humane setting for the indigent mentally ill.

Pierce, of course, is widely remembered as the president who started the tradition of the White House Christmas tree.

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This story about Dorothea Dix and Franklin Pierce was updated in 2025.