Does this title touch your life? If you seek hope and healing for yourself or a family member know that you are not alone. Ten percent of our population will in their lifetime seek treatment for some form of mental illness. If you are here because you work in this field I thank you. I know it is often thankless work and if you work in a public institution likely underpaid and under-funded. When it comes to insurance coverage too often the story is too little treatment that is far too hard to find. And if you have no money or insurance finding help can turn into Mission Impossible. To me this a religious issue. That "inherent worth and dignity of every person" we say we believe in is violated every day when people desperately seek help and fail to find it. Is it dignified to live on the street?

But rather than just being a Jeremiah and rail at society, which does little good since guilt alone seldom solves anything, I want to explore what it is that makes society and us tolerate this. What is it about mental illness that is still considered less deserving than say for example diabetes? What are the myths we believe about this many-headed hydra we lump together under the term mental illness?

On the surface it may seem as if we as a society have at last arrived at some understanding and acceptance of mental illness as a real disease. After all we can turn on our television set and find cute cartoon ads for anti depressant medications that make the pills seem both harmless and about as common as vitamins. A typical ad shows a sad, listless woman sad walking across a field where even the flowers are wilting. After she takes the pill she is practically floating and the flowers are blooming, birds are singing and all is bliss. Oh, that is was that easy! We could put all of society on such pills and have no crime, no violence and all live perfectly happy together. Sounds a lot like some kind of science fiction dream and a lot like Huxley’s book A Brave New World where society is kept peaceful, unaware and dumb by the drug Soma. Now let me say with emphasis that medication can be both valuable and helpful, a lifesaver even, but no magic pill will solve the problems of how we live our lives. Self help books abound and talking about seeing a therapist is hardly shocking any more where once it disqualified someone to run for public office. So one might assume that we have finally developed a mature attitude toward the large cluster of illnesses, disorders and maladjustments that we call mental illness. And while I applaud the advances we have made I would also say that is not true. There is still a very real stigma and a lot of myths surrounding mental illness. Some of it is ignorance. The jelly like wondrous substance we call the human brain is still largely a mystery. Yes, we know more today than we ever did before about its chemistry and neurons, we even have a map but have any scientist answered the question of who we are? Our minds, ourselves, our identity, are all wrapped up in what may well be an illusion: that we are in full control of our minds. When we encounter someone who seems crazy and out of control, someone on a city street who hears voices when there is no one there, who mumbles to them selves, who is dirty and oddly dressed and we turn away making them invisible to us and themselves, what are we really doing? We may be afraid of what they may do next, the unpredictable. We may feel ashamed at their presence as a rebuke on a mental health system that is too often a revolving door, under funded, too often forgotten by lawmakers, leaving lost souls in rags on city sidewalk. But in our guts, deep down is there not a deeper fear? That it could be us.

It is this basic fear of an invisible illness we little understand, of ‘going crazy’ that makes it so hard to talk about. Avoidance is easier. The term mental illness does not help us either. Why do we lump together so many different diseases? To put severe debilitating schizophrenia in the same box as a mild depression is akin to saying that cancer and the common cold are alike. Yet we do.

And whom do we call crazy? When I worked in a State Hospital some twenty years ago we used the DSM III as our diagnostic manual. It had a bewildering number of diagnoses and was, I believe, the first manual where homosexuality was no longer considered a disease. The term hysteria comes from the Greek word for womb and began as a definition of a nervous disorder suffered by women because of what was believed to be their wandering womb. Which occasionally would move to their brain, make them crazy and impair their mental abilities. Opponents of women’s vote and those who felt that women were not suited for study in higher institutions used those quotes liberally. Which I today find rather, well hysterical!

We need to beware of labels. Whom society labels as crazy may have more to do with its inherent prejudices than any reality. But we also need to realize that there are common illnesses such as depression that are all too real and that medication or counseling can help. And sometimes we get caught balancing civil rights against health concerns. Can you force someone into treatment? Who decides? Or do you let them die on the street?

What we need is a Dorothea Dix for our times. In hearing her story we might find some hope that what we do in our lifetimes, however small, when compared to her accomplishments, will make a difference. For her every life had value, every human being deserved kindness and proper care, no matter how despised, neglected or forgotten by society. This is a lesson society still needs to learn. It is also one of our key religious values. Dorothea Dix was a frail and very human woman who followed her ideals and accomplished what seem to be nearly superhuman feats.

Dorothea Lynde Dix was born in Maine. Her mother was bedridden and her father often absent, intent on saving souls as a fundamentalist preacher. She would later write: " I never knew childhood!" Saddled with too much responsibility she longed for the chance at a real education. At the age of twelve she ran away from home to join her grandmother, a Boston widow. But even in Boston she did not fit in. Young ladies of the time were expected to be refined, charming and have just enough education to make a suitable match. Dorothea cared not at all for fancy dresses, dances or parties. She was headstrong and independent and too much for her grandmother to handle. So she went to live with her great aunt Sarah Duncan where she finally felt at home. Here she could study to her heart's content and at the age of fourteen she began a school that was a success. In 1819 she returned to Boston and opened a school for young girls. Over the door were hung a sign with the one word: Hope. It was at this time she began to attend the Federal Street church where she encountered the Unitarian Theologian Rev. William Everett Channing. He cut a less than impressive figure. He was short, sparse, pale and thin. His voice when not preaching was low, somewhat monotone. But as she listened she was captivated. Instead of the familiar warnings of hell and damnation he stressed the infinite goodness of God. Instead of original sin and the depravity of humanity he spoke of our inherent dignity and competence. Channing was a reformer. This was a religion Dorothea Dix could live by and with. But in 1824 she was stuck by that age's dreaded disease, tuberculosis. When in 1831 she started a school again but she suffered a physical and nervous collapse. For the next few years she visited friends and began to lead the life of a typical spinster, very civilized, good deeds but nothing extraordinary.

In March 1841 however she found her calling. A Divinity school student asked her to teach a Sunday school class at the East Cambridge Jail. She reluctantly agreed and upon arrival at the prison was appalled at the living conditions but especially at the discovery that among the criminals were housed a group of women whose only crime was insanity. These "lunatics" as they were commonly called lived in dirty, cramped and dark quarters, some confined literally to cages, without furniture, adequate clothing, blankets or heat. When she asked the jailer his comment was that these women do not feel the cold anyhow, nor do they notice the filth they live in. This was a common belief at the time. It was a comment that she would hear again and again in the coming years as she became a one-woman crusade for reform. She began with a campaign to get heat for these women and ended up documenting inhuman conditions all over the state. The encounters seemed sadly alike. This is a typical passage: " After some difficulty I was allowed into the yard where stood a small shanty enclosing a cage not more than eight or ten feet square. Very cold, air within burdened with noisome vapors. All still except now and then a low groan. At last I saw a human being, partially extended cast upon his back amidst a mass of filth. "He'll soon rise up and beat about the place like a wild beast" said the mistress. "And cannot you make him more comfortable? Asked I. "Can he have some clean dry place and a fire?" " As for clean it will do no good. He is cleaned out now and then but what is the use for such a creature?" "But a fire, there is space even for a small box stove?" "If he had a fire, he'd only pull off his clothes, so it is no use." "How do you give him his food?" "O," she pointed to the floor " one of the bars are cut shorter there we push it through to him." Here is the crux of the matter. Where the jailer saw: a creature, a wild beast, Dorothea Dix saw "a human being". A human being that should be treated at least with elementary care and kindness: food, adequate shelter, clothing and heat. In Massachusetts she presented the first of many "memorials" to the legislature, as reminders to the lawmakers of intolerable conditions. With new bills introduced she began to travel to other states. In New Jersey, the State Hospital was built in 1848. She called it "her first child" and would later in her life choose to retire and eventually die there in a small adjoining apartment. In the years following she went from New Orleans to Nova Scotia presenting her notes to State Legislatures in thirty states. Her effect was clearly felt in 1843 there were 13 Mental Hospitals in the United States, by 1880, 123. In an age of coaches, carriages and an occasional steam ship, she would travel 30.000 miles in three years. She became the conscience of this nation calling upon: "the responsibility that the State owes to its less fortunate citizens."

With the advent of the Civil War she was appointed Superintendent of Army nurses. While she worked hard this was not her finest hour. The qualities that made her such an effective voice, a latter day prophet calling people to task did not necessarily make her a good organizer or help her fit into the military chain of command. Clara Barton and Lousia May Alcott served as her nurses, the latter remarking that: "she was a kind old soul, but very queer and arbitrary." Louisa treasured forever though, a book inscribed to her by D.D. as she remarked "better than any Doctor of Divinity was the name of that remarkable woman."

She died in July 18, 1887 asking the doctor to "not give me any of those anodynes to relieve pain. I want to-feel-it all. And please tell me when the time is near. I want to know."

Her life is worth celebrating. But the best memorial we could give her would be to follow her example. As horrifying as her accounts are of how the mentally ill were treated, can we really say that we are doing much better? Yes, hospitals and treatments have improved tremendously. But many of our severely mentally ill citizens are no longer in those hospitals, nor in half way houses or even in any kind of out patient treatment program. They live instead on our city streets where we rush by, avert our eyes and try not to notice the woman sleeping attired in thin clothing in a doorway without even minimal shelter. If how a society treats its weakest members is a measure of that society, how are we doing? We know a lot more about the causes of mental illness and we can treat it more effectively. But too many people slip through the cracks. Because the attitude of seeing those bag ladies and homeless men as less than human is still very much with us.

In her address to the North Carolina Legislature Dorothea Dix wrote: "I come not to urge personal claims, nor to seek individual benefits; I appear as a friend of those who are deserted, oppressed, and desolate. In the providence of God, I am the voice of the mentally ill who pine in the cells, and stalls and cages, and waste rooms of your jails and poorhouses. I am the revelation of hundreds of wailing and suffering creatures, cut off from all healing influences, from all mind restoring cures.

Could the sighs, the moans and shrieks of the mentally ill throughout your wide extended land reach you here and now, how would your sensibilities to the miseries of these unfortunate be quickened, how eager would you be to devise schemes for their relief---plans for them restoration of the blessings of a right exercise of the reasoning faculties."

Today I wonder what she would have found to say to those same legislators who in the large cities may well be passing by such figures every morning. Have we become more hardhearted in this century? Have we become so overwhelmed with modern living that we have abdicated our responsibilities? It is not now nor was it ever fashionable to espouse such causes: prison reform, humane treatment of the mentally ill which to my mind includes food and shelter. We do not know what she would have said today, this woman prophet, to awaken our conscience and spur us to action. But what we do know from her life is that she was tenacious and stubborn. Her causes were not any more popular back in her days. She would not have given up. Let us not give up either. Step by small step let us work to build a society wherein every human being is treated with respect and dignity. None of us know which act will make a difference in the long run. We stand on the brink and cast our good deeds like small round pebbles into the water. Every one of them create a wave that spreads in ever widening circles, reaching ever farther, perhaps even those whom we shall never know. As we today the widening circles of her good deeds reach us here two centuries later.