3. To Be Released, Patients Had To Fake Wellness
There was no process or appeal system to fight being involuntarily committed to an asylum. The doctors and staff would assume that you were mentally ill and proceed under that belief, unflinchingly and unquestioningly. Any attempt to persuade them of one’s sanity would just be viewed as symptoms of the prevailing mental illness and ignored. Patients quickly discovered that the only way to ever leave an asylum, and sadly relatively few ever did, was to parrot back whatever the doctors wanted to hear to prove sanity.
In episodes perhaps eerily reminiscent of Captain Picard’s “four lights” patients would have to ignore their feelings and health and learn to attest to whatever the doctors deemed “sane” and desirable behavior and statements. Doctors at the time had very rigid (and often deeply gendered) ideas about what acceptable behaviors and thoughts were like, and patients would have to force themselves into that mold to have any chance of being allowed out. Even those who were truly well, like Nellie Bly, were terrified of not being allowed out after their commitment. She and her editor discussed various emergency plans on how to rescue her from the asylum should they not see fit to let her go after her experiment was complete.