Mental health has always been part of the human experience, yet for much of history, it remained a taboo topic. Feelings like depression or anxiety were often kept hidden, and seeking therapy was wrongly viewed as a sign of weakness or madness. Mental health institutions were places of fear, where those in need were often neglected or mistreated. Thankfully, in 2025, the conversation around mental health has shifted. While stigma still exists, we’re making meaningful progress. One early trailblazer who helped spark this change was Nellie Bly—her courageous work brought attention to the harsh realities of mental health treatment and helped lay the groundwork for reform.
Finding Her Passion
Nellie Bly, born Elizabeth Jane Cochran on May 5, 1864, in Armstrong County, Pennsylvania, faced adversity early in life. After losing her father at the age of six, her family relocated, and by age 15, she enrolled in school in Indiana, PA. However, due to financial hardship, she had to leave after just one term and moved to Pittsburg[h] with her mother to join her older brothers. Like many women in the 1800s, Elizabeth struggled to find meaningful work. When the Pittsburg[h] Dispatch published an article criticizing women in the workforce, she fired back with a bold open letter advocating for more opportunities—especially for women supporting their families. Impressed by her response, editor George Madden offered her a position at the paper. It was then that she adopted the pen name Nellie Bly. Though initially limited to writing about so-called “women’s topics,” Nellie aspired to report on issues that mattered to everyone—men and women alike.
Accepting a New Assignment
In 1886, Nellie Bly moved to New York City, determined to find a reporting job that would allow her to cover more impactful and serious issues. A year later, her boldness paid off when she walked unannounced into the offices of the New York World, one of the nation’s top newspapers. She pitched a story on the immigrant experience, but instead, editor Joseph Pulitzer offered her a different assignment—one that would define her legacy. He challenged Nellie to go undercover and investigate Blackwell’s Island, an infamous mental asylum known for its inhumane conditions. Rising to the task, Nellie pretended to be mentally ill in order to gain admittance. What she discovered inside would shock the nation.
Uncovering the Truth
Nellie Bly’s reporting on her time inside Blackwell’s Island stunned the public and sparked real change, including increased funding to improve the institution’s conditions. She documented her harrowing experience in a series of articles later compiled into her groundbreaking book, Ten Days in a Mad-House. What she uncovered was deeply disturbing. Nurses shouted at patients and beat those who didn’t comply. Meals consisted of gruel, spoiled meat, barely edible bread, and filthy drinking water. Patients labeled as dangerous were bound with ropes, while others spent their days sitting silently on hard benches, exposed to the cold with little protection. Sanitation was nearly nonexistent—waste surrounded eating areas, rats roamed freely, and the bathing process was especially traumatic. Patients were doused with freezing water, then aggressively scrubbed by attendants, often using the same dirty water and shared towels—spreading infections and skin diseases. Rather than healing, the institution’s conditions often worsened the mental health of those inside. Nellie’s brave undercover work exposed these horrors to the world and forced a long-overdue reckoning.
Sparking Change
Nellie Bly’s investigation didn’t just raise eyebrows—it prompted real accountability. Her exposé led to a grand jury investigation into Blackwell’s Island, with Nellie herself assisting in the process. One of the most pressing questions the jury examined was how someone of sound mind could so easily be admitted to a facility meant for individuals with severe mental illness. Nellie revealed that during her initial examination, the physician seemed more interested in flirting with the attending nurse than evaluating her mental state. While doctors and staff scrambled to justify how they were misled, it became painfully clear that the system was deeply flawed. As a result of the investigation, the grand jury mandated reforms, including a significant increase of $850,000 to the Department of Public Charities and Corrections—equivalent to over $28 million today. They also called for stricter, more thorough admission processes to ensure only those truly in need of psychiatric care would be committed.
The Beginning of a Movement
Nellie Bly’s groundbreaking investigative journalism left a lasting mark on both mental health reform and the role of women in media. At a time when women were largely confined to domestic roles and excluded from serious journalism, Nellie defied expectations. Her undercover report on Blackwell’s Island sparked national outrage, leading to increased funding for mental health institutions and prompting much-needed reforms in patient care and admission procedures. Her work challenged the public to rethink how society treats the mentally ill and pushed for safer, more humane conditions. Beyond her impact on mental health advocacy, Nellie opened doors for future generations of women in journalism. She proved that female reporters could tackle serious, complex issues—shifting the narrative from the “women’s pages” to major topics like labor, politics, and crime. Nellie Bly’s legacy is one of courage, compassion, and trailblazing change.
