Throughout the 1800s, the mentally ill population was alienated from the rest of society. This segregation was cruelly displayed in many institutions for the mentally ill. They were placed into asylums on separate islands miles away from society. For example, Blackwell violence in New York. These institutions were an improvement. Dorothea Dix, a school teacher, visited a jail in 1841 and realized that many innocent people with mental illness were being put into jail cells with criminals. The jail's poor conditions, along with the views from other inmates, further degraded the condition of many mentally ill people symptoms. For the rest of her life, Dorothea Dix wrote an advocated for the construction of mental institutions. She directly helps build 30 institutions for the mentally ill. A few months after her death in July 1887, Elizabeth Cochran, commonly referred to by her pen name Nellie Bly continued to advocate for the mentally ill.

Nellie Bly risked her life and community to stand against the poor treatment of the mentally ill people by exposing the brutal reality of Blackwell's Island insane asylums. Bly is assigned by the New York World to get herself admitted into a sane asylum and write an article about the treatment of patients. She arrived as Nellie Brown at the temporary home for females in New York on September 18, 1887. Her goal was to be considered insane and be admitted into Blackwell's Island insane asylum. She began saying random things throughout the night, maintaining her persona as an insane woman. The next morning the police are called take Bly. She was brought before the police chief and judge. Bly refused to talk, and the judge sent her to Bellevue Hospital.

The first doctor, Bly, saw Bellevue ask her about where she came from, which she denied any memory. The second doctor asked her if she saw faces on the wall, heard voices, and what the voices said. She told the doctor that she does not hear voices, but she does not listen to them. The third and final doctor asked her to stretch her arms and move her fingers. These were standard procedures and testing the sanity of patients. Nellie Bly said," I found no correlation between these tests in a person's sanity and can determine a perfectly normal person to be insane. From the moment I entered it, they were not on the Island. I did not attempt to keep up the zoom roll of insanity." The rooms had barred windows that stood five feet above the ground. One doctor told her that there were more than 300 women in the building. By was in and nearly 1,600 total in the mental institution. The same doctor said to Bly every door is locked separately, and the windows are heavily barred so that escape is impossible. Should the building burn, the jailers or nurses would never think of releasing their crazy patients?

Now a dozen women could escape all would be left to rose to the jack. The food barely qualified throughout the day. They were given a cup of unsalted beef and tea orbit of cold meat in a potato, a cup of oatmeal gruel, and a cup of tea in the size of buttered bread at dinner. The women would fight over the food doing other people's only food. After having bread stolen, another patient offered Nellie's hers, but it was so horrible that she could not swallow it. The other patient told her that she must, or she will go crazy. At one of the dinners, she found a spider living in her bread. When Bly asked the nurse for something of substance, the nurse snapped.

Here at the public institution now a person cannot expect to get anything. The nurses thought that living in an asylum is a charity, and the person should be thankful for what you get. There was a motto written on the wall and the pavilion that read, "I would have liked to put above the gates that open to the asylum 'He who enters here leaveth hope behind." There was a tub filled with ice-cold water, and all the women were stripped and bathed in the same water, soap, and washcloth. One of the patients recalled firmly, "I got one after the other three buckets of water over my head ice-cold water." These were some of the experiences that people had gone through in the asylum.

After leaving Blackwell, Bly went on to write multiple articles and exposed the asylum's horrors in a book. In total, she wrote three articles and books about her experience in the mental institution. Another newspaper wrote another article covering her journey. The articles Behind the Asylum Bars And Inside the Mad House, written by Nellie Bly, were first published in the New York World. Another New York newspaper called the New York Sun published an article on October 14, 1887, claiming that Nellie Bly's article is exaggerated and mainly false. Nellie Bly quickly published an article targeted at the Untruth and Every Lie and swore by her truthful account by her experience Blackwell's Island.