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January 28, 2016

Last year, I amended the state budget with a provision directing the Department of Administration in consultation with the Department of Cultural Resources to establish a task force to 1) collect the artifacts and memorabilia associated with Dorothea Dix and the Dix Hospital and 2) identify options for establishing a permanent memorial on the Dix Campus to honor the work and contributions of this extraordinary woman. I was pleased when Secretary Bill Daughtridge appointed me to chair the task force. That work is well underway; the report will be presented to the Joint Legislative Oversight Committee on Health and Human Services in April.

Although Dorothea Dix's story is well known among advocates for the mentally ill, the general public is generally unaware that she launched a new, more humane treatment for the mentally ill that led to worldwide reforms. The Dix Hospital in Raleigh is one of 32 mental health facilities she helped establish in 23 states and several other nations.

Dorothea Dix was born in1802 to a well-educated, but periodically abusive Maine family. Her father was an alcoholic; her mother had bouts of depression. When she was 12, her wealthy grandmother took her in and assured her a good education. As a young woman, she opened a series of schools; but bad health led her to writing. In 1836, she went to England hoping for a cure. There she met Quaker reformers investigating madhouses and asylums and advocating for more humane treatment for the mentally ill.

After returning to the U.S. in 1840, she did her own inventory of treatments for the mentally ill in Massachusetts. Her report to the state legislature, describing the mentally ill living in "cages, stalls, pens!" and "Chained, naked, beaten" led to a 200-bed expansion of the Worcester Insane Asylum in 1843.

From that victory, Dix completed similar investigations in other states and presented detailed, moving accounts of her findings to state legislatures. She usually succeeded in getting a bill passed and a state facility promised.

Dorothea Dix came to North Carolina in 1848 and completed her inventory in time to present the findings to the General Assembly that same year. But she encountered a legislature reluctant to spend money; the bill passed in committee but failed on the floor. Then fate intervened. At the Mansion House Hotel where she was staying, she was nursing the dying wife of James Dobbins, a leading Democrat. On her deathbed, Ms. Dobbins asked her husband to support Dixís efforts. His moving speech won enough votes to pass the bill. On January 29, 1849, the bill became law.

The hospital admitted its first patient in 1856 and served thousands of mentally ill North Carolinians over the next 156 years. In 2000, as part of mental health reform, the General Assembly found it would be less expensive to build a new facility than to renovate and upgrade the aging buildings on Dix Hill. The legislation that passed dedicated the funds from closings beds at Dix to the expansion of community based services thought to be more appropriate for many of the people being served at Dix. The last patient was transferred to the new hospital in Butner in 2012.

That promise to use funds saved from closing beds was not kept. Instead they went to balance the budget during the 2001 recession and then to pay for three smaller, new hospitals. At least partially as a result, the planned community based services were inadequate to meet the demand. Thousands of mentally ill that could have been treated in the community or housed and treated at Dix languished and are still languishing in emergency rooms across the state or in jails or prisons. Others are among the homeless who could get treatment if we had expanded Medicaid.

In 2015, Dix Hill was sold to the City of Raleigh for a destination park. All the buildings have been emptied and closed or renovated and leased to the State for the next 10 years for office space. The artifacts and memorabilia were stored in one location and will soon be cataloged and moved to appropriate storage. The Dorothea Dix Task Force is developing recommendations on a long-term agreement with the City of Raleigh and potential buildings to use for an appropriate memorial and museum.

The very best memorial to Dorothea Dix would be to have this process move us to take a new inventory. Let's travel across the state and find out where the mentally ill are and how they are being treated. Letís write up our findings in a memorial to the General Assembly and letís find the same determination that energized Dorothea Dix. Letís provide a more humane treatment for the mentally ill that is comparable to the advances she made in the 19th century.

As always, thank you for your support of my work in Raleigh as your representative. Please let me know of your position on issues, your suggestions for legislation and your requests for help.

Verla Insko

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Verla Insko, NC House · 300 N. Salisbury Street, Room 502 LOB · Raleigh, NC 27603-5925 ·
Phone (919) 733-7208 · Mobile (919) 618-9889 · E-mail verla.insko@gmail.com or verla.insko@ncleg.net