Madness, Maladies and Misogyny: Women and Mental Health in the 1800s

Over the course of psychiatric history, a great many people have been confined for a wide variety of reasons, and a large proportion of those lived the rest of their lives within asylums. There was a limited understanding of psychiatry in the 19th and early 20th centuries, and although there were those whose hearts were in the right place, there were a great many misunderstandings about the nature of mental health, and there were some who misused the system for their own gain. Men and women suffered in this system, but in this blog post we are going to examine the relationship between women and ‘madness’.

Lack of Understanding and Clerical Errors

The first thing we shall examine is the lack of understanding of mental health at various points in the past, and the many maladies that women were admitted for. The medical profession lacked understanding of the nature of mental health in general, and this was combined with the predominantly male doctors’ lack of understanding of women and women’s health. There was the view that women as the ‘fairer sex’ were deemed as ‘biologically vulnerable’ and were diagnosed with maladies such as “gynaecological disorder”, “Hysteria”, “Menstrual Deranged”, and “Female Disease”, amongst a number of others. Historian Nancy Tomes suggests that rather than diagnosing patients, doctors tended to merely confirm diagnoses made by the patients’ families and other non-medical professionals.

There were also instances, including those reported by investigative reporter Nellie Bly in the late 19th century, of female immigrants being sent to asylums as a result of their poor spoken English, as well as poor women who had been sent there, presumably in error, instead of the local workhouse.

Portrait of A Woman Addicted to Gambling [Left] and Portrait of a Woman Suffering from Obsessive Envy (The Hyena) [Right], Oil on Canvas, Théodore Géricault, 1822

Reputation and Control

There is, however, evidence of more sinister powers at work when it comes to female internment in asylums, as women were admitted to private asylums for tenuous reasons with little evidence. This included those who were confined for reasons such as a “lack of modesty”, “argues with husband”. Women who expressed different religious beliefs to their husbands could also find themselves admitted to an asylum if they refused to adhere to their husbands beliefs, or even if it was deemed more socially beneficial for their husbands and/or families for them to be confined.

An example of potential internment for reputational purposes lies with the case of Alice Christina Abbot, a 17-year-old American who in 1867 allegedly poisoned her stepfather. She claimed that he had been having an “improper connection” with her since she was 13 years old. These accusations were dismissed in court, and she was admitted to an asylum. We do not know what happened to Alice following her entry into the asylum, and we will never truly know whether or not she was actually ‘insane’, or whether her admission was a way of covering up the horrific actions of her stepfather and used as a way to save the family from scandal.

Elizabeth Ware Packard and the Anti-Insane Asylum Society

Portrait of Elizabeth Parsons Ware Packard, Lithograph Illinois State Historical Society

An additional example is the troubling story of Elizabeth Packard. An American teacher, Elizabeth married a Calvinist minister by the name of Theophilus Packard. The couple had six children. They had religious differences, and Elizabeth began to question his beliefs and express her own opinions. They disagreed on a number of topics, including religion and slavery. At this time, a husband could have his wife committed to a psychiatric asylum without a hearing or her consent. As a result, Elizabeth was confined to Jacksonville Insane Asylum in 1860, where she remained for three years. After pressure from her children, she was declared ‘incurable’ and she was discharged back into the care of her husband. She was then locked in the nursery of their home with the windows nailed shut to prevent her from leaving. Following intervention from a friend, who Elizabeth managed to alert by passing a letter through the nursery window, she secured herself a trial. The trial lasted five days. Members of Theophilus’ family and congregation testified against Elizabeth, but those in the community who were not members of his church testified in her favour. The final testament was given by Dr Duncanson, who later stated: “I did not agree with … her on many things,” but nevertheless testified, “I do not call people insane because they differ with me.… You might with as much propriety call Christ insane … or Luther, or Robert Fuller.… I pronounce her a sane woman and wish we had a nation of such women”.

Elizabeth was declared sane, and upon her release returned to their home, to find it had been rented out the day before to another family. Her belongings had been sold, and her husband had left the state with their children. She appealed to the courts, but at the time married women in the states involved had no claim to either their children or their property. Elizabeth Packard went on to found the Anti-Insane Asylum Society, and committed herself to campaigning for women’s rights, freedom of speech, and for reform of the asylum system. As a result of her campaigning, multiple states passed laws to ensure that anyone being committed to a psychiatric asylum, including married women, had the right to a trial.


To conclude, ‘madness’ was little understood for much of history, and in historical terms only very recently have we begun to understand mental health better. This lack of understanding, as well as more sinister misogynistic reasons, including the exploitation of the asylum system on the part of some, combined together, meant that many women were unjustly confined, on little evidence, and treated cruelly.

Suggested reading:

For an introduction to Women and ‘Madness’, see ‘Women and Madness‘. To find sources and images related to women and psychiatric history, see the Wellcome Collection. To find more modern information on women’s mental health, please see the National Institute of Mental Health.

By Josh Green

Josh completed his PhD at the University of Southampton in 2017. His research focused on former psychiatric asylum sites and their continued presence in the UK, looking at themes such as memory, stigma, conservation, and governance. Josh’s haphazard career has led to his contribution to the Department of Health’s advisory document “Health and Wellbeing”, serving ice-cream, dolphin conservation work, teaching at universities and secondary schools, and working in museums. As well as the history of psychiatric asylums, Josh’s interests are wide ranging and include health policy, prison hulks, and quakers, amongst seemingly endless other things.